Every professional football player, no matter how strong, fast, or powerful, is haunted by a simple phrase: “next man up.” It means you are expendable, a commodity. It signals that no single player is worth the good of the team, and it suggests that if you leave the game, your job is, quite literally, in jeopardy.
This mindset creates enormous pressure throughout the National Football League, and it helps to explain a lawsuit that more than 200 former players filed against all 32 NFL teams last week. The suit alleges that, for decades, teams and their medical staff conspired to illegally obtain and distribute painkillers to players to keep them in the game, intentionally disregarding the players’ health. Additionally, the suit contends that teams and their medical staff withheld crucial information about the extent of players’ injuries and misstated the drugs’ risks. It further alleges that several coaches, such as Don Shula of the Miami Dolphins, threatened to cut players from their teams if they did not take the drugs and return to the field.
The lawsuit is similar to one filed last year against the NFL as a whole. In that case, which is being appealed, the judge ruled on technicalities and punted the dispute to the bargaining table. Meanwhile, the NFL argued that it isn’t responsible for the actions of the individual teams.
While the details of the most recent case are just emerging, the specifics of the 2014 suit are eye opening. As part of the suit, quarterback Jim McMahon stated that he suffered a broken neck and ankle during his career, which doctors never informed him about. Instead, they medicated him and pushed him back into play. He developed an addiction to the powerful opioid Percocet, at one point taking more than 100 pills a month. Another player alleged that for five years, medical personnel hid the news that he had a broken leg and callously fed him a “constant diet” of pills to mask the pain. At times the narcotics given to players were allegedly “stacked” with anesthetics and powerful anti-inflammatories including Toradol, which can cause severe kidney damage. One of the plaintiffs in the 2014 case, former linebacker Scott Fujita, stated that the drugs were given out so unreservedly, he and his teammates used to joke about adopting “drug-free Wednesdays.”
But the pressure has been no laughing matter. Players—most of whom are on a year-to-year contract—train virtually their whole lives to play in the NFL. They are eager to prove their toughness, and they trust the medical staff. They fear being tagged as “prone to injury” or, if they question a drug regime, “difficult,” which could spark subtle retaliation. They also don’t want to trigger locker room jibes about their fortitude. (“Johnson came back in four weeks, why do you need five?”)
That pressure also exerts itself on the medical staff. Big medical practices pay teams as much as seven figures to secure an NFL affiliation—a huge boon to their business. This means, however, that to get their contracts renewed, the medical practices must please their clients, who are the teams, not the individual players. Just consider this scenario: A doctor decides a player needs six weeks to recover, and the coach bends his ear and says, “Get him back in three.” Of course, not permitting an injury to fully heal will increase exponentially the risk of a secondary, career-ending injury.
Painkillers are considered the magic bullet that gets players back on the field. Unfortunately, as Phoenix House’s Chief Medical Officer Andrew Kolodny, M.D., points out, opioid painkillers are essentially “heroin in pill form.” They offer short-term relief, but over time, stop working well as the person taking them develops tolerance. That’s when even the strongest players can develop a life-threatening addiction. This is something few medical staff spelled out clearly, according to allegations. So it’s no wonder that NFL players are four times more likely to develop addiction problems than the general population, according to a study from Washington University School of Medicine in St. Louis.
Whatever the outcome of the case, the NFL needs to end its drug problem. For starters, medical teams need to be independent from NFL teams. They also need to base their medical diagnoses, prognoses, and lengths of recovery on gold standards of care, not subject to manipulation by coaching staff. Next, players need to know that if they sustain an injury, they can feel confident that they can recover fully without being cut from their team. Once they’re healed, then they can compete for their jobs, rather than having to prove themselves with a screaming injury masked by powerful painkillers.
Additionally, NFL team doctors need to make sure their players completely understand the risks of the medications they are offered, so they can give informed consent. And they need to ensure that medical guidelines governing the handling and prescribing of narcotics are enforced. