044 TRAMADOL IN CYCLING

In cycling the use of painkillers is as old as cycling itself.  They swallow almost  everything  to feel better and suffer less from all kinds of aches and pains that occur during races of 200 km or more, on bad roads as in Paris-Roubaix or in hellish weather conditions, like the classics in spring. The analgesics are often saved in a little plastic jar, often in combination with other preparations, in order to be ingested during the race. A painkiller from the old box is Optalidon from Spain, which contains 125 mg propifenazon and 25 mg caffeine. Please note that Optalidon from Belgium is a completely different drug. The Belgian Optalidon only contains ibuprofen. Long live the European regulations.

Left plastic jar for the race, right for the final.
The content of the jar.


TRAMADOL

Tramadol is a painkiller which in recent years has become extremely popular in the peloton. It is a more powerful analgesic than the old conventional means. Logically, it is in fact related to morphine from which it is derived. And it is still not on the doping list despite pressure from cycling itself. Team doctors and even cyclists are convinced of the performance-enhancing effects of Tramadol. Moreover, the belief prevails that the agent affects riding ability negatively whereby the large number of crashes is explained. The argument that Tramadol can be addictive and is responsible for a number of cycling junkies is less known but is certainly a part of reality. Indeed, in Thailand, where I have lived for a few years now, it is used by the outgoing youth on a large scale as a partydrug, in combination with coca cola the cough suppressant dextrometrophen and / or an antihistaminicum. Without prescription you cannot get it anymore in Thailand.

In the Gaza Strip, Tramadol is also swallowed widely. Not as a painkiller but as a softener of the inhumane living conditions by the excessively aggressive attitude of Israel.

Tramadol dosing at least not too high because of the possible side effects that are highly dependent on dose. In Thailand Duocetz was freely available. That is the same product as Zaldiar in the Netherlands. Containing paracetamol 325 mg and Tramadol 37.5 mg. It was widely used by cyclists. One or at most two tablets a day or once a day one capsule Tramadol 50 mg. The retard form was not used because of the slow uptake in the blood. The highest dose was not to be exceeded, was 2 x 50 mg of tramadol, two divided doses.

Duocetz Thailand
Tramadol 50 mg capsules
100 mg


TRAMADOL NOT ON THE DOPING LIST

Last year I wrote an article about Tramadol, the morphine-like painkiller that for some years had been widely used in the cycling peloton. I wrote it from my own experiences as team doctor of Vacansoleil in 2009 where that medicine was widely used. That was legal and without the risk of a positive doping test; after all, Tramadol was not on the doping list. It struck me that the use became increasingly intense and that many riders took it on a daily basis, even during the quiet stages in the Tour of Spain that year. And I remember the quarrel with the riders who did not agree with my decision to prescribe nothing in the final stage in Madrid, so no Tramadol. I had not experienced previously such behavior in the twenty years that I had then been involved in cycling. And in retrospect it seems to me that this was typical behavior of a junkie who wants to score his next shot.

Afterwards, I read the interview with Taylor Finney who drew attention to the ‘gray zone’ of drug use in the cycling peloton. In which he referred to the use of drugs that are not on the doping list. Analgesics (Tramadol) and caffeine he especially mentioned. Combinations of pills that the riders carry with them in small boxes in the race to take during the race or in the final. To go even deeper, to ease the pain and discomfort of the finals. Moreover, Finney noted that the number of crashes by the use of such drugs has increased alarmingly.

In addition, a for cycling unusual procession of riders and team doctors who report their concern for the use of Tramadol. With of course the usual denials but the moral of the story of the insiders is that Tramadol is a dangerous and addictive drug that increases the performance and actually increases the risk of crashes. Unanimously, the opinion of these practitioners is that Tramadol belongs on the doping list.

Moreover, I wrote an article about the use of Tramadol in the Gaza Strip. It is widely used there to alleviate the pain and suffering of the wretched existence of the entire population.
And since I live in Thailand, I also regularly tested Tramadol on my training laps on the bike. That of course leads to subjective evidence but from personal experience I dare to claim that Tramadol improves bike performance.

And WADA did not take appropriate action despite the fact that they have put tramadol for years on the monitor list. That means, they are testing for the agent, but that a positive test does not have any consequence. A spokesman for WADA stated that Tramadol is quite often found in the urine samples of riders who undergo a doping test. But an exact number or percentage of people he will not disclose, they do not have the guts. I’m not going to speculate about the disastrous policies of WADA. I know that there is a surplus of resources on the doping list that do not belong there. * Why WADA has kept Tramadol outside the doping list for years is a great mystery to me. Must the first fatal victim necessarily fall???

* You can control the use of doping substances for the simple reason that a particular agent is performance-enhancing. A second reason for opposing it is that is harmful to health. Tramadol meets both criteria: it increases performance and it is harmful to health; not only the health of the user himself, but also that of the other athletes. Crashes in finals are indeed hardly ever solo crashes. And the consequences can be dramatic. WADA claims that doping users should be detected in order especially to protect no-doping users.

TRAMADOL IN PRACTIC

Twice I experienced that riders from my team finished the race after a crash without any problem. Both riders had prior to a crash already taken their daily dose of tramadol 50 and 75 mg respectively. Examination after the race yielded, except for the usual skin abrasions, no peculiarities. In the hours after that race arose for both riders a pain in the wrist that got worse by the minute. On examination in a hospital a wrist fracture was observed for each rider.

The same thing happened to Contador during the Tour de France in 2014. In a fall he seriously injured his right knee and leg. Contador also continued for some time the race before leaving the Tour. Contador took tramadol. And with tramadol he did not feel the pain and could sustain for a long time his effort. The sharp wound in the knee and tibia fracture eventually forced him to retire.

In the above cases, tramadol pops up as a painkiller which also robs the mind of a healthy look on the physical condition.

Contador after the crash
on the bike
in the hospital

SUMMARY TRAMADOL

  • Tramadol is a painkiller derived from morphine.
  • Tramadol is extremely popular in the peloton.
  • Tramadol makes the cycling performance much easier.
  • Tramadol affects the riding ability negatively.
  • Tramadol causes a large number of crashes.
  • Tramadol can be addictive and is responsible for a number of cycling junkies.
  • Team doctors and cyclists unanimously believe that tramadol belongs on the doping list.
  • WADA has put tramadol on the monitor list for almost ten years.
  • A spokesman of WADA stated that tramadol is quite often found in the urine samples of riders who undergo a doping test.
  • After all those years tramadol is still not on the doping list.
  • In comparison with the attitude on  meldonium this is incomprehensible.
  • No transparancy about tramadol, too much transparancy about meldonium

 This smells like corruption. Of course there is no pharmaceutical company that wants their products to be placed on the doping list.