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Sunday, October 13, 2019

Major League Baseball has an opioid problem. Now what?

Jumping ahead to materials not being discussed in other threads:

But there’s a broader problem here: is it not starting to look like Major League Baseball has a major, major problem with opioid addiction?

One player is dead. A team employee — also an addict — was involved in the player’s drug acquisition and use. And not just some rogue outside trainer or a guy who wears a mascot costume. It was a long-standing and high-ranking front office employee. And that’s before you get to the part where, if he is to be believed, a full 20% of the Angels’ big league roster abuses opioids as well.

Which is to say that Major League Baseball, in all likelihood, does have a major, major problem with opioid addiction. It seems logical that it would extend beyond the Angels, at least. From gambling and throwing games in the early days of the game to alcohol addiction during its alleged “Golden Age” to cocaine in the 1970s and 80s and on to PEDs in the 90s and early 2000s, vice and/or addiction in Major League Baseball always — always — extends to more than one club. Players on other teams are rivals but they’re also friends, interact and socialize both during and after the season. They all face the same pressures and temptations and are thus all subject to the same addictions. And that’s before you acknowledge — which we must — that the opioid epidemic our nation has seen over the past decade respects few if any social, cultural, or economic boundaries. If five guys on a team are using, you can bet there are many more on other teams as well.

So what does Major League Baseball do about it?

Some thoughts on a broader issue in the sport, by a longtime site associate.

 

QLE Posted: October 13, 2019 at 12:18 AM | 42 comment(s) Login to Bookmark
  Tags: mlb, opioids

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   1. Walt Davis Posted: October 13, 2019 at 03:31 AM (#5890046)
From gambling and throwing games in the early days of the game to alcohol addiction during its alleged “Golden Age” to cocaine in the 1970s and 80s and on to PEDs in the 90s and early 2000s

Greenies? What greenies?

It's easy to see how pitchers would get into this -- they just have more pain to deal with and are more likely to undergo surgery at some point. I haven't read the Skaggs stuff too closely but I wonder if he started in the aftermath of his TJ surgery in 2015.
   2. ajnrules Posted: October 13, 2019 at 04:41 AM (#5890050)
The entire country had an opioid problem. Tyler Skaggs was a victim like thousands of others.
   3. Fancy Crazy Town Banana Pants Handle Posted: October 13, 2019 at 09:33 AM (#5890063)
I mean, I feel like I have known that players (especially pitchers) use waaaaay too many painkillers for decades now. Like how many stories of players shooting up with stuff to play through pain are there?... Seems like a completely commonplace occurrence. Obviously the circumstances are extremely tragic, but his really comes as exactly the opposite of a surprise.
   4. flournoy Posted: October 13, 2019 at 11:52 AM (#5890079)
The entire country had an opioid problem.


I see this assertion all the time. What data is there to support it? In my entire adult life, I haven't known anyone who I knew or suspected to be a drug user.
   5. snapper (history's 42nd greatest monster) Posted: October 13, 2019 at 11:59 AM (#5890081)
I mean, I feel like I have known that players (especially pitchers) use waaaaay too many painkillers for decades now. Like how many stories of players shooting up with stuff to play through pain are there?... Seems like a completely commonplace occurrence. Obviously the circumstances are extremely tragic, but his really comes as exactly the opposite of a surprise.

Except Skaggs was snorting lines of oxy, not taking pills for pain. It's an entirely different usage.

I've had ten surgeries, if I'm counting right, so I'm fairly well versed with opiates. Percocet, Percodin, Vicodin, Oxycodone, oral morphine, injectable morphine, intravenous morphine, codeine, etc., I've taken them all.

None of them get you high if used as indicated. They take the pain away, often make you nauseous, and make your face itch. You wouldn't use them recreationally to get that effect.

People with chronic pain do get addicted, but it very rarely kills them unless they move to snorting the pills, or taking heroin (which is often laced with fentanyl).
   6. Tom Riddle Posted: October 13, 2019 at 12:08 PM (#5890084)
#4 is a joke, right?

