San Jose Bills Fan Posted April 16, 2013 Posted April 16, 2013 NoSaint and I and a few others have been kicking around a discussion about Toradol (brand name) for several months now. The discussion has taken place in this thread about Junior Seau and CTE but as the story develops, it definitely needs its own thread. Toradol is an anti-inflammatory analgesic commonly used by NFL players to manage severe pain. As many of you know, there are many NFL players who have become addicted to narcotic, opiate-type painkillers so Toradol is attractive in that it's not physically addicting like for instance, hydrocodone. The downsides are several. Toradol has side effects like most medications and overuse of Toradol has been linked with gastrointestinal bleeding, kidney and liver bleeding and failure, as well as other significant health risks. Also, while not physically addicting, Toradol is mentally addicting because many NFL players endure so much pain that without pain medications, it's difficult for them to function normally. They need Toradol to act like normal human beings off the field and also to practice and play football on it. Another problem is that Pain is part of the body's defense system. Pain is feedback and allows us to modify our behavior so that we don't harm ourselves. When you desensitize the body from pain, it becomes possible to inflict more damage to your body than your body would normally allow itself to endure. So by killing pain, an individual can more easily endure pain which can be and become acute, traumatic, chronic, and long term. Many NFL players endure pain from the time they play till the time they die. There are many interesting facets to the Toradol story: 1) The NFL is starting to take steps away from Toradol use. Several clubs have banned the use of Toradol while others are requiring players to sign a waiver of legal claims in order to have it administered. In response to the waiver of liability, the NFLPA filed a grievance seeking to eliminate the waiver. 2) NFL sources have told ProFootballTalk that some players now are getting Toradol on their own. So like with the head trauma issue, you have a situation where the league is now trying to take action to legally protect itself (and medically protect its players?) while some of the players are trying to resort to fairly extreme means to keep their careers alive and chase the money while they can at the risk of their own health. Unlike the head trauma issue, there is no question that these players know all the risks associated with Toradol. The fact that they take these risks is similar in some respects to the risks some people take in their occupations (corrections, law enforcement, military, coal mining, deep sea fishing, etc). It makes me think a few things. NFL football players with their non-guaranteed contracts, shorter careers, and higher incidences of long-term injuries as well as their higher risk of catastrophic injuries are not like baseball and basketball players. In every way they are much more like the gladiators of ancient history. I also think about the issue of pain management. PFT sums it up pretty well: It therefore becomes imperative for the league and the union to find the safest strategies available for helping a player deal with pain. Recently, there has been a quiet push to drop marijuana from the substance-abuse policy, since plenty of players use it after games as a pain-management device. With marijuana recently legalized in Washington and Colorado for recreational use, it’s about time the NFL realizes that letting guys smoke pot may be the most effective way to help them deal with the wear and tear of playing football — especially if Toradol and other potent medications should be used sparingly or not at all.
BringBackFergy Posted April 16, 2013 Posted April 16, 2013 Interesting thread/post SJBF - be interested to see where this leads. I take it Tylenol or ibuprofen doesn't touch the level of pain these guys endure. Hoping they find a safe alternative soon.
JPS Posted April 16, 2013 Posted April 16, 2013 Does ANYONE have a problem with weed?? I "pass on grass", but I could care less if it was legal for pain management or recreational use. I assume broad legality will happen in my lifetime and the NFL will FOLLOW.
benderbender Posted April 16, 2013 Posted April 16, 2013 Does ANYONE have a problem with weed?? I "pass on grass", but I could care less if it was legal for pain management or recreational use. I assume broad legality will happen in my lifetime and the NFL will FOLLOW. It definitely can't be considered performance enhancement. Ask Ricky Williams.
NoSaint Posted April 16, 2013 Posted April 16, 2013 Interesting thread/post SJBF - be interested to see where this leads. I take it Tylenol or ibuprofen doesn't touch the level of pain these guys endure. Hoping they find a safe alternative soon. For perspective I'd say read this - its worth the time http://www.miamiherald.com/2013/01/13/3179926/dan-le-batard-jason-taylors-pain.html I don't know that there's a safe alternative pain killer for THAT.
BringBackFergy Posted April 16, 2013 Posted April 16, 2013 Does ANYONE have a problem with weed?? I "pass on grass", but I could care less if it was legal for pain management or recreational use. I assume broad legality will happen in my lifetime and the NFL will FOLLOW. I don't want my kids to do it...but terminal patients, arthritic, and even NFL players experiencing pain should be allowed. However, if current players are permitted, aren't we then allowing them to mask the pain and endure more damage to the body (as the post references). Maybe pot doesn't work like that...I don't smoke.
