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There’s a lot to look at with James Paterson’s doping case with the IRB, but the key point seems clear to everyone, the whole episode wasn’t really his fault.

Paterson tested positive for Oxycodone following the USA’s match with Italy on September 27 at the Rugby World Cup. Oxycodone is a powerful painkiller, derived from opium. When a player is given such a drug, his team is required to declare it to the IRB and apply for a therapeutic exemption in order to take it.

Paterson, who has played professionally in New Zealand for four years, should have know this, and did. But he trusted the USA team to do the job right. They didn’t. Team doctor Patrick McNair, who joined the team on September 17, failed to follow procedure, and in the hearing with the IRB, said as much:

Dr. McNair during his evidence acknowledged he had made an “egregious error”. Indeed, in his view “James’s only error was in trusting me to protect him from banned substances.” - IRB Judicial Committee Report

A stark admission, and one backed by USA Rugby CEO Nigel Meville, who said in USA Rugby’s statement on the matter that USA Rugby was at fault, and apologized to Paterson.

Why did Paterson receive this drug? He did so following the Russia match, when he had to leave after injuring his shoulder – diagnosed as a rotator cuff tear and tendonosis.

He was given one tablet of Oxycodone which, Paterson testified, made him feel lethargic. He played against Italy, although added he was disappointed in his contribution, worried he might injure the shoulder more.

So the key things to remember:

1. Paterson did not take a performance-enhancing drug. The term “doping” is used to mean any banned drugs, but most observers think of it in terms of using it to enhance performance. Use of marijuana is doping, but few would argue it aids performance.

2. Paterson was prescribed the Oxycodone by his doctor as a painkiller following a very painful injury.

3. Paterson should have been more proactive in questioning whether he was allowed to take it.

Fromt the IRB Judicial Committee Report:
While … the BJC can understand the reasons why the Player required pain relief and placing his trust in an experienced and well qualified Team Physician, the BJC cannot overlook the fundamental imperative of the RWC Anti-Doping Programme. That is, as mentioned the Player also had the personal responsibility of checking the individual Oxycodone tablets which were handed to him by Dr. McNair were not banned. 

On the other hand, it’s worth noting that on September 27, game day against Italy, Paterson was given eight medications. It’s hard to imagine that anyone could have kept track of them all.

4. Dr. McNair was the one who didn’t follow procedure, and acknowledged as much. In addition, the flood of shots and pills given Paterson, who was clearly eager to play against Italy, put the player in the worst position possible for being able to ask the right questions.

5. The IRB stated that there was no attempt to cover up the Oxycodone usage, and Paterson answered all of the IRB’s questions with candor and professionalism.


In the end, the IRB was lenient with Paterson, as they should have been. He screwed up, and his team management screwed up even more. It was partially his fault, but mostly someone else’s (and that person said so). He used a painkiller to alleviate pain from an injury, not a supplement or performance enhancer.

In 2011, the IRB handed out six suspensions for doping: one for six months, three for nine months, and one for two years. Paterson’s four-month suspension, during a time that is relatively rugby-free, can be considered a very light punishment in that context.

In 2010, five suspensions were handed down, with suspension times averaging just below 15 months. The lowest was five months, for Cannabis.

But … this was the only doping event of the Rugby World Cup. Paterson had to be suspended, because the IRB has to be seen as being serious about doping. And USA Rugby gave themselves a black eye with the whole affair.

The entire episode spells out how bad such a mistake can be. What drugs to use, why, when, and how they are handled should be forefront in any team doctor’s mind. In addition, the head coach, who wasn’t at the IRB hearing and wasn’t mentioned in the decision documentation, has to be aware of everything give to his players. It’s not enough to trust one doctor, especially one flown in for part of a tournament; everyone involved has to take responsibility. It’s a good thing, in this case, that enough people did so that James Paterson will be on the field much sooner than might have been the case.