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Former Cy Young winner takes powerful drug to aid his performance, no one cares

Apr 9, 2012, 11:32 AM EDT

New York Mets Photo Day Getty Images

What if I were to tell you that there was a former Cy Young winner who was taking a controversial and powerful drug?

A drug that could prove dangerous to him in the long run and has been linked to organ damage? A drug that other players who have used it say gives them a feeling of invulnerability? A drug that experts are wary of for athletes because its long term effects when taken regularly aren’t known? A drug that is injected into the buttocks. A drug that, despite all of this, the player uses because it helps him recover from injury, soreness and fatigue and helps him get back on the field?

Why, I hope you would say nothing, because as David Lennon of Newsday reports, it’s totally OK in Major League Baseball:

When Johan Santana said last week that he received an injection of Toradol, a powerful anti-inflammatory medication, to stay on schedule for his Opening Day start, it hardly raised eyebrows in the clubhouse.

The reason? Santana is not the only one to benefit from the drug, and its use is more common than people might think.

There is not some logical bright line between what is a horrible, terrible PED and what is an acceptable drug in the world of sports. We like to pretend there is, but really, there isn’t. The biggest difference is that some are on a banned list and some are not, and that Santana and others use Toradol under a physicians care and guys who take banned drugs don’t.

Ultimately, these drugs are allowing players to do what their body would not naturally allow them to do. Here, it’s ignoring pain that could keep them from playing or certainly playing well.  With other drugs, it’s recovering from injury faster (HGH) or hitting a ball farther than they otherwise might (steroids). Either way, their performance is enhanced. Their natural state is altered by pharmaceuticals.

It would be awesome if we could approach some of the banned PEDs in this way and determine whether they present acceptable risks. Whether they serve a valuable purpose that, under a doctor’s care, don’t raise serious ethical concerns.  But we just don’t roll that way in professional sports these days.

  1. asharak - Apr 9, 2012 at 11:36 AM

    Spoiling for a fight on Easter Monday are you, Craig?

    PS> You’re not wrong.

  2. WhenMattStairsIsKing - Apr 9, 2012 at 11:46 AM

    As long as players don’t take what they’re not supposed to, there’s not much we can say. If Santana wants to take something that can hurt him long term but is legal to take, that’s up to him.

    Yes, this medication changes his performance. So would ADD medicine that is also common and allowed with prescriptions. Even Advil affects your performance as something that makes pain go away when it naturally wouldn’t.

    I think Santana did something potentially foolish, but if he was under team advisement and it’s allowed, pointing the finger at him isn’t really justified.

  3. Reggie's Bush - Apr 9, 2012 at 11:46 AM

    Terribly irresponsible reporting.

    According to Lennon, “Toradol is an NSAID, or nonsteroidal anti-inflammatory drug; it’s in the same class as over-the-counter medication like Advil, Aleve and Motrin. The difference is that Toradol is far more potent – it must be prescribed by a physician.”

    So then there’s that…

    • WhenMattStairsIsKing - Apr 9, 2012 at 11:54 AM

      I admit, I’m not always thrilled when Craig posts something and comes off as if he knew about this all along in some sense. I love the guy, but it happens.

    • jfwiii - Apr 9, 2012 at 11:59 AM

      Those facts would seem to support Craig’s point that Toradol is an “acceptable” performance enhancer and that people are unwilling to recognize that the exercise of banning some drugs but not others ignores a huge gray area.

    • Mark - Apr 9, 2012 at 12:07 PM

      More like terribly irresponsible commenting. The last line of your quote is one key difference (the potency of the drug). Other key points:

      “R.A. Dickey said he relied on numerous injections last season to cope with a painful case of plantar fasciitis. Mike Pelfrey credited the drug for allowing him to make 33 starts in 2010 and throw a career-high 204 innings that season. Without Toradol, Pelfrey said, that would have been impossible.”

      Going to go out on a limb here and say that if all it took was an advil to stop Plantar Fascitis, guys like Troy Glaus would have played longer, and people around the world would have simply used that. It’s extremely painful, and taking an Advil doesn’t give you this sense of invulnerability.