On a broader note, opioids seem like the most dangerous of these different addictions (gambling, coke, PEDs) if it really is spreading across MLB...
   7. . Posted: October 13, 2019 at 12:09 PM (#5890085)
None of them get you high if used as indicated.


Actually, they very much do. It took me all of two doses after surgery to realize this, at which point I quit. They aren't just painkillers, they're "drugs" in the sense in which we use that term to describe things like weed and cocaine, which is precisely why we see so many stories of addiction. It was the pretty obvious realization that they were "drugs" which made me stop taking them almost immediately.

People with chronic pain do get addicted,


This is completely false empirically. People get addicted to them because they're drugs and so they use them recreationally.
   8. Fernigal McGunnigle Posted: October 13, 2019 at 12:18 PM (#5890088)
None of them get you high if used as indicated. They take the pain away, often make you nauseous, and make your face itch.
I think painkillers affect people in different ways. A single dose of Percocet makes my wife violently ill, while I get high and sleepy-happy on basically any opiate or opioid. I could absolutely see myself getting hooked on them, while I think it would be physically impossible for my wife to become and opioid addict. This sort of thing I suspect is true of almost any drug, all the way to alcohol and caffeine (though with less divergence in drugs with smaller effects).
   9. DFA Posted: October 13, 2019 at 12:41 PM (#5890091)
Given the amount of surgeries and pushing their bodies to the maximum, it seems to follow that the baseball players would be overprescribed pain medications relative to the population as a whole. For any number of reasons, however, it is going to be difficult to find out how rampant addiction in throughout major league and minor league baseball however. I do wonder how other organizations have tried to gather data on this, if they have at all.
   10. Fancy Crazy Town Banana Pants Handle Posted: October 13, 2019 at 12:49 PM (#5890092)
None of them get you high if used as indicated. They take the pain away, often make you nauseous, and make your face itch. You wouldn't use them recreationally to get that effect.

People with chronic pain do get addicted, but it very rarely kills them unless they move to snorting the pills, or taking heroin (which is often laced with fentanyl).

It's very very risky to make generalisations about effects of drugs based of single anecdotal experiences. One of the most common reactions to opioids is that it does create a massive surge of endorphins, and creates a sensation of euphoria. But reactions to these are not uniform in any way shape or form (that is why there are so different variants of them, because sometimes you just have to cycle through the different kinds until you find one that is effective, doesn't have to severe side-effects, doesn't become addicting etc).

The other thing is that use over longer periods can have some very very odd effects. For one, the more opioids you take, the less effective they become. Which means the more you take, and the longer you use, the higher dosages you will need to maintain the same painkilling effect. Which creates stronger and stronger withdrawal symptoms when you do try and stop using.

Another is that because of the increase of endorphins triggered by the opioid use, your body reduces its natural production of endorphins, which creates a lot of adverse reactions during periods when you are not using. Feeling lethargic, depressed etc, and thus creating more incentive to use again.

There is also the very fun fact, that using opioids over extended periods can actually cause your body to generate more pain as a response. Which people try and counter by using more and more opioids.
   11. snapper (history's 42nd greatest monster) Posted: October 13, 2019 at 01:26 PM (#5890094)
It's very very risky to make generalisations about effects of drugs based of single anecdotal experiences.

Well, it's really 10+ experiences of taking heavy doses of opiates and opioids for two weeks to two months. But it is only an experience with a single person's body chemistry.

I think painkillers affect people in different ways. A single dose of Percocet makes my wife violently ill, while I get high and sleepy-happy on basically any opiate or opioid. I could absolutely see myself getting hooked on them, while I think it would be physically impossible for my wife to become and opioid addict. This sort of thing I suspect is true of almost any drug, all the way to alcohol and caffeine (though with less divergence in drugs with smaller effects).

This is true, but even if you did get hooked, it wouldn't kill you if you just kept taking the pills orally, unless you took a truly massive dose.

The deaths we see reported on a mass scale are almost all caused by heroin laced with fentanyl, or snorting the pills (like Skaggs). People aren't dying because they take 2 Vicodin every 4 hours for a long period of time.
   12. snapper (history's 42nd greatest monster) Posted: October 13, 2019 at 01:29 PM (#5890095)
This is completely false empirically. People get addicted to them because they're drugs and so they use them recreationally.

