The pills that bring some comfort can also light your life on fire
STORY BY DAMIEN ASHENHURST WITH THANKS TO DR STEVEN JENSEN AND THE MAGNIFICENT BAYNES FAMILY
Pain is a part of riding dirtbikes. Nobody gets out of this game without crashing and from scraped elbows to broken bones, we all know crashing hurts. Taking a tablet to ease the pain is so commonplace that few of us ever stop to think of the effects the drugs we take in have on us beyond easing the discomfort. I’ve smashed so much ibuprofen in my life because it works on the smaller stuff, but there is plenty of research available now on the increased risk of heart attack and stroke (Federal Drug Administration), or even decreased levels of testosterone levels in men (Proceedings of the National Academy of Sciences of the United States of America) after prolonged use of ibuprofen as found in Neurofen and Advil. Now this can get real nasty when you look at a powerful anti-inflammatory like Toradol which is at the centre of a lawsuit against the NFL (National Football League) by retired players. The NFL has been woefully inadequate when it comes to looking after the health of its athletes. Keith McCants, who was fourth overall pick in the 1990 draft recalls in a Vice piece called ‘Painkillers in the NFL,’ “Consuming over 183 pills a week, not knowing the effects it had on my liver and my kidneys. Or, more importantly, my development of split-personality with my violent tendencies that my family had to deal with.”
Keith is talking specifically about drugs designed to keep him on the field and playing at his best even though he may be carrying an injury. Most of these drugs are pain killers and in his case included Morphine, Lortab, Percocet and Cortisone. “You turn into a monster on the field and you take that monster home with you and you hurt the people that love you.” This is the downside and truth about killing pain at an elite level in an effort to perform week after week.
Every pain killer has a downside. Paracetamol (Panadol) does and Aspirin too, but in this feature we’re going to look at a real and all too common killer. Opioids are the big daddy of easily available pain management. They generally work the best, particularly on severe injuries, but the death toll derived from the addiction rates are frightening and climbing year-on-year.
Why is this something that needs to be addressed in a dirtbike magazine? Because riders, to be more specific racers, are at risk of opioid addiction and the horrors that can follow.
I’ve spoken to several riders off-the-record who have described turning to opioids (prescribed by a doctor), to cover an injury and race the following weekend. That stretches to the next weekend and the next and then it’s damn hard to get off that pain killer because an opioid is addictive – heroin is an opioid for example.
One rider explained that he would save his daily doses until the night time so he could take them all in one hit to achieve that high feeling the opioid brings. So he wasn’t using them to kill pain all through the day, instead the compulsion was to accept the pain and be rewarded with a big dosage at night. I recently broke my wrist and had to tell the doctor I didn’t want the Endone he was about to proscribe me because I know I’m partial to that high and that’s not a good thing – it might be legal but I’m a dad and I have a job, a lawn and a dog and things that need to be done. I don’t for one second assume that I’m immune to the lure of opioids and getting one more prescription and then one more just to keep some around and on and on it goes.
The danger for athletes is two-fold. It’s masking a severe injury and risking making it worse as you ‘battle through it,’ and then it’s the risk of addiction. Stephane Roncada was at the top of the sport and battling James Stewart for wins when he started using opioids to deal with a back injury, which eventually lead to three months in rehab to get off the popular med, Vicodin. As he told Transworld Motocross in 2005, “The symptoms from Vicodin withdrawals are horrible. The symptoms are the same as people who are addicted to heroin, and it will make you go completely nuts. And on top of that, I had a deep depression. It started even before rehab. The more you take Vicodin, the more your body hurts when you don’t have it, and the more depressed you are, so it makes you suffer because you can’t stop. If you do, you’re completely miserable. I got to the point where I couldn’t make a phone call or watch TV or run an errand without it. I couldn’t do anything.”
Austin Stroupe went down a dark path via opioids which essentially derailed a career which at one point had him battling Ryan Dungey for wins to since then having been arrested for possession of heroin.
Nico Izzi has had troubles that began with opioid addiction which lead to heroin addiction, an overdose, photos online of a girlfriend with a black eye and finally prison time. Taking it one, awful step further, Tyler Evans committed suicide after severe bouts of depression and personal struggles which many tie to the use of opioids.
Jumping to another sport, the death of three times World Surf champion, Andy Irons, shocked many but to those close to him his opioid addiction had reached horrendous proportions and brought about severe mental health problems.
To give you an idea on how far this can go, Australian rapper, 360, admits to swallowing up to 90 pills of Nurofen Plus a day at the height of his addiction. That was primarily to get him through a day when heroin wasn’t available.
These guys didn’t get their opioids illegally at first. They were prescribed by a doctor to treat an injury. All too often this isn’t monitored properly and so the intake becomes excessive. It’s no longer only about treating an injury but getting the euphoric feeling that opiates bring. After a while the supply is either cut off, becomes less effective or too expensive and the somewhat readily available solution is another form of opioid, heroin. Because the addiction is that damn strong.