      “Toradol is different from cortisone-type treatments, which are injected directly into the problem area and do not have a systemic effect on the entire body. David Wright received a cortisone shot during spring training to help heal his abdominal strain. Scott Hairston took three injections in roughly a six-inch radius to help a strained oblique.

      But that focus on one particular area does not produce the same overall feeling of invulnerability that Pelfrey described after getting his shots of Toradol, which he regularly did an hour before his starts if something was bothering him.

      “You don’t feel anything,” Pelfrey said. “If someone punched me in the stomach, I wouldn’t feel it.””

      Again, I’m going to go out on a limb here and say Advil/Motrin don’t give you that kind of impact. Even if it’s hyperbole, it’s pretty clear that Toradol is a hell of a lot stronger than Advil, even if it’s in the same class.

      “That’s because Toradol is most often used to treat patients suffering from postoperative pain or other serious trauma, according to Dr. Nathaniel Berman, a nephrologist at Manhattan’s Rogosin Institute and an assistant professor at Weill-Cornell medical school.

      “When somebody comes into the hospital with acute pain, a kidney stone, say you just had hip surgery or you’re going to set a broken arm or something, you might give them a shot of Toradol,” Berman said. “It’s use has only been established in short-term treatment, and from what I understand the studies are all short-term treatment, so I don’t think anybody can really tell you what the long-term effects are.””

      So just to be clear. Doctors typically give this to people who have a kidney stone (probably one of the most painful things anybody can go through save for giving birth) or a broken bone. And this is in the same class as Advil?

      Come on. Put two and two together. You get a kidney stone and you take an Advil you’re not going to even notice. If they’re giving you Toradol, it must be some pretty serious stuff.

      “”This is what you would give somebody instead of morphine ,” Berman said. “But it doesn’t have the same neurological effect. It doesn’t work on pain receptors. It’s sort of upstream from pain – you don’t feel the pain because you don’t have the [inflammation] that’s stimulating the pain.””

      Again, this is what they use (Toradol) instead of morphine. You want to stick with that argument of yours about it being remotely similar to Advil?

      Sorry bud, but you’re way off base. I’m with Craig on this. These are some pretty hardcore medicines, considering it’s supposed to be used on broken bones or severe injuries or post op surgery for short periods of time. Plain and simple, if you consider PED/steroids cheating, then I’d put Toradol in the same class.

      All the quotes were from Lennon’s article linked by Craig.

      • drewsylvania - Apr 9, 2012 at 12:25 PM

        Was going to comment, but Mark said it much, much better than I could.

      • cur68 - Apr 9, 2012 at 12:51 PM

        If drmonkeyarmy sees this, he’ll have more to say on the topic. All I have to add is that Advil = a Ford Focus & Toradol = Mitsubishi Lancer Evolution. Both are four door, small family cars available with standard transmissions and as station wagons. They even have child seat restraints. One of them has ~ 160hp. The other about 300+ hp. Same class of car, VASTLY different performance.

      • indaburg - Apr 9, 2012 at 2:51 PM

        I know in my ER, toradol (ketorolac) is given regularly for pain, and not for serious trauma or kidney stones. Cur, when comparing Advil to a Ford Focus, are you comparing over the counter 200 mg or prescrition strength (800 mg)? Same drug, but different performance based on how souped up it is. Also, Toradol might be a Mitsubishi Lancer Evolution, but it isn’t a Lamborghini Aventador. Hell, it isn’t even a Corvette.

        As a patient, I have received Toradol myself, and I never felt invincible. The pain was dulled, but not eliminated. We’re not talking Demerol or Oxycontin.

      • pharmerbrown - Apr 9, 2012 at 3:15 PM

        NSAIDs are permitted because they are 1.) non-steroidal, and 2.) don’t inherently improve performance. The bright line that Craig was referring to is still obscure, but should rest somewhere in between “medically necessary/ curative” and “blatantly performance enhancing with no curative effect”. Of course, that line is tough to see. Sure, Tommy John was a decent pitcher, but how many pitcher’s performance IMPROVES after the surgery (a 2-4 mph jump on the radar). Antibiotics, NSAIDs, and the setting of a broken arm do not inherently improve performance so much as they restore performance to pre-injury or -sickness levels; PEDs raise the bar on performance. Again, if a player is in a car accident and his doctor prescribes Methyltestosterone as part of his recovery, MLB won’t (to my understanding) penalize him provided he cleans up before returning to the game, but if he continues taking it beyond the “recovery” period and into the “improvement” period.