San Jose Bills Fan Posted April 16, 2013 Author Posted April 16, 2013 For perspective I'd say read this - its worth the time http://www.miamihera...ylors-pain.html I don't know that there's a safe alternative pain killer for THAT. The irony is that Jason Taylor is handsome, articulate, a great dancer, the complete antithesis of the football warrior archetype. Even old school Parcells dissed him like he wasn't worthy of being in "the club." And yet Taylor endured more pain and painkilling than most of his peers.
JPS Posted April 16, 2013 Posted April 16, 2013 For perspective I'd say read this - its worth the time http://www.miamihera...ylors-pain.html I don't know that there's a safe alternative pain killer for THAT. Thanks for the link. Good article.
BringBackFergy Posted April 16, 2013 Posted April 16, 2013 For perspective I'd say read this - its worth the time http://www.miamiherald.com/2013/01/13/3179926/dan-le-batard-jason-taylors-pain.html I don't know that there's a safe alternative pain killer for THAT. Read the whole article...amazing. These guys really are gladiators.
Saint Doug Posted April 16, 2013 Posted April 16, 2013 Ketorolac is an excellent analgesic. It has been shown to be as effective as opiods in trials, but has zero abuse potential. Let's not give this drug a bad name. However, this drug has restrictions as do most medications. Due to renal issues, it shouldn't be used for more than 72 hours. It's the team's physicians we should be pointing our fingers at. This medication cannot be dispensed without a prescription. But, let's no drag a perfectly good medication through the mud.
NoSaint Posted April 16, 2013 Posted April 16, 2013 The irony is that Jason Taylor is handsome, articulate, a great dancer, the complete antithesis of the football warrior archetype. Even old school Parcells dissed him like he wasn't worthy of being in "the club." And yet Taylor endured more pain and painkilling than most of his peers. I'm not even sure his experience is all that unique. The length of his career certainly made the laundry list of terrible events longer but.... Can we say a guy like Stevie isn't dealing with similar weekly? He seems perpetually to have a list of injuries that he's playing through. Or fitz playing through the ribs, fred rushing back from injuries... Or a number of fringe guys that refuse to take themselves out for fear they will never get back in. I suspect, the more I read, that we'd likely be embarassed to cheer like we do if we knew half the story behind closed doors.
San Jose Bills Fan Posted April 16, 2013 Author Posted April 16, 2013 Ketorolac is an excellent analgesic. It has been shown to be as effective as opiods in trials, but has zero abuse potential. Let's not give this drug a bad name. However, this drug has restrictions as do most medications. Due to renal issues, it shouldn't be used for more than 72 hours. It's the team's physicians we should be pointing our fingers at. This medication cannot be dispensed without a prescription. But, let's no drag a perfectly good medication through the mud. I don't think anyone has done that yet. I'm not even sure his experience is all that unique. The length of his career certainly made the laundry list of terrible events longer but.... Can we say a guy like Stevie isn't dealing with similar weekly? He seems perpetually to have a list of injuries that he's playing through. Or fitz playing through the ribs, fred rushing back from injuries... Or a number of fringe guys that refuse to take themselves out for fear they will never get back in. I suspect, the more I read, that we'd likely be embarassed to cheer like we do if we knew half the story behind closed doors. And that's why I have a special respect for football players and don't lump them in with other North American professional athletes like so many others do.
Mr. WEO Posted April 16, 2013 Posted April 16, 2013 The irony of equating football players with "gladiators of ancient times" is that there was little that was voluntary of entering the arena back then. And of course, no one was concerned with pain control.... Toradol is a drug that is given to nearly every patient undergoing general anesthesia for surgery in this country every day. It is not a maintenance medication. Some of its side effects (GI bleeding, easy bruising, kidney failure) are the same as those that can be caused by over the counter NSAIDS like ibuprofen.
jr1 Posted April 16, 2013 Posted April 16, 2013 A gent should be able to partake in some pot brownies on a Sunday night
NoSaint Posted April 16, 2013 Posted April 16, 2013 Ketorolac is an excellent analgesic. It has been shown to be as effective as opiods in trials, but has zero abuse potential. Let's not give this drug a bad name. However, this drug has restrictions as do most medications. Due to renal issues, it shouldn't be used for more than 72 hours. It's the team's physicians we should be pointing our fingers at. This medication cannot be dispensed without a prescription. But, let's no drag a perfectly good medication through the mud. I don't think anyone's blaming the misused drug but I do think its interesting to see in parallel to the concussion suit the terrible medical advice from team drs here, and players total lack of care to ask questions or research. Adds some shades of grey to the player safety discussion.
