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Friday, January 4, 2013

"Shoot Me Up, Coach. I'm Ready To Play Today."

 
Victory at what costs?

Pain is an understood but under-reported
part of college football.
 
The use of painkiller injections
is seldom discussed,
and almost completely unmonitored
by the NCAA.

An ABC Interiew

"And it is the dream of countless American families. A knock on the door from a big-time college football scout and a spot on a team that fills coliseums on Saturday. But tonight comes a revelation from a former star about the pain and pressure that exists inside the nation's football factories and the injectable risks some young men take in order to stay on the field."
 
Reporter Brian Ross:

"Game day at USC in Los Angeles. Part of the huge college sports industry with lucrative tv contracts, millionaire coaches and avid fans all dependent on their star players giving everything on the field, even when hurt."
 
Former USC lineman Armond Armstead:

"There's really no other option because I want to play, they wanted me to play, they needed me to play."
 
Ross:

"But now ABC News has found that behind the scenes of that drive to win at USC and other major colleges, in tucked away training rooms underneath the stadium is the closely held secret of team doctors using powerful prescription painkillers to get student athletes on the field, despite painful injuries."
 
Armstead:

"No discussion. Just go in. Give me the shot, I'll be on my way."


(Brian Ross, "Ex-USC Player: Painkiller Injections Caused
Heart Attack," ABC News, January 3 2013)
 
 
 
 
Controversy surrounding the drug, a generic version of Toradol, has grown this year following claims by former USC lineman Armond Armstead that he suffered a heart attack after the 2010 season, at age 20, following shots of generic Toradol administered over the course of the season by the team doctor and USC personnel.

Toradol is recommended for the short-term treatment of post-operative pain in hospitals but has increasingly been used in college and professional sports, and its use is not monitored by the NCAA, the governing body of college sports.

Despite stated label risks of possible fatal heart attack, stroke or organ failure, college football players across the country are still being given injections of a powerful painkiller on game days so they can play while injured, an ABC News investigation has found.

Only two of the country's top football programs, Oklahoma and the University of Nebraska, reported to ABC News that they have limited or stopped the use of the drug in the wake of growing concern about its risks. Oklahoma said it stopped using the painkillers in 2012 after using them repeatedly in 2010 and 2011. Nebraska said its doctors now restrict its use.
 
"While team physicians reserve the option to use injectable Toradol, it is rarely prescribed, and its use has been avoided this season following reports of heightened concern of potential adverse effects," Nebraska said in a statement to ABC News.

(Megan Chuchmach and Brian Ross, "Ex-USC Player: Painkiller Injections
Caused Heart Attack," ABC News, January 2 2013) 
 
The top two college football programs, Notre Dame and Alabama, refused to answer questions from ABC News about the painkiller. They play for the national college championship on Jan. 7, 2013.
  
In professional sports, the NFL, NHL and NBA allow the use of Toradol but require teams to keep close track of injections and report the information to the league.

The NCAA, the governing body of college sports, has no such requirement to regulate or even track the use of painkillers, a spokesperson told ABC News. Only one narcotic analgesic is banned by the NCAA -- heroin. And, only doctors or nurses are authorized to give injections, though the NCAA does no spot-checking.

Read more here: http://www.thestate.com/2009/10/06/972507/painkiller-control-rests-out-of.html#storylink=cpy

Studies on painkiller prescription abuse among college football players are non-existent, despite a warning from NCAA-approved addiction counselor Marcus Amos that the problem is "rampant."

In a statement, the NCAA said it requires member schools to follow state and federal laws about medical treatment and prescription medicine, and publishes guidelines that include "best practices" for the handling of medication. "NCAA members have decided that it is their individual responsibility to assure compliance with appropriate medication and treatment guidelines," said the statement.


Game Example

Here is an example of the use of painkillers during a college football game between Mississippi and USC in 2009:

"At halftime of last week's upset of No. 4-ranked Mississippi, USC quarterback Stephen Garcia took some kind of shot - he said it was cortisone, an anti-inflammatory steroid that is not a painkiller - to get back on the field. C.J. Spiller, Clemson's Heisman Trophy candidate, went to the locker room during the first half of last week's 14-10 loss to TCU and said he took a shot before returning to a game in which he had 227 all-purpose yards.
 "'I did what I needed to do,' Spiller said." 
 (Gene Sapakoff, "Painkiller Injections Common in College Football:
A Shot In the Arm Numbs the Pain," The State, October 4 2009)


Read more here: http://www.thestate.com/2009/10/04/970144/painkiller-injections-common-in.html#storylink=cpy
According to Sapakoff, here is a quick review of some of the reported painkiller injections during 2008. (Players' names are not listed in the documents because federal privacy law protects the identity of individual painkiller users.)  South Carolina administered 169 Toradol injections to players on game days over the 13 games of the 2008 season, according to records obtained by The (Charleston) Post and Courier.

Using the trade name of the drug for the 2007 season, USC players received 133 Ketorolac injections over 11 games (the school did not provide information for the game against Kentucky).

Clemson gave 92 Toradol injections and seven Marcaine injections on game days during its 13-game 2008 season and 30 Toradol injections and 24 Marcaine injections over its 13 games of the 2007 season.

Players at the Football Championship Subdivision level get painkiller injections, too. The Citadel administered 16 Toradol shots over its 12 games of the 2008 season.

Tim Tebow, Florida's All-American quarterback, revealed last that he hurt his throwing shoulder in the 2008 opener against Hawaii and took painkiller shots before every other game during the Gators' national championship season.

