Red Sox reviewing Toradol policy

FORT MYERS, Fla. -- Boston Red Sox pitcher Jon Lester said that the team's medical staff and general manager Ben Cherington told the club's pitchers Monday that they are reviewing its policy regarding the use of Toradol, the legal anti-inflammatory drug that is widely used in baseball and other pro sports but is under increased scrutiny because of potentially harmful side effects.

Lester said he has taken Toradol "quite a bit" since first being introduced to the drug before a playoff start "a couple of years ago," but has experienced no adverse effects.

"It's good they're looking into it," Lester said. "As players, though, we just think it's a bigger Advil, a stronger Advil. But I think it's nice to know our organization cares about us long term and wants to nip this thing in the bud.

"If they ban it or outlaw it or say you can't take it anymore, it's not going to affect anybody. I think guys use it more for getting loose, and for comfort level, than masking pain."

Lester's former teammate, Jonathan Papelbon, said in an ESPN Boston story posted Sunday that he and many other Red Sox players had undergone Toradol injections, a practice he learned was not permitted by the Philadelphia Phillies, the team that signed him as a free agent last year.

Another Red Sox pitcher, Clay Buchholz, acknowledged last season that Toradol use might have contributed to the inflammation of his esophagus that sidelined him for 20 games. Buchholz was hospitalized in intensive care and lost three or four pints of blood while dealing with the condition, which is a known side effect of the painkiller.

In December 2011, a lawsuit was filed by a dozen retired National Football League players who said the league and its teams repeatedly and indiscriminately administered the drug before and during games, thus worsening injuries such as concussions.

Red Sox manager John Farrell, whose stint as the team's pitching coach dovetailed with Papelbon's time in Boston, spent the past two years as manager of the Toronto Blue Jays. Players used Toradol in both places, he said.

"Not everyone," he said. "It was guys who had a positive experience [with it]. It was not something that was recommended, by any means."

Farrell, a former pitcher who underwent two reconstructive elbow surgeries, was asked what recommendations he would make toward a Toradol policy.

"Well, one, it's a legal drug," he said. "I think there are certain instances where it's been helpful for guys. But I think one thing we always have to keep in mind is the safety of the player, and not knowing what kind of side effects it might have, if there's anything that can jeopardize that long term, then safety is first and foremost."

Buchholz's experience served as a red flag for him, though Farrell emphasized that no definite connection was drawn between the drug and Buchholz's condition.

"If that's one person that it did affect, then what's the percentage of guys who could possibly encounter that?" Farrell said. "That I don't know. I think anytime you have potential negative side effects, you have to be really careful about the recommendation of it or the prolonged use.

"If it was that detrimental, there'd be a question of whether it would be a legal drug. I don't think it falls into the PED category by any means."

A major league executive, speaking on background, said that it had become part of the game's culture years ago for trainers to administer Toradol injections, even though legally only a doctor is authorized to do so. Papelbon said he was injected by a trainer. Lester said the majority of the time, he was injected by a physician.

With MLB giving greater attention to the practice, the executive said, the Red Sox made it club policy for only doctors to administer Toradol injections at the outset of spring training last year. That policy remains in effect.

"If somebody had come up to me before all this stuff came out and said, 'Is Toradol an issue?' I would have said no," Lester said. "I wouldn't have thought twice about it.

"I think the Toradol thing is such a big issue because of the NFL lawsuits. Obviously, MLB doesn't want a big group of players to come back and say, 'Whoa, we want a part of that.'"

Lester said he thought the team did a good job of monitoring players' usage.

"I took it quite a bit," he said, "but my dosage was not like these NFL guys are taking. I was taking very small dosages.

"I like it for the simple fact it helps. I don't use it as a pain-masking agent. The dosage I was using it for was more to help get loose for the games. That can be tough in certain months, every five days getting our bodies ready to go.

"The dosages we were using and what I heard guys were taking -- I'm talking about the Red Sox -- it's nothing compared to the NFL guys."

Lester noted there are side effects to most drugs that players take.

"I've had guys taking too much Advil who had problems, who had ulcers, stuff like that," he said. "Cortisone shots, there is a risk of infection or your body rejecting it.

"I've heard of organizations at the All-Star break line their pitchers up [for cortisone shots] -- shoulder, elbow -- come back in four days."

The major league executive said it was doubtful that most teams would ban Toradol outright, because of its benefits to manage pain. What is being reviewed, he said, is whether pitchers should be allowed an injection as a matter of routine.

"It's their decision," Lester said, "and obviously they want our best interests, too. They don't just want to give us stuff, and once we're basically out of baseball they don't care about us anymore. They obviously want us to have long and healthy lives.

"And, obviously, with my past [as a cancer survivor], I don't want to jeopardize my health with more strain and issues down the road."