Rubes Posted April 16, 2013 Posted April 16, 2013 For perspective I'd say read this - its worth the time http://www.miamiherald.com/2013/01/13/3179926/dan-le-batard-jason-taylors-pain.html I don't know that there's a safe alternative pain killer for THAT. Holy crap. I had no idea.
Tcali Posted April 16, 2013 Posted April 16, 2013 Ketorolac....--From what I have read it is no more dangerous than motrin(ibuprofen) in the proper doses. same side effects as all NSAIDs. many Docs I know subscribe high doses of ibuprofen for VERY short time periods. problem with any NSAIDS is that you develope a tolerance for them. and the effective dose goes up and up--while the side effects skyrocket. drug abuse is drug abuse. there are no side affect free drugs out there no matter what the popular drug of the moment is. marijuana is certainly not the harmless herb that many think of----esp not at the level where it is going to be in the same ballpark as a painkiller that high doses of NSAIDs are. --And forget about remembering the plays.
thebandit27 Posted April 16, 2013 Posted April 16, 2013 I was actually prescribed toradol 17 years ago. I was 15, and had suffered a broken back (4th, 5th, and 6th thoracic vertebrae) in a checking-from-behind incident while playing high school hockey. The stuff is absolute magic. My back literally felt like it was being split in two, consistently, and a single dose of toradol made it really quite manageable. I will say, however, that over time, I began to miss the numbing affect of it once the doctors deemed that I no longer needed it. For me, it's a double-edged sword. These guys get paid so much money, and the vast majority of them feel like they need to be on the field to earn it. Compounding the issue is that there's a brotherhood mentality to any team, and most players don't want to leave their team without their services, so they're often willing to do whatever's necessary to get on the field. Fans, media, and coaches all foster this approach, whether we mean to or not, by the attention we pay to the game and, especially, individual players. I'd like to think that advances in science and technology will result in better, safer pain management practices, but that's no guarantee. I also believe that, if it's not toradol, it'll be some other wonder-drug for pain management that players cling to...and who am I to tell them that they shouldn't do so? My personal opinion is that the NFL would be going too far in banning toradol; I think the responsibility of the NFL is to inform players of the risk(s) associated with both short-term and long-term usage of the drug, and allow players to make their own decisions. The NFL, as hard as it may be, needs to find a way to walk a fine line between being proactive with regard to player safety without unnecessarily limiting the choices players get to make with respect to their personal well-being. Just my 1 cent.
Saint Doug Posted April 16, 2013 Posted April 16, 2013 I don't think anyone's blaming the misused drug but I do think its interesting to see in parallel to the concussion suit the terrible medical advice from team drs here, and players total lack of care to ask questions or research. Adds some shades of grey to the player safety discussion. I think the team physicians are under great pressure to be "yes men" and prescribe anything, within reason, to players. They're not going to be a Michael Jackson doctor, but if they say no, there's likely a long line of other physicians waiting to take their dream job. And it must be tough too. These players live under extreme circumstances and are going to have chronic pain during the season (and likely after it too). You need to treat their pain and ketorolac is a non-habit forming analgesic. You can't place them on chronic opiods, so there's a trade-off. That said, there's something to be said for Motrin 800 mg. It is also a great analgesic, but is also associated with side-effects with chronic use. For those who don't know, toradol and motrin, while not exactly the same, belong to the same drug family, NSAIDs.
NoSaint Posted April 16, 2013 Posted April 16, 2013 I think the team physicians are under great pressure to be "yes men" and prescribe anything, within reason, to players. They're not going to be a Michael Jackson doctor, but if they say no, there's likely a long line of other physicians waiting to take their dream job. And it must be tough too. These players live under extreme circumstances and are going to have chronic pain during the season (and likely after it too). You need to treat their pain and ketorolac is a non-habit forming analgesic. You can't place them on chronic opiods, so there's a trade-off. That said, there's something to be said for Motrin 800 mg. It is also a great analgesic, but is also associated with side-effects with chronic use. For those who don't know, toradol and motrin, while not exactly the same, belong to the same drug family, NSAIDs. totally understand - the machine must keep moving. players have to suit up, docs have to do what they can to suit them up because theres always someone standing behind that wants that high paying gig. problem starts to happen when accusations of not disclosing the risks, or actually lying about the risks start to come out. I only take joe horn so serious, but when he alleges that the doctors flat out told him what amounts to "just keep doing it, theres no risk." It makes you cringe. Now that very well could be joe hearing what he wants to hear, or saying what he thinks will get him paid - i dont want it to come across like im blindly following the players on this - but it does cause some worry about their medical care
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