When I was young, I was a big reader and, if I got my hands on a series, then I wanted to finish it. That included such literary gems as The Saddle Club, the Jinny series, by Patricia Leitch, and, of course, that cornerstone of young adult fiction in the 80s: Sweet Valley High. My mother banned me from reading the latter after I read On The Edge. In this instalment, Regina Morrow, a sweet and wealthy girl, who knows the Wakefield twins, falls in with a bad crowd and takes a tiny amount of cocaine. She dies.
Honestly, that is probably why I’ve never even been remotely tempted to take cocaine. That and my medical education and my autopsy experience, of course.
Recently, Evgeny Kuznetsov of the Washington Capitals, tested positive for cocaine use in a routine drugs test. This has led to a four year ban from international hockey but, because the NHL doesn’t consider cocaine a perfomance-enhancing drug, he’s unlikely to face NHL discipline. It is, however, considered a substance of abuse and he has agreed to undergo education, further regular tests and an interview with the NHL Commissioner.
It is unfortunate that, earlier in the summer and a couple of months prior to this development, a video emerged of Kuznetsov in a hotel room.
Now, he wasn’t taking cocaine in the video, but he was certainly cocaine-adjacent.
He denied all knowledge of the situation and said that he excused himself from the room when he realised what was happening. Unfortunately, he also said that he would pass a drug test. Reader, he did not.
Unfortunately, Twitter responded as Twitter does. For one, I’m disappointed that Kuznetsov lied. However, drug addiction and drug use are not to be taken lightly and we simply cannot know how big an issue this is for Kuznetsov. Drug use is not a character flaw. The important thing is that he’s now owned the situation, he’s seeking treatment and he is supported, by his family, his friends and his legions of fans. And, yes, disappointed as I am, I support Evgeny Kuznetsov.
There were three terribad takes that I came across. The first set were the bad faith tweets claiming that people were more upset about this than about the badly-handled cases of domestic violence in the NHL. This are two separate issues and no one should trivialise how appallingly the NHL deals with accusations of domestic violence. It is clearly a huge problem that someone who tests positively for PEDs automatically gets a longer suspension than someone who has committed violence against women (or anyone). The fact that the NHL is too toothless to ban Slava Voynov for life tells us everything we need to know.
The second alarmingly awful takes come from people who are trivialising cocaine use. I saw a disturbing number of people claim that it was just cocaine. Cocaine is highly addictive. It is an incredibly dangerous and unpredictable drug. Users do not built up a tolerance to it and it is dose-independent; this means that any amount of cocaine can cause catastrophic, usually cardiac, side effects.
As an autopsy pathologist, I can assure you that any amount of cocaine is significant. Death in these circumstances may not be termed ‘cocaine overdose’ but it may well be termed ‘cocaine toxicity’.
Regina Morrow, fictional though she is, is a remarkably accurate cautionary tale. She had a pre-existing cardiac condition that predisposed her to that fatal outcome.
The third bad take that I want to mention, and the last, is this notion that because cocaine use is allegedly very prevalent amongst NHL players, we shouldn’t be alarmed. To the best of my knowledge, there is no data about the specific rate of cocaine-related morbidity and mortality amongst athletes but the rate of cocaine-related deaths is rising in the United States, and around the world.
Applying a little bit of pathophysiology knowledge, however, would suggest that cocaine is an absurdly stupid thing to do when one is an athlete. As I mentioned previously, cocaine affects the heart. It does this in a number of ways, in both acute and chronic mechanisms. It affects the heart muscle itself, and it affects coronary arteries, which supply blood to the heart, by thickening those vessels and causing thrombi, or blockages. Given the anaerobic demands placed on NHL players, anything that can disturb the equilibrium of the heart is a huge risk to take. Cocaine can either cause a fatal arrhythmia, or it can cause a myocardial infarction (heart attack) and both are causes of sudden death.
Now, I know that I’m not going to change anyone’s mind but I wanted to speak my own mind.
I love Evgeny Kuznetsov, even though I’m deeply disappointed at how all of this has transpired, and I know that this incident has affected people who have either lost loved ones to drug use or continue to see them struggle.
I’m rooting for Kuznetsov, I support him and I sincerely hope we see him giving the bird in the best and most Kuzy sense, in the upcoming season.