Steffon Armitage gives an "abnormal" test

http://www.espnscrum.com/france-top-14-2012-13/rugby/story/167588.html#

They are right, depending on his metabolism the morphine could be easily explained by the pain-killers he was on.

Also, who the hell would take morphine as a performance enhancer? You'd feel less pain, but you'd also be unable to think clearly or do anything!

ChequeredJersey wrote:They are right, depending on his metabolism the morphine could be easily explained by the pain-killers he was on.

Also, who the hell would take morphine as a performance enhancer? You'd feel less pain, but you'd also be unable to think clearly or do anything!

Maybe they should test more front rowers for Morphine

ChequeredJersey wrote:
Also, who the hell would take morphine as a performance enhancer? You'd feel less pain, but you'd also be unable to think clearly or do anything!

Bloody hell half the Irish national side must be on it!

Morphine is feican brilliant

Yeah but not as tool to improve rugby!

Also, Stef's build leads me to the conclusion he is not a heroin addict

eirebilly wrote:Morphine is feican brilliant

cracker! billser

mistake by Toulon medic who forgot to report it on time I guess...or a ploy to prevent Armitage to play in the England summer tour in the event he had been selected

He has a special metabolism. Or he's the only player to ever take painkillers.

One of those.

First up is that we don't know what these abnormal levels are and whether they are consistent with the explanation given. We shall see, but for now I will give the benefit of the doubt and assume this is all innocent. However, innocent is not okay in my view and what concerns me here is that the reaction to this is likely to be "...oh well, it's just pain killers, no problem then". Well actually it is a problem.

Painkillers can improve performance. One of the many factors that can limit physical performance is pain. Pain is not a curse, it is there to inform you that either something is damaged and needs to be looked after, or that you are getting closer to your limit than your body would like and may cause damage. Certainly in the case of the latter, numbing the pain allows you to push yourself that bit further (naturally this comes with an increased injury risk).

Total aside from any potential benefits, I think it's fair to reflect on why doping is banned. I'm pretty sure it was some time in the 60s that an anti-doping movement started to gather pace. It wasn't some kind of concern over technology giving an unfair advantage - most products were readily and cheaply available, and technology has and will always give an advantage (be it better equipment, analysis, diet, etc). The reason for the anti-doping movement was to protect the athletes, to try and create an environment where they didn't need to dope (and risk their health) to get to the top of their sport. If we are going to allow teams to use painkillers to excess, pushing players beyond the limits their body can reasonably tolerate then what was the point? Why don't we just let them take whatever they like and be done with it? Personally I don't want players playing through injury and/or causing injury that might otherwise have been avoided. This can result in them being retired earlier than they might otherwise be the case, and can completely destroy their joints and ligaments causing them a whole host of problems later on in life.

Now, I'm not completely against pain killers, nor am I having a go at Armitage (I think there should be rules on this, but never applied retrospectively). Of course there are times for pain relief, I'm not suggesting that athletes should be banned completely. If you've got a headache you take a couple of paracetamol, if you've taken a slight knock you take a couple of ibuprofen. If you need something stronger like codeine then fair enough that too is fine. However, as I see it if you do need something stronger ibuprofen/paracetamol to be able to take to the field then you should be resting and recovering not causing more damage to your body.

Apologies for rant, but there you have it!

Using pain-killers prophylactically is dangerous, as Big says pain is a vital sign from your body that you are damaging it.

The solution is advice, preferably from medical professionals and the team coaches, because the practice affects the team and the player adversely but not the sport. Rules put in place will stop pain-killers use where it is appropriate and are not the best way to sort out this problem.

I am sure, however, that Armitage's test is not related to an attempt to cheat. Even codeine (as opposed to morphine) would only adversely affect your performance, as it makes players sleepy, impairs thought, will make you seem to be more dehydrated, reduces the action of the sympathetic nervous system that you need to run or "fight" at your best, dulls your reactions, reduces your breathing (not physiologically relevant usually in Codeine but with exercise it would be only an impairment) and can cause dizziness. I would go so far to say that it would be one of the most useless possible drugs on the rugby field. Doesn't matter that you can't feel pain if you are also half-asleep

I take the point that blanket rules may stop usage when it is appropriate. However, I'm not convinced that advice alone is sufficient - certainly not from a coach that has a vested interest in getting a player onto the field, or a team medic that may be under significant pressure to achieve the same. There really needs to be some kind of independent check to ensure that long term damge isn't being overlooked for short term gain.

Complete non-story until results come in. Slow press day, and they just can't help themselves whip up a little controversy where none exists.

I really do hate the British press.

I know that you are serious CJ but i can tell you that i was on Morphine for a bit a few weeks ago and i have never felt better. I have clear memories now of scoring the winning try for Ireland in RWC-2011.
You should all try living in a Morphine world for a day or two

It's good sh*t. Happens to be part of the reason it's so addictive

I'll have some of that jack.

Not even going to joke about getting any, just in case the GMC get hold of that info!

If I can offer a bit of perspective from my experience as the doc, both on duty at a lot of Rugby matches and other sports (though below the top level) and as an Orthopaedist. If I wanted to numb someone up, there are a number of approved legal injectables I would prescribe and administer. The last thing I would use is any opiate derivative (morphine, codiene, etc.). They slow reaction time and have negative impact on the cardiovascular system. Even at the low doses one would find in Panadol Ultra or Nurofen Plus. If a top athlete's reactions are even slightly impaired, the injury risk skyrockets. I have no idea why Armitage would take it or why it might have been recommended. But no possible way it will enhance performance.

Offering a strong narcotic for serious pain relief is not done casually. Just the opposite, really. When needed, however, it can be a life saver.

whocares wrote:mistake by Toulon medic who forgot to report it on time I guess...or a ploy to prevent Armitage to play in the England summer tour in the event he had been selected

, i missed this one yesterday.