THE DEVILS’ IN HOW YOU USE IT
According to figures supplied by the CDC (Centre for Disease Control), about 200 people die of a drug overdose every day in the US and around two thirds of them are overdosing on opioid pain medication. In 2016 alone, 42,249 US drug fatalities, 66 per cent of the total, involved opioids, the report says. That’s over a thousand more than the 41,070 Americans who die from breast cancer every year.
Figures from the Australian Institute of Health and Welfare show that one million Australians aged 14 years or older have reported recent non-medical use of a pharmaceutical drug and that deaths from the use of opioids has more than doubled here over the last ten years, while sadly prescriptions for these drugs continue to rise which shows how willing health professionals are in dispensing opioids, though to be fair it’s a far greater problem in the States than it is here…yet.
So what’s the overriding message here?
Opioids are a part of our sport. We are often in pain and they kill that pain better than a Panadol or Nurofen. But the transaction isn’t that simple. They can be dangerous. You almost certainly won’t be told this in any detail when the prescription is handed over which is a big part of the problem. They are, for some people, deeply addictive and that addiction leads all too often to depression, a move to a different drug when the supply runs out or low and as we’ve seen, lives are ruined or in the worst cases ended. That’s not the case for everyone but it’s just not rare either.
The message from me to you is to be careful. To recognise if the pain killer you’re on is no longer being used to do that job but to alter your state of mind. And let’s be honest here – it’s a pretty good feeling to be high on opioids. That’s why it’s been such a successful drug both legal and illegal in the first place. Wars have been fought over the supply control. It finds a sweet spot in some people that can’t be matched.
So maybe as a first step, give the pack to someone else who can dole-out the correct dosage when needed so you’re not able to go too far in the first place. But, if you recognise or if you’ve been told that something isn’t right, don’t blow it off. Don’t let it go too far. At least take the examples of the well-conditioned athletes I’ve mentioned above, who knew their bodies, had trained so hard to achieve one thing and dedicated their lives to competition and yet saw it all collapse from the ingestion of a pill that made them feel euphoric and calm but in the background is doing damage to their bodies and their minds.
I’m not saying never take an opioid, just do so knowing the dangers and be mindful of the length of time you’re on them.
The American Journal of Public Health reported that teenage athletes are 50 percent more at-risk of misusing prescription drugs so this is a problem that’s all too relevant to dirtbikes but not talked about nearly enough.
At the top of the tree is fentanyl, an opioid that can be hundreds of times more potent than heroin…just let that sink in. Deaths from fentanyl, pethidine or tramadol have increased nine times from 2006 which is when it became easier for doctors in Australia to prescribe them. In fact prescriptions of opioids rose from ten million in 2009 to 14 million in 2016 (Penington Institute). The flip side is always that opioids are undeniably excellent pain killers and many people are in need of a drug far more powerful than anything ‘over the counter’ to treat legitimate maladies.
But the numbers don’t lie. Opioid deaths in Australia outnumber those of heroin or ice or any other drug category for that matter (smartrecoveryaustralia.com.au/Penington Institute) so while the US has a serious issue on its hands, our society isn’t immune to the effect and we need to recognize the dangers.
We have a small community here in the world of dirtbikes and opioids have well and truly found their way in. That doesn’t mean we can’t use them responsibly but let’s look after each other on this one.
OPIOID OR OPIATE?
I’m not a doctor. I’m not even all that smart if I’m to be honest. All of the info in this feature has been taken from excellent sources and to explain the difference between opioid and opiate I’ve left it to the centeronaddiction.org to take it from here.
“Opiates are drugs derived from opium. At one time “opioids” referred to synthetic opiates only (drugs created to emulate opium, however different chemically). Now the term Opioid is used for the entire family of opiates including natural, synthetic and semi-synthetic. An opiate is a drug naturally derived from the flowering opium poppy plant. Examples of opiates include heroin, morphine and codeine.
On the other hand, the term opioid is a broader term that includes opiates and refers to any substance, natural or synthetic, that binds to the brain’s opioid receptors – the parts of the brain responsible for controlling pain, reward and addictive behaviours. Some examples of synthetic opioids include the prescription painkillers hydrocodone (Vicodin) and oxycodone (OxyContin), as well as fentanyl and methadone.
It is important to note that while all opiates are opioids, not all opioids are opiates. Additionally, just because opiates are natural does not mean they are less harmful. Just like opioids, opiates are highly addictive and frequently misused.” – centeronaddiction.org
Australia’s Annual Overdose Report 2018 – Penington institute
Opioids continue to be implicated in the majority of accidental drug-related deaths in Australia. Comparing 2002-06 to 2012-16:
• The rate of accidental deaths involving heroin increased 1.8 times;
• The rate of accidental deaths involving oxycodone, morphine or codeine doubled (two-times increase);
• The rate of accidental deaths involving methadone doubled (two-times increase);
• The rate of accidental death involving fentanyl, pethidine or tramadol increased by seven times.
• Overall, the rate of accidental deaths involving pharmaceutical opioids between the 2002-06 and 2012-16 comparison periods has increased 2.4 times across Australia.
• Upon closer analysis of the data, it becomes clear that regional areas are driving the increases in fentanyl-related mortality. In QLD and NSW, the two states with the highest rate of fentanyl-related mortality, the greatest number of deaths occur outside of the capital cities.