The clubhouse in Boston is a Nation divided. According to a lengthy report by ESPNBoston’s Gordon Edes, manager Bobby Valentine hasn’t been well received by his coaches or players, and each side has expressed frustration over the lack of communication that has resulted. Over the next few days, Edes’ allegations of discord will probably be hotly debated in Boston, but that storyline actually buried the lead. The real bombshell was buried halfway through when Edes relayed how Valentine was surprised to learn that pitcher Clay Buchholz’ hospitalization may have been linked to the use of Toradol. What’s more, according to Edes’ source, there is evidence of a greater drug dependency, with at least two other pitchers on Valentine’s staff receiving regular injections.
Toradol is one of the brand names for ketorolac tromethamine, a nonsteroidal anti-inflammatory drug that is legal to use with a doctor’s prescription. However, according to the U.S. National Library of Medicine, it is intended for the “short-term relief of moderately severe pain and should not be used for longer than five days”. Getting regular injections before a start doesn’t seem to fit that indication, but nonetheless, the practice of using Toradol on a regular basis has become prevalent throughout sports. The NFL has most notably developed a dependency on the anesthetic (see clip below), but apparently baseball is not that far behind.
[Toradol] certainly helped, especially in the first months after the injury. I don’t think it’s a panacea, but it helps you get where you have to go.” – R.A. Dickey, quoted in the New York Times, April 13, 2012
Make no mistake about it, Toradol is a performance enhancing drug. After all, if a player can’t get on the field, he can’t perform. Granted, the drug is legal and clearly permitted under baseball’s drug policy, but should it be, at least in the manner and to the extent that it is currently being used? Just because the medication doesn’t build muscles that can add distance to a homerun, baseball can’t ignore the potential for abuse, not to mention the health implications that could have for its players.
Tordaol use has become prevalent in the major leagues, but do the players really know what they are taking?
Toradol’s side effects are foreboding, and that’s assuming the drug is used as recommended. But, what about the longer-term effects for players who use the substance habitually? Are they compromising their health just so they can take the field, and if so, are they doing so without a full understanding of the risks involved? If baseball is really concerned about the health of its players, these questions must be answered unequivocally.
In the aforementioned New York Times article, Dr. Gary Green, the medical director for Major League Baseball, seemed to dismiss concerns about Toradol, calling disagreements about how it is administered a “difference of opinion” and describing the drug as having “a good analgesic impact” with side effects that are “well known”. In other words, it doesn’t seem as if baseball is taking the matter seriously, at least not yet. Last December, a group of NFL players filed suit against the league, alleging that the sport was negligent in allowing Toradol to be administered so rampantly. The outcome of that trial could go along way toward shaping Major League Baseball’s policy on Toradol, but in the meantime, Bud Selig is missing the opportunity to lead the way.
Is Toradol really a performance enhancing drug? Is there a distinction between drugs that help you take the field versus those that allegedly help you perform once you are on it? And, if so, does that mean we are more concerned about the health of the record book than the health of players? Those aren’t easy questions to answers, but Major League Baseball has a responsibility to examine them closely and, at the very least, provide its players with more information about the risks involved with Toradol, or any drug administered by team doctors. The sport can’t simply be content to regard the potential health impact as a “difference of opinion”, but instead must make the examination of all substances a priority under its drug policy. Otherwise, baseball will lose the credibility it has slowly rebuilt since the fallout from the steroid era, and, if that still doesn’t appeal to the powers that be, it may also lose a few lawsuits along the way.
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Great piece!
Thinking quickly, the PED distinction should be drawn based on whether a drug is being used for a legitimate medical purpose and under normal medical supervision.
Pain killers are a tricky area — they may be prescribed to deal with a temporary situation, or to help control chronic pain. If a pitcher suffers pain in the ordinary course of doing his job, a doctor might be doing the right thing (medically speaking) by prescribing the routine use of a pain killer in a manner that is generally regarded to be safe. While one might think that it is “cheating” to use pain killers in order to play a professional sport, the truth is that we tolerate the safe use of pain killers by people in all walks of life.
More difficult questions arise when pain killers are used in sport for purposes that go beyond what we’d think of as good medicine — for example, to allow an athlete to play hurt (and risk more serious injury), or to mask normal feelings of fatigue. The articles you’ve cited make it seem as though certain pitchers receive Toradol injections routinely, perhaps without requesting pain relief.
As for whether Toradol is a PED — wow, that’s a difficult question. It’s possible to argue that “playing clean” means playing without the benefit of pain relief. I would probably argue for a different approach, one that would follow what I think are baseball’s existing rules, and sanction the abuse of prescription drugs.
For the reasons you cite, Toradol is different from anabolic steroids (I won’t mention HGH because that’s probably nothing more than a placebo), but, ultimately, my bigger concern is the health of the players, and it seems to me as if the current usage of Toradol might actually be a bigger threat. If players need pain killers to handle the occasional bump or bruise, that’s one thing. But, in the NFL, and now apparently MLB, it is becoming part of the pre-game ritual, just like amphetamines before the recent ban. In my opinion, that’s just as dangerous and has just as much of an impact on performance.
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