        What about Lasek eye surgery, hip replacements on active players, or ligament restructuring?

  4. skids003 - Apr 9, 2012 at 11:49 AM

    It’s OK, when it damages him he can hire Sokolov or some other shyster lawyer and sue.

  5. jpoo087 - Apr 9, 2012 at 11:50 AM

    Someones just pissy that the Braves dropped 3 straight to the Mets me thinks.

  6. RedHeadedBastard - Apr 9, 2012 at 11:56 AM

    This is the same drug that NFL players use. Brian Urlacher, for example, stated that he gets those injections before games and that he will continue to use it despite the unknown consequences in the long-term.

  7. whatthehellisansky - Apr 9, 2012 at 11:58 AM

    The biggest difference is that some are on a banned list and some are not, and that Santana and others use Toradol under a physicians care and guys who take banned drugs don’t.

    Physician? This is the Mets medical staff were talking about here. Look at their track record – i wouldn’t consider them physicians, nor would i take medical advice from them…

  8. natstowngreg - Apr 9, 2012 at 11:59 AM

    Not being a doctor, I can’t tell why this is different. I can see this going overboard. Ex., Olympic athletes being prohibited from taking anti-histamines or other over-the-counter medications. Just a couple of questions, in case there is a doctor in the house:

    1. How is getting a shot of this anti-inflammatory durg different from getting a cortisone shot? Cortisone shots seem to be common, and part of treatment for injured players. Or from taking two extra strength aspirin tablets (also anti-inflammatory)?

    2. Is Toradol approved by the Food and Drug Administration?

    • CJ - Apr 9, 2012 at 12:53 PM

      you can scroll up for Mark’s responses which are much more thorough but in short: 1) cortisone shots only affect a specific area, Toradol works on the entire body. 2) my understanding is yes for short term uses, but no testing has been done over the long term.

      • natstowngreg - Apr 9, 2012 at 5:46 PM

        Thanks.

  9. bgeary8 - Apr 9, 2012 at 12:08 PM

    Bravo, Craig.

  10. randall351 - Apr 9, 2012 at 12:08 PM

    Cortisone is actually a steroid as well so it should be less likely for an athlete to be able to use a steroid shot instead of Toradal, which is approved by the FDA, and is actually a pretty common shot administered in many pain relief clinics and emergency rooms for all sorts of ailments.

    • The Dangerous Mabry - Apr 9, 2012 at 1:44 PM

      Corticosteroids and anabolic steroids are about as different as antihistamines and opiods. Don’t let the word “Steroid” confuse you into thinking they’re the same thing.

      • natstowngreg - Apr 9, 2012 at 5:59 PM

        Thanks. This has confused me, in part because of my own experience. After suffering a detached retina (which, due to other problems in the eye, resulted in 4 operations), I had to take a lot of eyedrops with prednisolone, a corticosteroid. According to Wikipedia,

        “As a glucocorticosteroid, use of prednisolone during competition via oral, intravenous, intramuscular or rectal routes is banned under WADA anti-doping rules.[11] Local or topical use of prednisolone during competition as well as any use out of competition is not regulated.”
        http://en.wikipedia.org/wiki/Prednisolone

        So I guess my use in eyedrop form didn’t disqualify me from competing in the Olympics. Never mind my complete lack of athletic talent.

  11. bigjimatch - Apr 9, 2012 at 12:09 PM

    MLB didn’t enact a steroid policy out of some magnanimous interest in player safety or devine sense of fairness/jusice; they spend decades ignoring the issue in the interest of ratings. They only enacted the changes when they received a lot of bad publicity and the public began to question the legitimacy of the sport. The policy fueled by PR interests, not safety or fairness.

