Painkiller

Shaquille O’Neal was never suspended for drug use of any kind during his decorated 19-year NBA career. The rugged 7-foot-1, 325-pound Hall of Fame center freely acknowledged playing through pain and openly worried about damage to his kidneys and liver from his prolonged use of legal anti-inflammatory medications.

He also recently recounted on “Inside the NBA” a bizarre story about testing positive for cocaine ahead of the 1996 Olympics. The result was thrown out — and never publicized — because O’Neal told officials he’d eaten a poppy seed muffin shortly before the test.

Never mind that while poppy seeds can trigger a false positive test for opioids such as morphine or codeine, they can’t do the same for cocaine, which is identified in drug tests by the presence of its major metabolite, benzoylecgonine.

So in his recounting of an episode from nearly 30 years ago, O’Neal was wrong either about the illegal substance for which he tested positive or about what he ingested that caused the false positive. Perhaps he just meant to say codeine rather than cocaine.

Point being, recollections can be fuzzy, and O’Neal isn’t immune to such fuzziness, something to keep in mind when listening to the four-time NBA champion ‘fess up to his use of painkillers on this week’s “Armchair Expert With Dax Shepard” podcast.

O’Neal toggled between referring to opioid painkillers such as oxycodone and powerful, nonsteroidal anti-inflammatories such as Indocin. He said he used opioids when recovering from injuries and took NSAIDs throughout his career.

But he also said his doctor told him he was addicted to painkillers, leading to “a heated discussion.” O’Neal didn’t feel high, he said, even when he would take more than the prescribed dose. “I would do homeboy math,” he said. “If it said take one, I’m taking three.”

“It was a club sandwich, fries and two pills for 19 years.”

O’Neal first discussed painkillers during his four-part HBO documentary “Shaq,” which premiered in 2022, and on the podcast Shepard mostly asked him to expand on what he’d said then about the potential damage to internal organs, the warnings from doctors and his current regrets.

In the documentary, O’Neal had this to say: “Sometimes I couldn’t play if I didn’t take it. All it did was mask the pain…. Had a lot of painkillers. I got limited kidney stuff now going on. I don’t have the full range, but I took so many painkillers that [doctors are] saying, ‘Hey, man, we don’t need you taking that stuff now. You got to be careful.’

“My kidneys are kind of just chilling out right now,” he continued. “I don’t want to flare ‘em back up.”

Both opioids and NSAIDs can cause kidney and liver damage, and O’Neal didn’t specify on the podcast which substances caused him the most concern. He said he struggled with accepting that he might have an addiction, eventually concluding, “I had to have them. So, is that addiction?”

And he hid the use of painkillers from his wife and kids, although he said “the trainers knew.”

As far back as 2000 — a year when O’Neal was the NBA‘s most valuable player and led the Lakers to the first of three consecutive championships — he expressed concern about the dangers of anti-inflammatories.

O’Neal suspected that the kidney disease that threatened the life of fellow NBA star Alonzo Mourning might be the result of anti-inflammatories and said he would stop taking them.

Two years later, however, O’Neal had resumed NSAID use. After a stomach ailment he originally believed was an ulcer, diagnostic tests were done on his kidneys and liver.

He described the results to The Times thusly: “I’m not great, but I’m cool.”

O’Neal was playing with a badly aching arthritic big toe, a sprained wrist and a handful of unlisted bangs and bruises. He needed the pills, although it was unclear whether he was referring to painkillers, anti-inflammatories or both.

“I tried to stay off of them, but if I don’t take them I can’t move or play,” he said in 2002. “I was taking them. When my stomach was giving me problems I had to get the test.”

O’Neal has long championed non-prescription means of addressing pain. He’s been the spokesperson for the topical analgesic Icy Hot since 2003 and he spoke on Capitol Hill in 2016, plugging efforts to give police better tools to recognize when drivers are under the influence of drugs. He pledged two years of funding for officers to become drug recognition experts.

O’Neal’s comments on Shepard’s podcast are a clear indication that his use of painkillers and NSAIDs continues to weigh heavily on his mind. He added that these days he relaxes with a different vice: a hookah.

“I’ve never been into weed,” he said. “Hookah, it enables me to follow the routine of sit your ass down.”

A pharmacist has urged holidaymakers to check the rules on taking a drug which is popular in the UK, but regulated or banned in other countries

A pharmacist has issued a stark warning to the millions of Brits who regularly take a medicine that is either banned or heavily regulated in several countries, including Greece and France. Co-codamol, which is a mixture of paracetamol and codeine, can be purchased in shops and is also prescribed to 3.5 million people.

The medicine is available in three strengths, the lowest of which contains 8g of codeine to 500mg of paracetamol and can be purchased without a prescription. Higher doses (those with 15g and 30g of codeine) are available only with a doctor’s authorisation.

Despite its popularity in the UK, the drug is considered illegal in Greece and is obtainable only with a prescription. It is entirely prohibited in Ethiopia, and possession of it in the United Arab Emirates or China could land you in prison.

In Thailand, it is classified as a category 2 narcotic. In Indonesia, Qatar, Singapore and Japan, it is either regulated or banned without specific licences or forms. Even with a prescription, bringing co-codamol into Mexico is forbidden, reports the Liverpool Echo.

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Since 2018, the drug has required a prescription in Australia and also necessitates one in France, Italy, India, Romania, Ireland, Canada, the US and Germany.

A number of EU countries permit low-dose over-the-counter codeine (up to roughly 12 mg per unit), but only under the supervision of a pharmacist: these include Bulgaria, Cyprus, Denmark, France, Ireland, Latvia, Lithuania, Malta, Poland, Romania and Slovenia.

Peter Thnoia, superintendent pharmacist at online pharmacy PillTime, issued a stark warning for holidaymakers, saying: “Know the rules of the country you’re travelling to, because you’d be surprised how many everyday tablets are banned or regulated abroad.

“For example, co-codamol is available over the counter and in supermarkets here in the UK. But in Greece, the codeine element is treated as a controlled drug – so you can only bring it into the country with a prescription and a doctor’s note.

“If you’re unsure on whether your medication is under restricted use in the country you’re travelling to, then check the official embassy website for your destination. It will explain exactly what you can – and can’t – bring into the country.

“It’s always best to be safe and check before you travel, so that you have all the essential medication you need to make sure your holiday is as enjoyable as possible.”

Peter also offered guidance on how to transport medications when flying: “Always keep your medication in your hand luggage, in its original packaging with the prescription label intact. Security staff may need to verify it, especially if it’s liquid or regulated.

“If you’re unsure, ask your doctor or pharmacist for a supporting letter. This can be especially helpful when travelling with larger quantities.”