Toradol and More

Common injected painkiller drugs given to college football players:

TORADOL (BRAND NAME) OR KETOROLAC (GENERIC NAME): A non-steroidal, anti-inflammatory drug used for mild or long-term pain. Repeated use may increase the risk of heart attack, stroke or allergic reaction. Should not be combined with aspirin or Ibuprofen. Also available, and often used by college football programs, in tablet form.

MARCAINE (BRAND NAME) OR BUPIVACAINE (GENERIC NAME): A local anesthetic often used to cause loss of feeling during surgery or during labor and delivery. Dizziness may occur.

(WebMD, Drugs.com, Medicinenet.com)


Read more here: http://www.thestate.com/2009/10/04/970144/painkiller-injections-common-in.html#storylink=cpy
Toradol/Ketorolac shots are intramuscular, usually given in the buttocks or upper arm. Marcaine is a numbing drug injected into a specific body part such as a sore shoulder. Doctors and trainers say the drug does not cause players to risk further injury because it does not completely deaden the pain. The players can still feel it, just not as much.

Sometimes players approach team medical staffers asking for pills or a painkiller injection. Other times doctors or trainers suggest or recommend a shot, or oral medication such as Advil or Tylenol.
"If the athlete comes in and says, 'Hey, I'm sore,' or they have an injury during a game, it's a way to kind of kick-start the recovery process," said Clemson director of sports medicine Danny Poole of Toradol injections.

 Shots also keep the best players on the field, but not all schools think painkiller injections are a good idea. Coastal Carolina over its 12 game days of the 2008 season gave out 62 Ibuprofen pills, 39 Aleve pills and eight Tylenol pills.

But zero shots.

"Everybody does it a little bit different," Coastal Carolina head athletics trainer Dwayne Beam said. "Not to say we would never give an injection in the future, but we're just very conservative."

(Gene Sapakoff, "Painkiller Injections Common in College Football:
A Shot In the Arm Numbs the Pain," The State, October 4 2009)

Coaches generally are not consulted when it comes to painkilling medication given to players. "I don't get involved in any of that," USC coach Steve Spurrier said. "That would be between the player, doctor and trainer. Basically, as a coach, all I say is 'Can he play or not?' If they clear him to play, we play him. If they say 'He can't play,' we don't play him."

My Take

In 2009, Sapakoff reported that the NCAA has a 120-page Sports Medicine Handbook that has not been updated since 2004. Subjects in this handbook include nutrition, skin infections, "menstrual-cycle dysfunction" and "depression intervention." He said the book includes one vague page on "The Use of Local Anesthetics in College Athletics."

This handbook, to me, illustrates the lack of responsible concern over the abuse of painkillers shown by so many medical professionals and pharmaceutical firms in America. And, it also underscores the need for appropriate action by the NCAA, an organization that evidently places more value on revenue than health.

Sapakoff said the NCAA has a 21-member Committee on Competitive Safeguards and Medical Aspects of Sports. The committee has two subcommittees: Drug-Education/Drug-Testing and Sports Sciences Safety. The officially stated general duties of committee members include providing the NCAA membership direction on "alcohol, tobacco and other drug abuse prevention programs," among other things. The committee meets twice a year.

"Mary Wilfert of the NCAA said the issue of painkiller injections in college football 'has not been a major point of discussion' within the committee.

"'The NCAA has never done a study on painkiller injections or other painkiller medication,' Wilfert said. A non-NCAA study done in 1991 reported that 75 percent of college athletes used some kind of painkiller medication for sports-related injuries.

"But the NCAA and ACC haggled this summer over an ACC rules proposal seeking to specify 'that an institution may provide fruit, nuts and bagels to student-athletes at any time.' Bagel quality was a sticking point.

"David Geier, director of sports medicine at the Medical University of South Carolina, said the NCAA would have a "gargantuan task" trying to monitor painkiller use.

"'There are just so many more teams than the NFL,' Geier said. 'It would be an absolute nightmare trying to keep track of that, especially at smaller schools. But probably not a bad idea.'"


  (Gene Sapakoff, "Painkiller Control Rests Out of NCAA's Hands," The State, October 6 2009)

Fruits and nuts? I believe the NCAA and the ACC already have too many "fruits and nuts" in charge of the Committee on Competitive Safeguards and Medical Aspects of Sports. When 75 percent of college athletes use "some kind of painkiller for sports-related injuries," yet the NCAA doesn't require tracking the distribution of painkillers or studying the long-term effects of using the drugs, they evidently do not care about the potential risks to the athletes: they care only about the money and the almighty game. And, oh yes... the bagels.

We should not limit our concern for athletes and drug abuse to performance-enhancing drugs. We must also study the effects of administering pain killers to injured participants in all sports. The potential for injury is high in contact sports like football. But, given the nature of competition, we can safely assume that all other less dangerous sports, to some degree, offer injections and "quick fixes" for pain. Do we care about what these drugs may be doing to our stellar athletes?

Having a field full of half-numb, injured athletes competing for a National Championship is not my idea of sports. That image reminds me of "pro" wrestling. The glory and the money are not worth the abuse to the body. Or, is it? Evidently, many college athletes and medical staffs believe so.

Teach your children well. And, while you're at it, safeguard them from others who wish to use them to their advantage.

Full Articles:

Gene Sapakoff     http://www.thestate.com/2009/10/06/972507/painkiller-control-rests-out-of.html

Brian Ross          http://news.yahoo.com/ex-usc-player-painkiller-injections-caused-heart-attack-184811728--abc-news-topstories.html

 
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