Doping

[Chuck(G)]

I was mildly surprised when this didn't come up for discussion when it was published a couple of weeks ago, so I'm posting it:

http://www.nytimes.com/2004/10/17/arts/ ... 7tind.html

[WoodSheddin]

inderal is nothing to be ashamed of

[Dan Schultz]

I was mildly surprised when this didn't come up for discussion when it was published a couple of weeks ago, so I'm posting it:

http://www.nytimes.com/2004/10/17/arts/ ... 7tind.html

There are always two sides to every story. However, if she was indeed making recommendations to her students I agree with the college's statement that "College officials, who declined to comment for this article, said at the time that recommending drugs fell outside the student-instructor relationship and charged that Ms. McClain asked a doctor for medication for her students. Ms. McClain, who taught at Rhodes for 11 years, says she merely recommended that they consult a physician about obtaining a prescription."

Aside from that, I'm a firm beleiver in "don't ask... don't tell" in most every aspect of one's personal life.

[The Impaler]

I think the bottom line is 'do what you have to do.' I myself do not use beta blockers, and actually, I enjoy the anxiety and nervousness before (and sometimes during) performances. What I've found is that changing my reaction to the nervousness or anxiety actually helps my performances. Whereas before I'd get nervous and allow that to affect response, airflow, technique, etc., now I try to harness that energy and apply it to the music I'm trying to make alive. What I've also found is that if I don't feel that before a performance, it really isn't that important to me. It's natural, human. And audiences recognize that and appreciate it. For me, music is about relating what I'm doing to my audience, whoever it may be, and I want as many human qualities about what I'm doing as possible to help establish that connection with my listeners.

That being said, there are so many ways to overcome anxiety without beta blockers that I would only reccomend them as a last resort. Studying with Pat Sheridan and Sam Pilafian and learning to use breathing to control my anxiety has been a great help to me, and more importantly, to my students.

[tjs]

I think what some people fail to realize, however, is how some people just experience "overwhelming" nerves. I never quite realized this myself till I met my wife. She has tried a whole bunch of different techniques from mental games to breathing techniques to .... We even worked together to try to help her through her nerve issues. No matter what she/we tried, she was still dying come performance time. I finally read about inderal and suggested she try it. She's pretty reluctant to take drugs, but she finally called her doctor who prescribed her some. It was exactly what she needed -- she was finally able to get through her first horn solos without having to worry about her nerves taking over.

Personally, I've never had issues with playing the tuba in public -- only the piano drives me nuts. Fortunately, I've been able to overcome most of my nerve-related issues without medication. I think it is important to keep an open mind, however, and recall that not everyone is the same and natural techniques may not work for everyone.

[Chuck(G)]

Here are a few trolls (at least I'm being honest about it) to toss around:

• * The article mentioned that a large number of performers simply get their beta blockers from associates rather than consulting a physician (which would leave a written record somewhere). But as I understand it, this is "illegal distribution of a controlled substance", a Federal crime.
  
  * Where does the line get drawn? Suppose after using beta blockers, one would like to improve their concentration, so a little Ritalin (not ordinarily necessary) does the trick. And then, maybe to improve the energy level of a performance, a little benzedrine. Of course, everyone likes to look good, so how about some anabolic steriods...
  
  * I can't cite figures, but musicians seem to experience a higher incidence of drug abuse than many other professions. Couild a beta blocker be considered a "gateway drug"?

The local community college, to their credit, has an interesting performance course, where members of the faculty and their guests crowd into an undersized room to listen to a student. The heating is turned up, members chat among themselves, tell jokes, take notes, hum, etc. all in an effort to unbalance the performer. I think it's a great idea--is this standard fare for most performance cirricula?.

[Lew]

Having experienced the same type of anxiety mentioned both when performing tuba solos, and when speaking in front of large crowds, including some over a thousand people at conferences, I completely understand the value of these drugs. Although I have never taken them, I certainly would if I found my condition to be totally debilitating.

I find it completely appropriate for a music teacher to recommend to her "adult" students that they consult a physician regarding these drugs if this level of anxiety impacted them. I don't think that it would be appropriate for her to actually give any prescription drugs to anyone, but she says that she never did this.

This appears to be the typical witch hunt mentality that seems to have taken over this country, especially by the far right and regarding drugs.

[Mark]

Here are a few trolls (at least I'm being honest about it) to toss around:

Chuck, you left the most obvious troll out:

If playing in front of audiences makes you that nervous, then maybe you're in the wrong profession.

