Many high level and pro athletes will tell you that at the highest levels of all athletic competition the use of PEDs is around 90%.
Anyone that believes the US just magically wins most athletic competitions because we are just somehow magically better because we are American is kidding themselves.
It is my belief that US athletes leverage the US technological edge by taking cutting edge drugs that haven't been banned yet while simultaneously cracking down on their foreign competition using drugs our athletes were using not long ago but that are now banned.