At the closing ceremonies, the prizes are given by Mark McGwire, Jason Giambi and Barry Bonds- all of whom were ironically involved in baseball's steroids scandal.
Jimmy confesses his drug use to the crowd and returns his medal, asking for his records to be cancelled and condemning those who use steroids as "pussies" (all the while the camera focuses on McGwire, Giambi, and Bonds).
There was some controversy surrounding "Up the Down Steroid" and the 2005 film The Ringer, as both feature the same plot: Someone pretending to be disabled in order to compete in the Special Olympics.
[1] In the opening scene, the boys are playing the same "Investigative Reports with Bill Kurtis" funtime game as they did in the season four episode "Cartman Joins NAMBLA".
[1] The episode's title refers to the 1964 young adult novel, Up the Down Staircase, by Bel Kaufman, which was adapted into a film in 1967 starring Sandy Dennis.
[3] "Up the Down Steroid", along with the thirteen other episodes from South Park's eighth season, was released on a three-disc DVD set in the United States on August 29, 2006.