Entries in Toradol (2)


Will Notre Dame Use Painkiller in Championship Game on Monday?

iStockphoto/Thinkstock(NEW YORK) -- Unlike championship rival Alabama, the team doctor for Notre Dame football, Dr. James Moriarity, told ABC News he does not rule out the "occasional use" of the controversial painkiller Toradol on game days to treat Fighting Irish players if "medically indicated."

By contrast, Alabama team doctor Dr. James Robinson said he has "never used it" on Crimson Tide players and will not use it during the BCS National Championship Game on Monday.

"I've actually been against it the whole time," Robinson told ABC News over the weekend in Miami, where the BCS game will be played.  "It's something we've never done."

Monday's game takes place amid a growing controversy in college and professional sports over the use of painkillers on players in general, and of Toradol specifically because of the possible increased risks cited on its label of heart attack, stroke, kidney failure and internal bleeding.

Toradol was developed for use in hospitals for the short-term treatment of post-operative pain but over the last decade has found its way into team training rooms in major sports.

"It's a good pain medication," Robinson, the Alabama team doctor, said.  "So post-operatively, and after an acute injury before we get them to surgery, things like that, we've used the medication... But we don't use it as a preventative medicine if you will."

Prior to the ABC News interviews with the two doctors over the weekend, college officials at Notre Dame and Alabama had refused to answer questions about whether its football players were given the powerful painkiller on game days.

An ABC News investigation found the generic version of Toradol is still being used in college and professional football programs across the country even as many team doctors have stopped using it because of concerns about the various risks.

Robinson said the use of such painkillers goes against his philosophy.

"If they're too injured, they're too hurt to play, we don't let them play," he told ABC News.

Notre Dame's Moriarity said he only administers the oral version of the painkiller and has not used Toradol injections "most of this year."

Moriarity denied the use of Toradol does not give injured Notre Dame players an edge, but said the painkiller is used on game days.  "When else would you use it?" he said.

"We have used it for people in pain from certain circumstances," he said.  Moriarty would not elaborate on specifics but said, "I don't think you could say it allowed them to play when they couldn't otherwise."

Moriarity said Notre Dame asks, "Are they fit to play?"

The ABC News report on Toradol focused on a former USC lineman, Armond Armstead, who claims in a lawsuit that a season-long series of Toradol injections by the team doctor resulted in a heart attack he suffered following the 2010 season.

The USC team doctor, Dr. James Tibone, told ABC News he continues to use Toradol injections on game day for injured players but said such shots did not involve any risk.

"These are healthy people," he told ABC News.  

The NCAA does not regulate or keep track of the use of painkillers or Toradol, unlike professional sports leagues.  NCAA officials have declined to comment on the ABC News reports.

Copyright 2013 ABC News Radio


Despite Risks, College Football Still Using Powerful Painkiller

iStockphoto/Thinkstock(NEW YORK) -- 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.

The drug, a generic version of 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.

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, but records show they were used consistently 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.

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.

Controversy surrounding the drug 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.

"I thought, you know, can't be me, you know?  This doesn't happen to kids like me," Armstead told ABC News.

The manufacturers' warning label for generic Toradol (ketorolac tromethamine) says the drug is not intended for prolonged periods or for chronic pain and cites gastrointestinal bleeding and kidney failure as possible side effects of the drug.

In addition, like other drugs in its class, the generic Toradol label warns "may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction (heart attack), and stroke, which can be fatal."

"This risk may increase with duration of use," the so-called black box warning reads.

In a lawsuit against the school and the doctor, Dr. James Tibone, Armstead claims the school ignored the stated risks of the drug and never told him about them.

"He was a race horse, a prize race horse that needed to be on that field no matter what," said Armstead's mother Christa.  "Whether that was a risk to him or not."

Armstead says he and many other USC players would receive injections of what was known only as "the shot" in a specific training room before big games and again at half-time.

"No discussion, just go in.  He would give the shot and I would be on my way," Armstead told ABC News.

Armstead said the shot made him feel "super human" despite severe ankle, and later shoulder pain, and that without it, he never could have played in big USC games against Notre Dame and UCLA.

"You can't feel any pain, you just feel amazing," the former star player said.

USC declined to comment on Armstead's claims, or the use of Toradol to treat Trojan players.

An ABC News crew and reporter were ordered off the practice field when they tried to question USC coach Lane Kiffin about the use of the painkiller.

Later at a news conference promoting the Sun Bowl, where USC was defeated earlier this week, Kiffin said he had no idea when or if Toradol was being used on his players, or about its risks.

"Well, if that was the case then, yeah, I did not know that until you told me," Kiffin said.  "You educated me, thank you."

USC and Dr. Tibone have asked a judge to throw out Armstead's lawsuit, and in a brief interview with ABC News, Dr. Tibone denied any wrongdoing.

He said he could not comment on whether he failed to tell Armstead of the possible risks of the prescription painkiller, because of the pending lawsuit.

The team doctor did confirm to ABC News that he used Toradol to treat Armstead's pain and that he continues to use the drug on other USC players.

"These are young, healthy people," he said.  "We still use it, we use it diligently."

Whatever the possible risks, an expert on medical ethics, Professor Arthur Caplan of New York University, said team doctors have an obligation to tell players.

"Even if you're the team physician, you still have to follow the standard of care and informed consent," Caplan told ABC News.  "You better be disclosing all risks."

In addition to Oklahoma and Nebraska, only four of the other top college football programs questioned by ABC News said Toradol is not used by their team doctors: Ohio State, Oregon State, Boise State and Georgia.

Most schools refused to answer whether players are treated with Toradol, but four confirmed its doctors use the painkiller: Clemson, Texas A&M, San Jose State and USC.

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.

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.

"If we keep track of what happens to, let's say, horses in horse racing, don't we owe it to the athletes to keep track of what's going on in college sports?" asked Professor Caplan.

Copyright 2013 ABC News Radio

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