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Opioids in Baseball: ‘More people are going to die if this doesn’t get fixed’

Los Angeles Angels of Anaheim v Seattle Mariners

SEATTLE, WASHINGTON - MAY 31: Tyler Skaggs #45 of the Los Angeles Angels of Anaheim warms up prior to taking on Seattle Mariners during their game at T-Mobile Park on May 31, 2019 in Seattle, Washington. (Photo by Abbie Parr/Getty Images)

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Editor’s Note: The following story contains both reporting and opinion/editorial content.

On July 1, Los Angeles Angels pitcher Tyler Skaggs asphyxiated while under the influence of fentanyl, oxycodone, and alcohol in his Texas hotel room. Last weekend, ESPN reported that Eric Kay, the Los Angeles Angels’ Director of Communications, knew that Skaggs was an Oxycontin addict, is an addict himself, and purchased opioids for Skaggs and used them with him on multiple occasions. Kay has told DEA agents that, apart from Skaggs, at least five other Angels players are opioid users. He reportedly also told DEA agents that other high-ranking Angels executives were aware of Skaggs’ opioid use. The Angels have denied that the team was aware of Skaggs’ addiction or Kay’s involvement until the ESPN report came out.

Last week news surfaced that Major League Baseball and the Major League Baseball Players Association are in conversations about possibly expanding baseball’s drug testing regime to include opioids. There has been relative silence, however, regarding Kay’s allegations that several players on a given team could be abusing opioids and that team officials could be aware of such use. An MLB spokesperson said that “MLB was unaware of any of these allegations. MLB will fully cooperate with the government investigation and conduct its own investigation when the government investigation is completed.” That’s an understandable position for the league to take given the ongoing investigation.

But one can’t help but wonder what those in and around the game think about Kay’s claims to law enforcement. To that end, I spoke with six baseball sources to get their insight.

The six men with whom I spoke differ when it comes to assessing the specific scope of baseball’s opioid problem. They differ on how many players use, the knowledge and/or understanding on the part of clubs and league officials of the problem and whether Skaggs’ death and the fallout from it will bring forth changes in the way the league approaches players’ drug use.

But they all agree that opioid use in baseball is a problem and that, for various reasons, the current system in place is not being utilized to effectively combat it. Most of them voiced surprise that more has not been made of this in the three and a half months since Skaggs died and that Major League Baseball, specifically, has not been more vocal about opioid use among players.

“More people are going to die if this doesn’t get fixed,” a former front office employee of a major league club told me. “I was hoping that Skaggs would be a wake up call, but seeing how everyone is responding, it’s a bunch of ass covering and little introspection.”

Boston Red Sox v Los Angeles Angels of Anaheim

ANAHEIM, CA - JULY 31: Starting pitcher Tyler Skaggs #45 of the Los Angeles Angels of Anaheim prepares to pitch while warming up before the game against the Boston Red Sox at Angel Stadium of Anaheim on July 31, 2016 in Anaheim, California. (Photo by Matt Brown/Angels Baseball LP/Getty Images)

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A former major league player I spoke with said he knew that Tyler Skaggs had a “pill problem” years ago. “When he passed I immediately thought he overdosed,” he said. He does not have any reason to believe the team knew of Skaggs’ addiction. Another former player told me, “I’m pretty sure the team had an idea Skaggs was using, [but] they probably didn’t know to what extent.”

Both former players are less certain that there is widespread opioid use in baseball. From the first player: "[addiction in baseball] mirrors society in that some people are addicted and they’re usually pretty good at hiding it.” The second player, referring to ESPN’s report of Kay telling authorities that five other Angels players used, said, “the notion of there being five guys using opioids regularly seems crazy, but who knows?” He said that, notwithstanding what he was told about Skaggs, he personally did not know of any players who used or abused opioids while he played.

Those who work off the field have a somewhat different impression regarding the scope of opioid use in the game.

One former front office employee, while not knowing the specifics of Skaggs’ case, says that Kay’s allegations that multiple players on a team are abusing opioids “do not surprise [him] at all.”

A current player agent I spoke to is “100% certain” that there an opioid problem in Major League Baseball. “What makes baseball so special that it doesn’t have an opioid problem?” he asks. “Of course it does.” When asked if five players on a team could be regular opioid users, he said “Of course five players could be using.”

Five players on a roster, of course, represents 20% of the big league club. Opioid usage in the population at large is not that high -- the National Institute of Health estimates that 6% of those over the age of 12 have abused opioids in the past year -- but the agent and others with whom I spoke observed that professional athletes, especially pitchers like Skaggs, undergo major surgery and experience greater wear-and-tear on their bodies than non-athletes and might be exposed to opioids at a higher rate than others. That’s speculation, obviously, but it’s speculation that makes a good amount of sense. Skaggs had Tommy John surgery in 2014.

Is it possible that people in the Angels front office apart from Eric Kay knew about Skaggs’ opioid use?

“I’m 100% sure they knew,” the agent said. “There’s no way these front offices do not know which of their players are on drugs.” Maybe not everyone in the front office knows, he told me, but in every front office there is at least someone who is aware of which players are using.

Another industry source who works with players and league officials on a regular basis told me that it’s “entirely possible that five players per team are heavy users of opioids.” He added, “a lot of people knew Skaggs used recreationally,” but, he said, that “no one thought he was an addict, even if they thought he used it too much.”

He suggested that this is less about teams blatantly ignoring opioid addiction as much as it was about them not truly grasping its seriousness or knowing where, specifically, to draw the line on illegal drug use. Part of what blurs those lines: the Joint Drug Agreement makes no distinctions between the various “Drugs of Abuse” it lists, despite the fact that there is a pretty big difference between the drugs that are banned.

The industry source, the agent and a second former front office executive with whom I spoke told me that marijuana -- which, at least as far as the JDA is concerned, is placed on the same level as opioids as a “Drug of Abuse” -- is ubiquitous in Major League Baseball. It is heavily used among major leaguers, they say, and they tell me that clubs are well aware of it. Clubs, however, are generally unwilling to put a player into the league’s drug system -- which entails probable cause drug testing and, potentially, suspensions -- simply for marijuana use. Which is quite understandable given everything known about the relative dangers of these two very different classes of drugs.

But, as the former front office employee explains, that leads to a bit of a slippery slope in the minds of some front office officials.

“Marijuana use is very prevalent. It does get a little out of hand at times. I think there’s sort of this subtle acceptance of it, but it also puts people in the position of determining for themselves what rules to actually follow and what drugs they apply to.I feel like you and I can sit here and say, OK, Craig smoked a joint, that’s not the end of the world, and distinguish that from blowing lines. I don’t think everyone makes those distinctions.”

To the extent that thought process does exist among front office officials, it could speak to a lack of education and understanding about opioids specifically and addiction in general. It might also speak to a flaw in the JDA, which, in its designation of both marijuana and opioids as “Drugs of Abuse,” despite documented differences between them in terms of danger and risk of addiction, creates an equivalency between them that is unreasonable. Indeed, given the way the JDA is worded, an executive could, with the best of intentions, put a player into a treatment program based on his opioid use only to have him later, once given probable cause tests, face discipline for marijuana use. It’s not hard to imagine someone hesitating to report a player for specifically that reason.

Los Angeles Angels of Anaheim v Toronto Blue Jays

TORONTO, ON - JUNE 18: Tyler Skaggs #45 of the Los Angeles Angels of Anaheim leaves the field during a pitching change in the eighth inning during a MLB game against the Toronto Blue Jays at Rogers Centre on June 18, 2019 in Toronto, Canada. (Photo by Vaughn Ridley/Getty Images)

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But let’s say a team does not drop the ball the way the Angels appeared to have dropped the ball with Tyler Skaggs. Let’s say that a team official became aware of Skaggs’ opioid use and, per the JDA, referred him to the league who them put him in a treatment program. Would that have made a difference here?

Those to whom I spoke are skeptical.

The industry source is critical of the treatment plans, telling me “they are geared toward getting a player back on the field and healthy enough to play baseball, not toward making them truly healthy.”

The agent is more blunt.

“The goal of the league, its teams, and the MLBPA is not to eradicate drug use. It’s to get players to pass drug tests.”

The agent believes, based on his clients’ own experience with the treatment program, that the league’s drug program would be happy with a result in which a player left the program free of addiction from a substance which is banned under the JDA but with an addiction to a substitute that is not specifically set forth in the “Drugs of Abuse” section of the JDA.

The agent is also critical of the resources teams make available to players short of referral to the full-blown, JDA-mandated treatment system. He says that some, but not all, big league clubs have designated front office employees who provide what those of us who work in a corporate environment might get from an EAP, or employee assistance program. A person to whom a player can confide about stresses and temptations that could lead to drug abuse but who could step in and not simply report them to the league unless it became clear that it was truly necessary. The agent has clients who have benefitted greatly from such resources on teams where they were present but have fared less well on teams that did not. He thinks that their absence might inspire players to hide their personal problems and their drug use rather than get some threshold treatment that might head off drug abuse before it begins.

No matter what one thinks of existing anti-drug infrastructure in Major League Baseball, some doubt that the league’s efforts to improve them in the wake of Tyler Skaggs’ death will bear much fruit.

The agent and the industry source are skeptical that further drug testing, including the initiation of random drug testing for opioids, will be useful. Part of this is because many opioids stay in the system for relatively short periods, making them difficult to detect unless the subject is using nearly every single day. The agent is likewise skeptical because drug testing is likely, eventually, to be accompanied by penalties and that if there were penalties attached, players with addiction problems would be less likely to seek out help before things became dire.

“Addiction is a disease,” the agent says, “and it must be treated as such.”

Whatever comes all of this, those I spoke with are pessimistic that the league will take the tragedy that befell Skaggs this past summer to heart and truly learn from past mistakes as opposed to hoping that the matter blows over. They believe that, unless something changes in the way in which drug addiction is addressed within the game, more players will die.

Follow @craigcalcaterra