Nonsense. Even if you use them as prescribed, over a medium to long period of time you can get addicted. Opiate withdrawl is a real, physical thing.

Are you really arguing that opiates aren't physically addicting?
   13. base ball chick Posted: October 13, 2019 at 03:33 PM (#5890107)
snapper (history's 42nd greatest monster) Posted: October 13, 2019 at 11:59 AM (#5890081)

...I'm fairly well versed with opiates. Percocet, Percodin, Vicodin, Oxycodone, oral morphine, injectable morphine, intravenous morphine, codeine, etc., I've taken them all.

None of them get you high if used as indicated. They take the pain away, often make you nauseous, and make your face itch. You wouldn't use them recreationally to get that effect


- they can ALL get a particular person high/addicted with the first dose. no, not the kind where they get withdrawal, but the kind where they get the kind of reaction from that drug immediately that makes them want to take more and more the second the effect they likes wears off.

teens have gotten hooked after taking a powerful opioid for getting wisdom teeth yanked - after ONE dose.

and people can and DO overdose and die on doses of LEGAL prescription opioids. they take too much and too often and it builds up. and or they take them with al K holl which is a not good idea
   14. snapper (history's 42nd greatest monster) Posted: October 13, 2019 at 04:40 PM (#5890111)
- they can ALL get a particular person high/addicted with the first dose. no, not the kind where they get withdrawal, but the kind where they get the kind of reaction from that drug immediately that makes them want to take more and more the second the effect they likes wears off.

teens have gotten hooked after taking a powerful opioid for getting wisdom teeth yanked - after ONE dose.


That's technically correct (which, of course, is the best kind of correct) but misleading. There are are very small percentage of the population who are genetically highly pre-disposed to addicition. I think that's what people are talking about with the "addicted on one dose", or "alcoholic after one drink" claims. Those people usually have long family histories of addiction. The average person, however, requires sustained use of a substance to become addicted.
   15. . Posted: October 13, 2019 at 05:13 PM (#5890119)
Are you really arguing that opiates aren't physically addicting?


??

No, I'm arguing the exact opposite. That wasn't clear?
   16. Cris E Posted: October 13, 2019 at 05:30 PM (#5890125)
My 11th grader had an ACL done a few years ago and was sent home with script for oxycodone and a refill. I went and got it filled and wound up with 60 pills for $18, though street value at my kids' school was reportedly much higher. He took one, it made his face itch (I thought he was the only one who ever said that) and the rest sat in a bottle that I returned to his surgeon at the one month visit. No one had ever mentioned to him that they felt five dozen opiates was too many, and he appreciated the feedback. Here's the thing: even if my kid didn't get hooked there's a market for this stuff that affects the larger community and degrades the ability to track and manage it properly.

Here's another thought: pro athletes have several things working against them with regards to these drugs: injuries and actual pain management, long periods away from home, high stress work situations coupled with low job security, and by the way a fair amount of disposable income. This is not a surprise. I think the NBA and NFL's pot situation is a similar informal pain management program, just as hockey goes with alcohol and opiates. It's a real problem in a lot of places.
   17. snapper (history's 42nd greatest monster) Posted: October 13, 2019 at 06:59 PM (#5890132)
He took one, it made his face itch (I thought he was the only one who ever said that)

There's a song about it.
   18. snapper (history's 42nd greatest monster) Posted: October 13, 2019 at 07:01 PM (#5890133)
No, I'm arguing the exact opposite. That wasn't clear?

No. I said:

People with chronic pain do get addicted,


and you replied:

This is completely false empirically. People get addicted to them because they're drugs and so they use them recreationally.

Which makes it sound like you think no one ever gets addicted just by using them to treat chronic pain, only by abusing them recreationally.
   19. flournoy Posted: October 13, 2019 at 07:15 PM (#5890134)
#4 is a joke, right?