    • mets79 - Apr 9, 2012 at 12:25 PM

      Well said, the goal is to be like the NFL where they appear to have a legitimate testing policy which is vindicated by the occassional bust (when someone is careless enough to be caught).

  12. sabathiawouldbegoodattheeighthtoo - Apr 9, 2012 at 12:17 PM

    You could say the same thing about Tylenol if you want to. Which is why it is fairly ridiculous that people are so outraged by steroid use. In fact, many steroid users did receive their drugs from doctors.

  13. thehypercritic - Apr 9, 2012 at 12:28 PM

    So toradol is a drug which, unlike roughly 90% of the banned substance list, increases the chances an athlete may suffer a lifelong injury and we’re fine with this.

    Adderall or too much caffeine however…

    That major league baseball deems it okay to put a ligament from another body into your freaking body or a drug to ignore excruciating pain “okay”, but drugs available to the public recovering from surgery with superior health care over the line when it comes to performance enhancement shows you how lacking in functioning brain cells anyone who puts faith in the list is.

    If you actually care what substances grown men, knowing the risks, want to take under a doctor’s supervision please keep your stupidity to yourself.

    Let’s do away with the banned substance list all together.

  14. drewsylvania - Apr 9, 2012 at 12:31 PM

    Players will always be trying to circumvent the MLB drug rules. And I don’t blame them one bit, because the rules are hypocritical.

    MLB could make itself look pretty good by finding out which drugs (and dosages) jeopardize the health of a player, and then banning any such usage. Now, you might have an enforcement problem, but better that than “ban these, but not these, because we say so”.

  15. churchoftheperpetuallyoutraged - Apr 9, 2012 at 12:42 PM

    Might have said it here before, but it bears repeating. As someone [can't remember, maybe Keri?] mentioned during the superbowl, which drug is more performance enhancing? The steroids Barry Bonds took or the ones the Patriots gave to Rob Gronkowski so he could play?

  16. drewsylvania - Apr 9, 2012 at 12:47 PM

    Also, it’s up to each individual player (and his doctor) to figure out what’s likely to cause him damage.

  17. makeham98 - Apr 9, 2012 at 1:01 PM

    is this the same drug that hbo real sports had a report on with nfl players? scary stuff

  18. notsofast10 - Apr 9, 2012 at 1:06 PM

    Nolan Ryan used to do commercials touting his use of Advil. Does pretty much the same thing if you take a big enough dose. No problem with Nolan.

  19. bbk1000 - Apr 9, 2012 at 1:14 PM

    Old news….I think the press is following the lead from Hollywood….no new ideas so they will keep writing about the same stuff, acting as it’s somehow a breaking story……

    • drewsylvania - Apr 9, 2012 at 1:31 PM

      Pointing out hypocrisy and making people think is something that should happen more often.

  20. metalhead65 - Apr 9, 2012 at 1:26 PM

    no one cares because it is a legal ant-inflammatory drug adminstered by a doctor.it enhances performance only by allowing the athelete to ignore the pain and compete. it does not help him throw the ball faster or hit the ball futher by building extra muscles like steroids does. so what excatly are you whining about? oh yea you are crying because it does nothing to support your it is ok to cheat by taking steroids argument right?

    • nategearhart - Apr 9, 2012 at 1:29 PM

      I’d be curious to know your thoughts on HGH.

      • metalhead65 - Apr 9, 2012 at 1:37 PM

        pretty simple it’s cheating. how do you compare the 2? is the toradal healing the injury? is it making him stronger? faster? no it takes away the pain so he can play. it does not give him the advantage steroids or hgh does.

      • nategearhart - Apr 9, 2012 at 1:41 PM

        You think faster recovery from injury is an unfair advantage?
        I don’t think there’s much difference. HGH recovers the injury faster so you can return sooner. Toradal allows you to play through the pain of the injury and return sooner. I need you to explain why one is cheating and the other is not.

      • drewsylvania - Apr 9, 2012 at 1:51 PM

        @MH

        It’s “cheating” because MLB says it’s cheating. If they banned Oreos, would that suddenly make sandwich cookies “bad”?