[tjs]

If playing in front of audiences makes you that nervous, then maybe you're in the wrong profession.

No kidding. That's one of the reasons I chose to spent my day happily writing software rather than practicing for my next recital/audition.

[FarahShazam]

Here are a few trolls (at least I'm being honest about it) to toss around:

Chuck, you left the most obvious troll out:

If playing in front of audiences makes you that nervous, then maybe you're in the wrong profession.

Well... from someone who experiences anxiety on some levels, my anxiety has nothing to do with my horn playing.

Just because I experience anxiety from life, does that mean I should be dead?

Of course not!

If I can take something to help me, and only I know my limits and body, I will, thank you very much.

Also, you forget that about 99% of the audience loves to hear the music, it is your peers that make you uncomfortable. If you screw up in front of your peers, they are likely the ones to say something. Not the audience.

Ask any professional. Would they rather play a solo in front of their peers, or a group of people paying to hear you play. I would go all the time with
the audience and NOT MY PEERS.

[Ames0325]

I don't see a problem with taking beta-blockers if the stage fright is THAT BAD as long as they are prescribed by a doctor. HOwever I think one should be careful with any kind of drug particularly something like beta blockers. I was prescribed beta-blockers a year or so ago to try and help with severe headaches I was experiencing and ended up in the hospital with and asthma attack as a result. So I just think one should explore all other options first and be careful with drugs.

Amy "who doesn't think having an asthma attack would improve her tuba playing"

[Matt G]

My only concern is if teachers are recommending the treatment before the problems are diagnosed.

While many musicians have a great wealth of knowledge, I would implore them to not recommend to any student any change of what they put into their bodies, even regular old food. If a students asks for help, then they should recommend the appropriate professional. After a professional relationship has been established with a student, and the student asks a direct question like "Do you take Beta-Blockers?", then the professor can reply with the correct answer.

Also, trade between students is illegal and should be viewed as such.

While I, personally, would evaluate my choice of profession and my success hinging on the use of a controlled substance, I know that most people use these drugs only when necessary and do not abuse them. I also agree that I cannot make decisions for them and that these drugs are legal to consume under advisement of a physician. However, if the professor of music is telling a student to take anything of this nature without the proper people being involved, then they should lose their job and be punished appropriately.

I'm sure most college music professors wouldn't want a mathematics professor telling their students what instrument to buy.

[corbasse]

I sometimes feel that because there is one common name (drugs) in English for all substances ranging from "harmless" painkillers, life saving medicines right up to illegal potential killers like crack that all these get thrown on the same big heap.
Reading stories about kids being expelled from school because they shared an asthma medicine they both need but one forgot to bring makes me scratch my head in bewilderment. Yes, linguistically speaking one kid has given drugs to the other, but as an outsider it seems completely insane. But then, in my language the word drugs is only used for stuff like heroine, cocaine, marihuana etc.

On the subject of inderal: it's a fairly harmless medicine, so if it makes you perform better, go ahead. You take an aspirine if you have to play with an headache, don't you? Would you fire a teacher for telling a student to use that?

Did I use it? Once. Got the job. Never used it since.

[Chuck(G)]

Disclaimer: I'm not a physician, nor do I play one on TV.

Everything that I can find indicates that propanolol (Inderal) isn't FDA-approved for anxiety attacks; for example:

http://www.rxlist.com/cgi/generic/propran_ids.htm

So what kind of physician would expose him/herself to charges of malpractice by prescribing such a drug? All drugs have side effects--even propanolol.
------------------------
I'm assuming that there are relatively few people who take propanolol for anxiety control before every performance. But what happens if you're one such person and you find that you've lost your supply just before a gig? Would you play anyway? Is it the pill that makes you able to perform? Does this bother you?

---------------------------
When I get a prescription for a drug, I check it out on Rxlist.com before I take it. I find that I'm better able to talk with my own physician about my treatment if I understand what I'm taking and what it does.

_______________________
Chuck "who's on hypertension meds, but not beta blockers"(G)

[WoodSheddin]

Disclaimer: I'm not a physician, nor do I play one on TV.

Everything that I can find indicates that propanolol (Inderal) isn't FDA-approved for anxiety attacks;

Drugs don't have to be approved for all secondary uses for a doctor to prescribe them. The manufactuters are not supposed to promote the secondary uses, I think, but prescribing them for such is legal.