No.
   20. Jeremy Renner App is Dead and I killed it Posted: October 13, 2019 at 07:18 PM (#5890136)
My uncle lives in the upper midwest. He was in a four wheeler accident and was prescribed pain killers. Somehow other people found out and all of the sudden he was being contacted by people he had gone to high school with asking him how he was doing and wanting to visit. He ended up flushing all this stuff down the toilet and gutting it out on alleve and Advil and telling everyone he had refused the meds. He reported the experience to the sheriff office who told him that nurses get money for telling people who has received pain scrips.
   21. Jeremy Renner App is Dead and I killed it Posted: October 13, 2019 at 07:20 PM (#5890137)
   22. Jeremy Renner App is Dead and I killed it Posted: October 13, 2019 at 07:30 PM (#5890139)
The Midwest includes the states of Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, Ohio, North Dakota, South Dakota, and Wisconsin. About 20% of the U.S. population lives within the Midwestern region (approximately 63,304,744 people), the third-largest region behind the South and West. Midwesterners typically reside in rural areas with low population densities.

The primary factors contributing to Opioid abuse in the Midwest include:

Isolation
Hazardous behaviors
Poverty
Low scholastic completion
Unemployment

Opioid Use In The Midwest Is Affecting Some States And Cities More Harshly Than OthersIn 2017, drug overdose fatalities in rural areas surpassed urban rates–upending the myth that drugs are a bigger problem for cities. In addition to having higher rates of cigarette smoking, high blood pressure, and obesity, people in rural areas also tend to be older and sicker than people in urban areas. Access to healthcare is likewise worse than it is in urban areas. Many counties rely on volunteer emergency services who may not be fully trained or equipped to handle an overdose. For this reason, overdose fatality rates are higher in rural areas. Often, by the time first responders arrive to provide life-saving care, the individual has already passed

credit--Anne Hazlett White House Senior Adviser for Rural Affairs.
   23. Jose is an Absurd Time Cube Posted: October 13, 2019 at 07:39 PM (#5890140)
I see this assertion all the time. What data is there to support it? In my entire adult life, I haven't known anyone who I knew or suspected to be a drug user.


CNN story on the issue.

During 2017, there were more than 70,200 overdose deaths in the United States and 47,600 of those overdose deaths involved opioids. More than 130 people died every day from opioid-related drug overdoses in 2016 and 2017, according to the US Department of Health & Human Services (HHS).
   24. The Duke Posted: October 13, 2019 at 07:50 PM (#5890143)
I see stories all the time, it seems to be in the paper a lot but I’ve never known anyone with an opioid problem nor suspected anyone. Of course I never really saw anyone addicted to crack cocaine either. I’ve seen plenty of drug use but haven’t seen any indication of either opioids or crack.

Is an opioid addiction easy to spot ?
   25. gef, talking mongoose & vexatious litigant Posted: October 13, 2019 at 07:57 PM (#5890146)
No one of my immediate acquaintance has ever committed suicide. Clearly, self-destruction is a wildly exaggerated "problem."
   26. PreservedFish Posted: October 13, 2019 at 07:58 PM (#5890147)
My state is in the top 10 in opioid deaths per population. But for me too the epidemic is all but invisible. I presume that I just do not cross paths with the types of people that are commonly afflicted.
   27. Jeremy Renner App is Dead and I killed it Posted: October 13, 2019 at 07:58 PM (#5890148)
24--Don't know if it's easy because you need a baseline against the person's historical behavior. Opiod addiction causes someone to have erratic sleep patterns, have dramatic mood swings, and being super impulsive. Physical signs can be constricted pupils and super itchy skin.
   28. Never Give an Inge (Dave) Posted: October 13, 2019 at 09:29 PM (#5890176)
I grew up in a small, wealthy suburb of NYC and admittedly live a pretty sheltered existence today, but it’s still touched people in my life. It’s possible to be oblivious to it I guess, but a couple of guys I grew up with have died in the past few years and there was no cause of death in the obituaries (“died unexpectedly”, etc.). I officiated my cousin’s wedding earlier this year—the friend who was going to be their best man died a few months before the wedding. I don’t think anyone explicitly said that it was an OD but it was obvious to me from other comments they made. An old HS friend who got back in touch with me recently doesn’t talk about it, but I heard from others that his younger sister and brother-in-law died of an overdose a few years ago.
   29. Never Give an Inge (Dave) Posted: October 13, 2019 at 09:45 PM (#5890181)
(Not to say that every overdose is opioids or that everyone who dies unexpectedly in their 30s is a heroin addict. But my point is that if you start paying attention you may notice that it is not as remote a problem as you think.)
   30. depletion Posted: October 13, 2019 at 10:10 PM (#5890194)
Major League Baseball has a different problem from the one most of you are describing. Sure no one wants to see a ballplayer, or anyone else, become an addict. But a unique problem is the vulnerability of the addicted player to compromising the integrity of the game. From what I understand of the latest revelation about Skaggs, he wasn't wandering through the bad part of town looking for a connection, he had one guy he was depending on. An addict will do just about anything to get more dope; I've seen this first hand. So if a player has that ONE guy, or lady, he is depending on, it isn't much of a leap for that guy to get his pitcher buddy to throw a couple of meatballs to the power hitters in tomorrow's lineup. The same issue exists for people at high corporate levels (insider info) and defense workers (espionage).
   31. depletion Posted: October 13, 2019 at 10:13 PM (#5890197)
He reported the experience to the sheriff office who told him that nurses get money for telling people who has received pain scrips