        Toradal takes away the pain so he can play. HGH and steroids allow the body to recover so he can play. Why split hairs?

    • drewsylvania - Apr 9, 2012 at 1:33 PM

      Wow.

      • paperlions - Apr 9, 2012 at 2:05 PM

        Are you not familiar with his work? This is pretty much par for the course.

  21. Walk - Apr 9, 2012 at 1:34 PM

    I suffer from kidney stones once passing a 9mm by 4mm by 4mm stone after lithotripsy(sp) to break it up from a larger mass. I get major stones big enough to cause a hospital stay about every two years. The pain literally takes me off my feet and hurt enough that i cramp up and puke. I get toradol shots usually to start then demerol or lately dilaudid for my pain meds. Only thing i can tell you is it works. In fact on a few occasions the stronger nardotic demerol was not needed until after i was admitted. I had no idea it was an nsaid type drug, but i am all for that and like it better now that i know.

    • sabatimus - Apr 9, 2012 at 5:07 PM

      I had a kidney stone once, so large that I couldn’t pass it, and it had to be broken into pieces via some kind of shock type thing that I don’t remember. ‘course, I was heavily sedated when it happened ;p. But my point (only half relevant I know) is that kidney stones are NO JOKE when it comes to pain. I fell and dislocated my left patella a couple years back and that hurt LESS than my kidney stone.

  22. tigerprez - Apr 9, 2012 at 1:57 PM

    What continues to be lost in this debate over PEDs is the difference between performance enhancers and performance enablers. Something like toradol isn’t going to make Santana throw 5mph harder than he did before or magically transform him back into the dominant force he was before his injury. Toradol (along with cortisone, advil, and even the dreaded greenies) are performance enablers. They make it so you can drag your broken body onto the field and compete with what you have. Steroids are drugs that make you stronger than you were before, so they’re peformance enhancers. They make you better than you could be otherwise (and, in Bonds’ case, make you the greatest player ever at an age when you should be fading into your twilight years). I know the Church of Steroids-Are-No-More-Dangerous-Than-Skittles-and-No-Player-Ever-Hit-Even-One-More-Homerun-Because-of-Them have their pitchforks ready for anyone who would are make that argument, but that is a crucial difference, I think.

    • paperlions - Apr 9, 2012 at 2:07 PM

      Actually, it is going to make Santana throw about 90 mph harder than he could if he didn’t take it. Pain is a naturally occurring phenomenon. Taking something that removes all hint of pain enhances performance above what a player could do otherwise.

      If someone is going to try to make this distinction, they are splitting hairs…..and as pointed out above, the long-term effects of drugs like this (and even cortisone) are worse than for anabolic steroids.

    • churchoftheperpetuallyoutraged - Apr 9, 2012 at 2:31 PM

      Steroids are drugs that make you stronger than you were before, so they’re peformance enhancers

      Except this isn’t entirely true. Steroids allow you to work out harder and longer than before to increase muscle mass thus providing additional benefits. It’s not as simple as Average Player + Steroids = Barry Bonds.

      You need to work out, you need to increase strength, you need to increase speed. Steroids allow you to do this longer, with more weight thus increasing the benefit.

      It’s this small quibble that many of us like to point out in the hypocrisy of the steroid outrage. There are a ton of drugs that are used for similar means, but they don’t get anywhere near the coverage that PEDs do.

    • metalhead65 - Apr 9, 2012 at 3:02 PM

      awsome reply! and you are right the church of steroids led by craig will be outraged but to bad the truth hurts somtimes.

    • chrisny3 - Apr 9, 2012 at 4:40 PM

      Steroids are drugs that make you stronger than you were before, so they’re peformance enhancers.

      This is absolutely correct. One can play all the semantical games they want, but the fact is there is a very stark line that differentiates a drug like Toradol from an anabolic steroid. And that is one is the key enabler to allowing an athlete to physiologically change his body in a fundamental way so as to add capabilities he would otherwise not be able to enjoy. The other, Toradol, simply blocks pain and inflammation so as to allow what capabilities are already there in an athlete to be better utilized. An athlete’s God-given talents are not altered in any way. This is a key fundamental difference between these two classes of drugs, and those blurring the line are either ignorant, blind, or just want to keep making excuses for the steroids cheats.

