Medical experts weigh in on Hamilton

When analysts weigh in on the dangers of signing Josh Hamilton to a multi-year deal they have valid reasons to be skeptical. Handing Hamilton a promise of tens of millions of dollars in exchange for steady and sustained on-field production is unquestionably a considerable risk. Recovering drug addicts often relapse. This isn't news.

Naysayers also often report as fact that Hamilton's past crack cocaine addiction has made his body brittle and more susceptible to injury in the present. But according to medical experts who specialize in the effects of recreational drug abuse on the body, the relationship between Hamilton's physical maladies and his history of crack addiction is tenuous at best, and most likely nonexistent.

While crack cocaine abuse has devastating effects on nearly every major organ in the body, medical experts say the damage is mostly short-term and typically reverses itself rapidly.

"The human body has an amazing capacity for dramatic and near complete recovery within a matter of weeks and months," said Dr. David Sack, M.D. and CEO of Elements Behavior Help and Promises Treatment Center in Los Angeles. "That's the good news."

While Hamilton has had at least two one-night relapses with alcohol since he got sober in October 2005, by all accounts he has not touched cocaine in more than seven years.

Crack cocaine wreaks havoc on the brain, causing the cerebral cortex and frontal and temporal lobes to atrophy. While Sack says it's possible Hamilton's reflex time and memory are not as good as they were before he ever used, his numbers certainly suggest his brain and fine motor skills still operate at a high enough level for him to be an elite baseball player. A team concerned that Hamilton is potentially brain damaged could administer an EEG to double-check for proper functioning, for instance.

Hamilton has certainly been injury prone. In his six years as a major league player, he has missed time with a sprained wrist, a trunk strain, a sports hernia, a broken leg, a rib cage fracture, an Achilles strain, patellar tendinitis and back stiffness, among other things. Cocaine puts the human body in an excited state that is less likely to respond to painful feedback. Muscles tighten and fear of potential danger diminishes, but that's only when a person is using.

"We don't see any evidence that crack abuse is related to dysfunction of joints and muscles long term," said Dr. Wilson Compton, M.D., director of the division of epidemiology research at the National Institute of Drug Abuse. "It just isn't there."

We don't see any evidence that crack abuse is related to dysfunction of joints and muscles long term. It just isn't there.

-- Dr. Wilson Compton

Hamilton was addicted to crack cocaine for the better part of three years. Many people who are addicted to the drug become emaciated since it stifles appetites and its users aren't likely to make good nutrition a priority.

"Poor nutrition could lead to brittle bones but because he's a professional athlete he's had access to the best doctors and foods since he's been in recovery," said Dr. Elizabeth Waterman, a psychologist at Morningside Recovery in Newport Beach, Calif. "He does have a history of injuries, but there's no evidence of a link."

Since Hamilton smoked crack cocaine and doesn't appear to have sustained any permanent brain, heart or lung problems, experts say the only drug-related physical maladies that could sideline him down the road would likely involve his teeth, lips or gums. He left a game with an abscessed tooth in August 2008, and underwent surgery for multiple root canals in the spring of 2010. While his teeth problems are likely to continue, it is unlikely that a dental-related injury would sideline him for more than a couple of days.

Long-term cognitive effects are still possible, experts warn. Compton says research on how crack addiction affects the likelihood of developing degenerative brain diseases like Parkinson's is still in its infancy. But as far as muscle sprains and broken bones go, Hamilton likely would have had the same proclivity toward injury today even if he'd never touched drugs or alcohol in the past.

"Still, it's a very tough decision for a club because relapse rates for crack cocaine are between 70 and 80 percent," said Dr. Sack. "And if he were to relapse, the physical decline would sadly be very rapid."