Dislocated my shoulder a few years ago and was given morphine, absolutely top gear I can understand why people can get hooked on it. Ddin't score the winning try for Ireland but was high enough to have an "out of body" experience - I watched the doc and nursing staff putting my arm back in from the ceiling of the treatment room.

I wonder if blind people ever have out of body experiences?

I'm not denying that they exist. A medic (in Southampton I think) is doing some research on it by putting pictures on top of cupboards an other places above the normally visible eye-line.

doctor_grey wrote:If I can offer a bit of perspective from my experience as the doc, both on duty at a lot of Rugby matches and other sports (though below the top level) and as an Orthopaedist. If I wanted to numb someone up, there are a number of approved legal injectables I would prescribe and administer. The last thing I would use is any opiate derivative (morphine, codiene, etc.). They slow reaction time and have negative impact on the cardiovascular system. Even at the low doses one would find in Panadol Ultra or Nurofen Plus. If a top athlete's reactions are even slightly impaired, the injury risk skyrockets. I have no idea why Armitage would take it or why it might have been recommended. But no possible way it will enhance performance.

Offering a strong narcotic for serious pain relief is not done casually. Just the opposite, really. When needed, however, it can be a life saver.

Always good to get your input doc. As a 37 year old who still has the occasional run out with the firsts I have been know to dose up on one of those products prior to a game. Given that 80% of our under 30 year olds have had to emigrate in the past year our dressing room often looks like a geriatric unit. Serious smell of talcum powder. Why are the benfits of talc only realised after 35?
Anyway, the Nurofen plus are handed round like sweets. I can't imagine my knees allowing me to play 20 minutes with out them. I haven't felt any of the side effects you mention except a tingling in my legs which is actually quite pleasant. However trusting your word that it's probably not the thing to do, what would you recomend? A lengthy warm up and stretch can only do so much.

What's the depth of your pharmacological knowledge Doc?
Clearly more than most of us. Is your view that Steffon was subject to normal biochemical processes or that he was just an effin idiot for taking stuff that every sportsman should know - not self-prescribe?

Portnoy wrote:What's the depth of your pharmacological knowledge Doc?
Clearly more than most of us. Is your view that Steffon was subject to normal biochemical processes or that he was just an effin idiot for taking stuff that every sportsman should know - not self-prescribe?

Good Question...!

Hey guys, sorry for not checking back in here earlier.
Let's take Steffon first. Opiates are compounds which most people metabolise at a fairly predictable rate. Highly tuned athletes perhaps slightly faster. Unlike steroids which can have false positives or false negatives for a number of reasons, the opiates are fairly easy to analyse and detect. Very difficult to have an exagerated high measurement. I hope the test was run twice with two different specimens. The reason for that is although the test is run automatically and is reliable, it is still set up by people, and people can make mistakes. But two positive results mean the material is present. But to be clear - these do not enhance performance in any way.
Conclusion: Dumb decision to take it near game time regardless of whether a doctor is involved or not. If there was a chance of being drug tested, be smart.

Submarine,
To start with, I feel your pain. I have some years on you and are still lacing up the boots to get rocked every week or so. I usually take four ibuprofens (Nurofen) at 200mg each (the standard dose) before playing, but not comnined with codiene. The codiene does slow your reflexes which makes you less productive and have a higher potential for injury.

To be fair, I know what gets passed around in a locker room and how it gets washed down. I used to do whatever was necessary to stay upright and minimise pain after playing. For the obvious reasons, I wouldn't endorse taking Nurofen Plus or anything similar before playing and certainly not in excess of the stated dosage. If you need a couple after playing, that's perfectly fine, that's the dose. Even a second, third or fourth dose 6 hours in between. Just be smart, no matter what you do. Also please keep in mind it is legal in the UK without perscription, and for good reasons. However, as the regulatory environment becomes more strict, everyone needs to be more selective how it is used, or it may be restricted as well.

Conclusion: Take 4 ibuprofens before playing (with a little food, please). Then apply liberal amounts of the smelly liniment before playing - the strongest, most repulsive one you can find. My personal favourite is Tiger Balm, but there are many others. Usually the stronger the smell, the stronger the cream/gel. Much of the impact comes from the smelly extracts and how they react on the skin. You may need it afterwards as well. This is what I do.

Oh yes, I love the smell of liniment and talc. It smells like victory..............

Tigerbalm is the post match warm down of champions. Tigerbalm and a Green King or two sooths all pains.

yappysnap wrote:Tigerbalm is the post match warm down of champions. Tigerbalm and a Green King or two sooths all pains.

Your friendly doctor prescribes liberal amounts of Tiger Balm with Boddington's (not in the same glass). Medically proven and tested with beat-up old centres.

Thanks for that doc. When it comes to linament, I'm like the non smoker who goes for beers on a friday with his work mates and mooches 20 cigarettes of any brand.
If it's smelly Ill rub it on. I have been know to borrow my mothers Arthritis stuff too. Not nearly smelly enough though.

Just don't grab the blue cheese by mistake, that definitely doesn't work.

Sometimes I need 300mg of Tramadol and 150mg of Diclofenac to get me through a day at work.

It's that or an operation and a minimum 8 weeks off work, painkillers are there to help people get through their daily lives without any more misery than absolutely necessary.

Don't diss 'em is my opinion, if Armitage took some PKs that metabolised into morphine what's the big deal? Dope testing is there to stop cheats from cheating, not to punish the side effects of certain medicines when mixed together.

As far as I'm concerned, pain is there to be managed and as long as you do it without breaking the rules, get on with it.