Jesus, what the f is going on. This is like some sort of nightmare.
   32. Hank Gillette Posted: October 13, 2019 at 11:52 PM (#5890248)
It’s possible to be oblivious to it I guess, but a couple of guys I grew up with have died in the past few years and there was no cause of death in the obituaries (“died unexpectedly”, etc.).


I have also seen that used for someone who committed suicide (“died unexpectedly at home.”).
   33. Howie Menckel Posted: October 14, 2019 at 12:16 AM (#5890256)
I know how much everybody hates the media, but here's a little secret: for many decades, every week - particularly on weekends - the typical media desk gets calls about "unexpected deaths" - usually of a young person.

if it's foul play, it's liable to be news. a murder or a robbery spree might subsequently impact other readers, for example.

but as soon as the local police chief and the desk guy have a brief chat that it was a suicide - well, you're not going to read about it in the newspaper (or now internet).

that's a family matter, and it is respected as such - to the very, very tiny relief that such tact brings a devastated family. but that's why you can't easily find that obit.

one rare exception was when a high school kid jumped off the roof and died during recess in front of 200+ other kids. there's no putting that genie back in the bottle, obviously.
   34. Never Give an Inge (Dave) Posted: October 14, 2019 at 08:01 AM (#5890291)
#32 yes and sometimes overdoses are really suicide attempts too.

I have lost a few friends to “sudden/unexpected” deaths that were not suicides/ODs (one due to an undiagnosed heart condition, two to strokes/brain aneurisms), and they used the same description. I had to ask what happened to find out the details. So I’m not suggesting that anyone lightly toss out accusations of drug abuse. Just knowing the people in question here I’m pretty sure at least one of them was an OD.
   35. Never Give an Inge (Dave) Posted: October 14, 2019 at 08:04 AM (#5890292)
#33 thanks. Although when I say “obit” I’m talking about “in memoriam” things posted online by family/friends, or in one case an online fundraiser to pay for funeral costs. I wasn’t talking about reported newspaper obituaries.
   36. Fernigal McGunnigle Posted: October 14, 2019 at 09:09 AM (#5890304)
I see stories all the time, it seems to be in the paper a lot but I’ve never known anyone with an opioid problem nor suspected anyone.
I'd never (knowingly) known or seen anyone with an opioid problem until I moved from Chicago to Boston in 2017. Then suddenly I saw a lot of them, including seeing someone revived from an OD with a naloxone injection in Central Square, Cambridge and finding a needle and a sleeping bag on my porch one morning. Opioid addiction is a national problem with local hot spots.
Is an opioid addiction easy to spot ?
This isn't what you're asking, but the Boston homeless/semi-homeless population had vastly more people who were completely passed out (not sleeping in an intentional way, but flopped over where they lay) or were semi-conscious with a "nobody home" look than the Chicago homeless/semi-homeless population did. I couldn't prove that any individual was an opioid addict, or even an addict of any sort, but in the aggregate it was obvious that there were a lot more opioids in the Boston population than in the Chicago one.
   37. snapper (history's 42nd greatest monster) Posted: October 14, 2019 at 09:10 AM (#5890306)
I see stories all the time, it seems to be in the paper a lot but I’ve never known anyone with an opioid problem nor suspected anyone. Of course I never really saw anyone addicted to crack cocaine either. I’ve seen plenty of drug use but haven’t seen any indication of either opioids or crack.

