Doping? "In principle powerless": Top athletes abuse painkillers

Ivan Klasnic is probably the most alarming example of what painkillers can do to the bodies of professional athletes.

Doping? "In principle powerless": Top athletes abuse painkillers

Ivan Klasnic is probably the most alarming example of what painkillers can do to the bodies of professional athletes. Three kidney transplants are behind the ex-Bremer. He's not the only one to warn that too much anesthesia is used in football, tennis and many other disciplines.

Tennis pro Rafael Nadal could not have won the French Open title without "some anti-inflammatory" in his problem foot. Soccer star Zlatan Ibrahimovic survived a large part of AC Milan's past championship season with a broken cruciate ligament only thanks to painkillers. Liverpool's Thiago kicked his foot numb after receiving a pain-relieving injection in the Champions League final. Can elite sport still work without painkillers? The development is alarming. Doctors and doping experts warn of dramatic health consequences and call for more sensitive use of ibuprofen and Co. - they do not believe in improvement.

It's about pills that reduce fever, inhibit inflammation or numb pain, so-called nonsteroidal anti-inflammatory drugs (NSAIDs). Drugs whose active ingredients are too weak to end up on the World Anti-Doping Agency (WADA) banned list and which are usually available without a prescription. "Except in special situations, such as Nadal's chronic pain, the drugs are often taken prophylactically by professionals. That's abuse," said sports physician Wilhelm Bloch from the German Sport University in Cologne. The expert estimates that, depending on the sport and category, more than 50 percent of the participants now regularly take painkillers.

The former professional soccer player Ivan Klasnic is one of the most well-known sports cases of painkiller use and its consequences. The former Werder Bremen player said he was "toxically poisoned". "Because I was given painkillers that I wasn't allowed to have." The drugs destroyed his kidneys and led to three kidney transplants. A legal dispute with his former doctors ended in 2020 with a settlement.

In addition to kidney damage, Bloch primarily mentions "liver and vascular damage" as possible consequences of long-term medication. "And in endurance athletes such as marathon runners, where microbleeds are more common in the gastrointestinal tract anyway, nonsteroidal anti-inflammatory drugs can increase bleeding." In addition, the drugs could affect the healing process after injuries. "The ability of the tissue to regenerate is sometimes limited," explained Bloch.

The list of prominent athletes who use painkillers can be continued at will behind Nadal and Thiago. Football world champion Toni Kroos revealed last year that he had played "six months on painkillers" due to an injury. Basketball legend Dirk Nowitzki said in 2016 that he didn't have to take painkillers - "other older veterans" did, however.

And the Norwegian ski star Henrik Kristoffersen, who was able to ski down the piste again one day after a serious fall in 2015, reported at the time: "My hip is all blue. It hurts. I took a painkiller - here I am." This is what everyday life in competitive sports often looks like, said Bloch and reported on clubs in which painkillers are common. "It's like a bowl of Smarties, almost everyone grabs it."

An investigation by the National Anti-Doping Agency (NADA) in German professional football showed that between the 2015/16 and 2019/2020 seasons, on average every third athlete in the men's and women's divisions took painkillers before games. Before games in the DFB Cup, the men's quota is even 40 percent. The proportion of women is so high; according to the study, four out of ten soccer players took painkillers. In the junior federal leagues it is 14 percent. Ibuprofen was consumed most frequently.

Experts keep discussing whether abuse of painkillers is doping. "Critical. In principle, it's about increasing performance," said Bloch. "Athletes reach a pain threshold under high stress. By taking painkillers, many try to push this limit in order to perform longer," explained the expert.

So why not put the substances on the doping list? "It's a hopeless fight. In principle, you're powerless when it comes to painkillers," said doping expert and pharmacologist Fritz Sörgel. "It would go all the way to the Federal Constitutional Court if you weren't allowed to take painkillers."

Instead of issuing bans, NADA tries to talk to athletes about the reasons and effects of painkiller abuse and to show sensible alternatives. In addition to behavioral preventive measures, a changed understanding of the system is also needed - in the environment of athletes as well as in society, said a spokeswoman.

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