Anaesthetics over aesthetics: welcome to rugby league’s painkiller knockouts

Famously, Andrew Johns played the 1997 grand final with a punctured lung and broken ribs that he only began to feel again after the injections and the celebrations wore off. Cameron Smith played his last match, the 2020 grand final, with painkilling injections for broken ribs. Cooper Cronk played the 2018 grand final with a broken shoulder blade and a brain switched off to the agony via ultrasound-guided drugs administered 15 minutes before kick-off and again at half-time.

We don’t hear so much about the failures, not since the horrible result of Graeme “Changa” Langlands’ needle before the 1975 grand final, when instead of numbing his groin it gave him a dead leg. Nor do we hear much about the everyday reality of painkiller use in professional sport. If more was heard about it, someone might start to think something is wrong.

Why are painkilling drugs legal? The use of strong opioids like morphine and synthetics like fentanyl are “controlled” in hospital settings. Mild pain relievers and anti-inflammatories such as paracetamol or ibuprofen are commonly used and legal. But between these poles are a large spectrum of painkillers, and they cause more ongoing problems for athletes than many substances on the banned list.

Josh Addo-Carr, who has allegedly tested positive for cocaine, had finished his season, and the only performance he could have enhanced was that of having a good time. Nick Kyrgios, a vocal critic of Jannik Sinner’s positive tests for performance-enhancing drugs, copped it sweet when he tested positive for cocaine after a night out. There is a selective logic at work here.

If we compared how many ex-athletes have harmful long-term addictions to painkillers to how many develop a cocaine habit, we might re-think what’s legal and what’s not.

The World Anti-Doping Authority (WADA) makes an exemption for “therapeutic use” of drugs that might otherwise be illegal. These include drugs for conditions ranging from asthma to acne as well as potentially addictive painkillers. The rationale, according to WADA, is that “there are no reasonable, permitted, alternative treatments available” and “the substance does not enhance performance, it just brings the athlete back to normal health.”

This is, for want of a better word, warped. Of course there are no alternative treatments: this is why injuries are injuries. They hurt. You can only play with injuries by numbing the pain. As for “not enhancing performance”, let me suggest that an athlete who can run and pass and kick with the help of painkillers is enjoying a more enhanced performance than if he was lying on his couch watching – which is what, for the sake of his “normal health”, he should be doing. And what is a drug addict doing if not taking a substance to feel “normal”?

The therapeutic exemption for strong painkillers exposes the arbitrariness of deciding which drugs are banned and which are allowed. Cocaine enhances no-one’s performance unless they take it on the field – it acts quickly and then stops. Since Diego Maradona’s time, no top athletes have been spotted having a bump during play. This is not to say anything positive about cocaine, just that it’s not a performance-enhancing drug. Likewise, cannabinoids are on the banned list even though the only Olympian who performs better for having it in their system is Snoop Dogg. Interestingly, many ex-athletes are using cannabis, legally, for pain management after they have retired. Yet, it has no exemption while they are still playing.

Painkiller abuse is sport’s biggest dirtiest secret, and it starts with prescribed, approved painkiller use. There is a distressingly long list of athletes who have begun using them while playing and then, unable to stop, have their lives wrecked by them in retirement. If harm were the true criterion by which drugs were made illegal, the list of “therapeutic exemptions” would look very different. And when it comes to “drug cheating”, painkillers are a lot closer to obtaining a pharmaceutical advantage than smoking a joint or snorting a line on holidays.

But … it’s the finals! We want to see Cleary, Yeo, Trindall, Walker and all those players who are being “brought back to normal health” with the help of pills and potions. If painkillers were illegal, we might not get the star power or the Cronkish legends of drug-fuelled heroics. If rugby league players were not allowed to get needled up to play, then the winners would have an asterisk over them because so many injured stars would be missing.

Yet, we tolerate a different kind of asterisk. We encourage footballers to play like there’s no tomorrow. We allow rules that call this “bringing them back to normal health”, so they can legally take dangerous substances. Among all the offerings that athletes make and that we ask of them, the trading away of their long-term health is the one that comes with the biggest asterisk and the deepest regrets. There’s nothing heroic about getting shot up with chemicals to play with a broken body; it’s just a legalised form of human sacrifice that shows the inconsistencies in our rules about drugs in sport.

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