  23. indaburg - Apr 9, 2012 at 2:39 PM

    I’m an RN, and when I saw the headline and started reading Craig’s alarmist prose, I couldn’t wait to read what this new mystical drug with such damaging and potent effects was. Then I saw Toradol. Seriously, Craig? Sure, Toradol can have side effects, but so does every drug on the planet. In my ER, Toradol was dispensed very frequently, and I never saw or heard of any patient who suffered an adverse effect when given appropriately. As others have posted, Toradol is basically a stronger version of Aleve or Motrin. (It’s a favorite in the ER to give to drug seekers in pain–it works with none of the highs from opiods like morphine.) I understand your point regarding the whole steroid debate, and how hypocritical it is to allow some substances but not others, but comparing steroids to a non-steroidal anti-inflammatory drug is like comparing apples to broccoli.

  24. drunkenhooliganism - Apr 9, 2012 at 2:49 PM

    If a drug ends in “ol” it’s a steroid. Johan Santana should be banned for the rest of his life and should be stripped of his Cy Young awards and his children must be banned from playing little league for the sake of the integrity of the game.

    • chrisny3 - Apr 9, 2012 at 4:45 PM

      LOL, ever hear of Pravachol? Guess not.

      • drunkenhooliganism - Apr 9, 2012 at 9:36 PM

        I would’ve went with Tylenol if I were you.

  25. thefreaksfg - Apr 9, 2012 at 3:07 PM

    It’s the same thing with the writers who won’t vote for known “cheaters”. It’s not about ethics or morality, it’s about public perception. Too many people are too stupid to understand that the sport has never been clean, and in the era where these known “cheaters” were caught, more people then ever were doping up.

    Not to mention, nobody really knows exactly what how any drug affects the player’s performance when it comes to baseball. We all know how it affects their body, but it’s never been fully proven when it comes to enhancing performance.

    Guys like Bonds, McGuire, etc. were all simply the poster children. Plenty of players the casual fan has never heard of have been caught taking these performance enhancing drugs, or continue to take them without being caught. Difference is, these players remain unknown because they’re not good (meaning there’s no effect whatsoever when it comes to these drugs and their performance), and the “superstars” get crucified because people are ignorant enough to think these ‘enhancers’ made them who they are.

    You can make an argument for steroids because they make you physically stronger (still no known correlation between being physically stronger and performance), but there’s a ton of drugs that keep players on the field and perform better by reducing the effects of injury, such as a cortisone shot the knee. If you play with that bad knee, it’s going to effect your performance in a negative way. Take that shot, and it’s clearly improving your performance if it helps your knee heal rapidly, or eases the pain. Once again though, this comes down to banned vs. not banned, or “cheating” vs. medicine.

    Just another example of why people need to do their own research and not let the media form their opinion for them.

    • metalhead65 - Apr 9, 2012 at 5:33 PM

      right there is no know correlation between steroids and performance, so barry bonds magicly changed his appearance with steroids and went from from 40 homers to 75 overnight but the roids had no effect on him doing it? sammy sosa went from scrawny 30 homer guy to 70 but the roids had no effect on his sudden improvement? you know sometimes you do not have to waste time with scientific studies or years of research if you just open your eyes and look at the evidence right in front of you.

      • thefreaksfg - Apr 9, 2012 at 6:05 PM

        A player getting that strong requires more than steroids. Not to mention, Barry Bonds was close to the Top 50 of hitters all time (by the numbers) before the year he was accused of starting on steroids.

      • metalhead65 - Apr 9, 2012 at 6:27 PM

        why do you people keep ignoring the sudden rise of power? he was already one of the greatest players before he started using then once he started juicing his power numbers went up. why because of the roids! I know that just taking them without working out will not help but the extra strength he gained by taking the roids made him stronger making him hit more homers. deny all you want but it is right there in front of you. look at a picture of him before he started juicing and after and there is no doubt! again I do not care how great a hitter he was he did not start hitting 70 homers till he started juicing!

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