Toradol is the latest drug to come under scrutiny:
Toradol is the nonsteroidal drug that Red Sox pitcher Clay Buchholz acknowledged last season might have contributed to the esophagitis that sidelined him for 20 games. Buchholz was hospitalized in intensive care and lost three or four pints of blood while dealing with the condition, which is a known side effect of the painkiller.
Papelbon said that when he was administered a physical by the Philadelphia Phillies prior to signing as a free agent after the 2011 season, doctors asked him if he used Toradol. When he answered in the affirmative, he was told that he would have to stop.
“They told me, ‘We don’t do that here.’ That kind of surprised me,” Papelbon said Saturday, speaking by phone from Phillies camp in Clearwater, Fla. “I haven’t had a single Toradol shot since.
“But here’s the thing you have to understand. There are so many organizations that do it. Not only baseball, but every sport. Football, basketball, hockey. It’s not just the Red Sox.”
The drug is legal and appears to work. The question now is it’s safety. This is another example of how sports use drugs to enhance performance. Rather than telling a player to take a day off, just mask the pain so he or she can play.
Interesting. I had been prescribed Ibuprofen for my femoroacetabular impingement (same thing A-Rod has) 400 mg, once a day. Apparently you can go up to 2400 mg a day. Basically I’ve got bone spurs on the ball part of the ball & socket joints. And feeling bone on bone is . . . unpleasant at the least. After about 18 months I started vomiting nearly every evening after eating, for some unknown reason. Then I got the prescription renewed, reread the side effects and found that nausea & vomiting are part of the side effects. It’ll be 3 years this Thursday since I last took it (Feb. 14 is an easy to remember anniversary) and my appetite still hasn’t come back.
So I took a drug (a NSAID) in order to practice Aikido. I was a PED user!
Now I grant there are certain substances I don’t want athletes to use, but I’m not going to be morally outraged when someone gets caught. What’s worse than PED users is righteous indignation sports reporters who probably had a good idea that something was going on.
The issue here was
1. Papelbon claims he was not informed of the side effects so could not make an informed decision. Also, he would not have known to stay away from other OTC NASID’s which could exacerbate the side effecs.
2. The other issue, more important, is the use is not in accordance with the manufacturers or FDA guiedlines to use short term only for acute pain. Buchholz was getting an injection every 5 days to treat chronic pain typical among pitchers, Papelbon also seemed to use it quite frequently. The safety of such usage is not known since it has never been studied.
3. The other issue is given it’s effectiveness to kill pain, if using it to play through an injury can cause more serious injuries. Pain is a message sent to the brain that a body part needs rest and is injured. Ignoring that can worsen an injury.
In light of the Red Sox issues with players returning from injury too early and then getting reinjured (Pedroia, Ellsbury, Papi, Daisuke, Hill, etc) one wonders if Toradol is contributing to this.
4. Since the side effects are so serious that some players/teams may avoid using it, it gives a clear competitive advantage to those willing to put their bodies at risk, and younger players may feel compelled to use it though they otherwise would not. This is exactly what happened with steroids. There may be players for example on the Phillies who are injecting themselves with Toradol despite FDA requirements it be administered only by a Doctor (like steroids).
I know Toredol well, as I have osteo-necrosis of my humerus. Works great for the pain, except that as my Doc informs me, can cause internal bleeding and kidney damage. I can see why athletes would use/abuse it for pain, but it really isn’t safe for long term use. PED?
As a scientist and one who works within the pharmaceutical space, I have had abundant experience with NSAIDs. Toradol (ie, ketorolac) is prescribed to treat pain and inflammation as “rbj” and “pyaglia” can attest. Similar to most NSAIDs, toradol can cause adverse effects for a fraction of its users including upper GI tract bleeding, ulcers, perforations, etc. The peer-reviewed scientific literature on this topic is enormous. In addition, these effects are severe and common enough that many pharmaceutical companies have been developing different formulations of NSAIDs to try and reduce these effects. The FDA also released a statement in 2005 that patients should use the lowest effective dose for the shortest duration consistent with individual patient treatment goals.
Unless a player is consistently taking toradol (which team physicians would likely disallow), not sure I would consider toradol a PED.