Experts caution against punitive measures as MLB, union discuss opioid policy

Major League Baseball and the Major League Baseball Players Association hope to agree on revisions to their drug policy in response to the sport's opioid epidemic by the end of 2019, but questions remain regarding potential discipline and treatment.

The difficulty may lie in differentiating between issues related to opioids - like oxycodone and fentanyl - and those related to the use of performance-enhancing drugs, medical experts told Jared Diamond and Louise Radnofsky of The Wall Street Journal.

"It's not the right mentality to think about this like a PED that they have to stamp out. That kind of mentality might make this worse," Joshua Sharfstein, a physician and vice dean of the Johns Hopkins Bloomberg School of Public Health said. "For a PED, people are trying to cheat. For opioids, they've lost control to a chronic illness inside their brain."

MLB currently tests for opioids and other "drugs of abuse" if it has "reasonable cause." The union has generally opposed mandatory tests for these substances based on concerns related to privacy and due process, as well as questions regarding what would happen should a player test positive.

Talks between the league and union regarding a revised drug policy started after the opioid-related death of Los Angeles Angels pitcher Tyler Skaggs. News of preliminary discussions came shortly after the release of Skaggs' autopsy results in September.

Under current policy, players who test positive for opioids are initially referred to a treatment board and may be suspended should they fail to comply with an assigned program. Experts are wary of a new policy that prioritizes discipline over treatment.

Punishment "drives people further and further away from the resources and the support systems that can really help them, because we've created this stigma that they're doing something wrong or that they're weak," said Greg Marotta, the CEO of CleanSlate. CleanSlate operates treatment centers for opioid and alcohol addiction.

"(Skaggs) probably was not weak," Marotta added. "He was struggling with things. He needed help in a system that has created a mechanism by which it's not OK to ask for help."

The medical experts interviewed by Diamond and Radnofsky suggested an ideal MLB system would involve medication, therapy, and discreet monitoring of players dealing with opioid-related issues.