The NFL didn’t need another off-the-field controversy, but the federal government delivered one anyway.
Last week, agents from the Drug Enforcement Agency performed surprise inspections of the medical staffs of five NFL teams – the Cincinnati Bengals, Detroit Lions, San Francisco 49ers, Seattle Seahawks and Tampa Bay Buccaneers. All five teams were playing road games, so federal agents visited the team doctors and athletic trainers in visiting locker rooms and airports.
DEA spokesperson Rusty Payne told reporters, “DEA agents are currently interviewing NFL team doctors in several locations as part of an ongoing investigation into potential violations of the Controlled Substances Act.”
Team doctors and the Controlled Substances Act
The federal Controlled Substances Act prohibits doctors from giving players prescription narcotics such as OxyContin and Percocet outside of the locations in which they are registered to prescribe them. Team athletic trainers are not allowed to provide these medications to players.
Use of painkillers for injuries during football and pain after football ends
Opioid use among former NFL players
ESPN’s Outside the Lines recently quoted an unnamed source close to law enforcement officials who believes that the DEA suspects that team doctors are giving players narcotic medications in states outside their registrations and in team hotels and stadiums. They also believe doctors and athletic trainers are not keeping adequate records of the medications given and the players to whom they are given.
The unannounced inspections appear to stem from a federal lawsuit filed in California in which 10 former players, including Jim McMahon and Richard Dent, accuse NFL teams and team physicians of regularly giving players painkillers to mask pain and keep them playing. Up to 1300 former players could join the lawsuit.
One star player’s perspective
Arizona Cardinals wide receiver Larry Fitzgerald described his experience treating pain after suffering an MCL injury of his knee. In a recent interview on Westwood One Radio, Fitzgerald disputes the notion that team doctors are simply pill pushers.
“We follow strict guidelines,” Fitzgerald recalled. “… If you have pain and you have something that is bothering you, you can go in and ask for (painkillers), and if they are able to get a script for it they are able to give it to you.
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“Every single pill that is handed out is documented. They only give you a certain amount for whatever time you need it for, and it is for usually only a day or two. It’s written down, and everything is taken notice of.”
The “return-to-play” culture of the NFL
Phil Closius, an attorney representing the former players in the lawsuit, not only believes that the team medical staffs are illegally distributing pain medications but also that the culture of professional football encourages it.
“If doctors don’t get players back on the field, you think they’re going to continue to be the team doctor? Everybody is subservient to this return-to-play culture – doctors, general managers, coaches, everybody. And that return-to-play culture is responsible for this illegal distribution on drugs,” Closius remarked.
Everyone involved is responsible.
If these allegations turn out to be even partially true – and I strongly emphasize if – then Closius is correct that everyone is responsible, including doctors, athletic trainers, coaches, owners – and players.
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We have heard current and former players admitting to hiding symptoms of concussions in order to stay on the field. Athletes are competitive by nature. If taking a painkiller can help them recover in a few days and play the following week, many would do it. They would even ask for the drugs in order to keep their positions.
Former Houston Texans defensive lineman and current talk show host N.D. Kalu explained that mentality to the Houston Chronicle. “You’re always trying something, and it’s not because you’re tough. You’re always in fear of losing your job. If you’re a superstar athlete, you’re in fear of becoming a role player. If you’re a role player like I was, you don’t want to lose your job.”
Use of narcotic medications among former NFL players
Whether doctors and athletic trainers are acting within the law is only part of the issue. The use of painkillers among current and former NFL players is a significant medical problem.
A study in the journal Drug and Alcohol Dependence found that retired players misuse narcotic pain medications at a rate four times higher than that seen in the general population. 52% of retired players admitted to taking narcotics during their careers. Of those, 71% claimed to have misused them.
The DEA investigation and needed changes
Hopefully the DEA investigation will bring more transparency about the treatment of pain in football, including how and where pain medications are administered, the use of Toradol and other drugs to help athletes play through pain and more.
It also needs to bring attention to the risks of these drugs to all parties involved. Doctors should discuss the risks of narcotics with players, and players need to understand the benefits and dangers of every substance they put into their bodies.
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Finally, we need to find ways to decrease the pain that this sport inflicts on its players in the first place. Instead of pills and injections to decrease pain, maybe the NFL can add more bye weeks and eliminate Thursday night games to give players more rest. Maybe the league can guarantee players’ contracts or increase roster sizes to eliminate this “play at all costs” mentality.
Ultimately the DEA investigation might turn up more than poor medication records. It could have us rethinking the entire culture of football.
Note: A modified version of this post appears as my sports medicine column in the November 28, 2014 issue of The Post and Courier.