From reading your posts, it looks like you may not suffer from dehabilitating performance anxiety in high pressure situations and therefore have probably not been prescribed Inderal before. Inderal is not a narcotic. It is not addictive in the classic sense and is certainly no gateway drug. It gives temporary relief from very specific symptoms. If you don't have the symptoms then the drug is pretty useless for you.

Inderal is also not a performance enhancing drug anymore than aspiron is performance enhancing for those who might get headaches before a high pressure audition or high profile solo performance. The dosages for performance anxiety, which BTW is a well documented common secondary usage for this drug, are extremely low compared to when it used for heart patients.

Most of the naysayers of Inderal are repeating the talking points they hear from the War on Drugs campaigns or from the contraversies surrounding professional sports with anabolic steroids. Inderal does not enhance you, it simply allows you to perform at your normal level under unusual circumstances such as auditions.

It is an injustice for a musician who is highly qualified for top positions to lose out on a 30 year career in music simply because he experiences dehabilitating anxiety for the 30 minutes of playing required to win the audition.

This discussion being tinted with the prospects of illegal drugs borrowed from friends is a distraction from the usefulness of Inderal for some people. Codeine is a useful drug for pain relief, but also can be taken illegally and is a narcotic, but for some reason is not as contraversial.

[Lew]

My only concern is if teachers are recommending the treatment before the problems are diagnosed.

The teacher in this case recommended that students talk to their physician. This seems to me to be a very responsible thing to do.

Also, trade between students is illegal and should be viewed as such.

It may be illegal, but whether it is a problem depends on the situation as far as I'm concerned. I someone has a prescription for the same medication and just forgot theirs, and it would help their performance, then I would have no problem with sharing medication.

[Chuck(G)]

Drugs don't have to be approved for all secondary uses for a doctor to prescribe them. The manufactuters are not supposed to promote the secondary uses, I think, but prescribing them for such is legal..

If it's the way you make your living that's at stake, then ya gotta do what ya gotta do.

But I wonder about teachers recommending a drug to students, instead of referring a student to a trained health professional who's familiar with the issue.

I certainly wouldn't trust a GP to come up with the best solution to an emotional problem. In my own personal experience, the "quick fix" with drugs is often the most common approach, and is usually not the best response to a patient with an issue whose basis is primarily emotional or mental. I've got my own horror stories to tell about modern "wonder drugs".

I certainly wouldn't trust a music teacher to tell me to get a prescription for Inderal when some non-pharmaceutical approach (meditation, desensitization, counseling, etc.) might do the job instead.

[Mark]

You take an aspirine if you have to play with an headache, don't you? Would you fire a teacher for telling a student to use that?

Well, since giving aspirin to children may kill them under certain circumstances (e.g Reyes Syndrome); I would think that a teacher should be fired for suggesting a student use it. Teachers are not doctors.

Reference: http://www.reyessyndrome.org/aspirin.htm

[Dan Schultz]

NM. Don't want this to turn into a flame war
but I don't think any music should sugest drugs to a student.
at the most I feel they should help the student get over the problems if the student can not get over the barrier then I am sure they are aware that there is a drug on the market for everything under the sun. If they feel it is that bad take something but it is not a music teachers job to play pharmacy tech.

This is not even a job for a pharmacist and certainly the job of a pharmacy tech. Chuck (G) is 100% correct.... Everything that I can find indicates that propanolol (Inderal) isn't FDA-approved for anxiety attacks; This is a heart medication. Anyone who takes Inderal without first seeing a competent physician has got rocks in his/her head.... at least according to my wife.... a great pharmacist.

[funkcicle]

In my limited experience(in my day job at a healthcare market research company, consulting with doctors and pharmacists every day), I'd put my faith in what my pharmacist tells me 10,000 times before the advice of my GP, and in many cases even my specialist. Of course I will see my doc first, but I will ALWAYS consult with the pharmacist myself before beginning any dosing regimen. Doctors do not have the drug knowledge that pharmacists have, nor are they even REQUIRED to. Ask your hospital-nurse friends who they call for drugging questions.. likely 9 times out of 10 it's not the doctor.

I'd say a good patient-pharmacist relationship is just as important as the doctor-patient relationship. I might go as far to suggest that one is useless without the other. Pharmacist consultation is built into the cost of the drugs, take advantage of it!

my $.02