Is an opioid addiction easy to spot ?


It's often an addiction of despair. People who become addicts are often unemployed, have health problems, are socially isolated, etc. So, it makes sense they're hard to spot.
   38. cookiedabookie Posted: October 14, 2019 at 10:45 AM (#5890344)
Being dependent on a drug to treat chronic pain is not the same as being addicted to a drug.
Signed,
Someone with chronic pain who now cannot get pain meds that work because of the opioid crisis.

I rationed out my last bottle of vicodin for two years, that's not what an addict does. That's someone who's desperate to take the edge off of their chronic pain. But instead, I take way too much tylenol and aleve, which is destroying my organs, I'm sure.
   39. snapper (history's 42nd greatest monster) Posted: October 14, 2019 at 10:49 AM (#5890345)
Being dependent on a drug to treat chronic pain is not the same as being addicted to a drug.
Signed,
Someone with chronic pain who now cannot get pain meds that work because of the opioid crisis.

I rationed out my last bottle of vicodin for two years, that's not what an addict does. That's someone who's desperate to take the edge off of their chronic pain. But instead, I take way too much tylenol and aleve, which is destroying my organs, I'm sure.


Absolutely. I sympathize. I was sent home from one of my last surgeries on the Fridsay before a long weekend with 10 pain pills, and instructions to take two every four hours. When I pointed out the math, their response was basically, tough, that's all you're gonna get. Luckily, I had leftovers from previous surgeries.
   40. villageidiom Posted: October 14, 2019 at 10:57 AM (#5890346)
No. I said:
People with chronic pain do get addicted,
and you replied:

This is completely false empirically. People get addicted to them because they're drugs and so they use them recreationally.

Which makes it sound like you think no one ever gets addicted just by using them to treat chronic pain, only by abusing them recreationally.


In the full post from which he quoted, you appeared to be making the point that people don't get addicted unless they're trying to get addicted (i.e. if they take as prescribed they won't get addicted). In that context you presented the chronic-pain group as an exception to your generality. I think he was objecting to that being the only exception, which really means he was objecting to the generality. It is confusing as he presented it, but everything else he said seems to fit with an objection to the generality.

That you did not become addicted is a blessing for you.
   41. . Posted: October 14, 2019 at 10:58 AM (#5890347)
Which makes it sound like you think no one ever gets addicted just by using them to treat chronic pain, only by abusing them recreationally.


My writing was unclear. What I meant to say is that people get addicted to them because they're "drugs," and not merely because they used them to treat pain. There are people who use them to get high even if they've never used them to treat pain.

Primarily because I have other things to pay attention to, I kind of missed the timeline where opioids even became a thing w/r/t sports pain. 25-30 years ago, guys would gulp down ibuprofen or similar anti-inflammatories (*) and it seems, though I could be wrong, that at some point since then, opioids replaced or augmented anti-inflammatories.

(*) Which also have not so great side effects, like singeing your kidneys (driving up creatine levels), raising blood pressure, and your liver enzymes, another thing I've experienced directly. At some point, it seems like anti-inflammatories were replaced by opioids. I missed that transition.
   42. depletion Posted: October 14, 2019 at 09:27 PM (#5890528)
Dear .
I don't think you missed anything w/r/t sports pain. The roots of the opioid problem has little to do with sports, but much more to do with working class people who get sore joints, tendons and muscles because they have to do physical work in order to make living. In 2005, around the time of hurricane Katrina, I was in the hospital for a week. Another gentleman on the floor told me he was in for painkiller rehab because he worked construction and had back pain. The guy was about 40. Not everyone gets kicked up to management when they get older. Somebody has to lift the garbage cans up to the truck, unload the 18-wheeler full of food, frame the house, and so on. And they have to do it everyday for years.

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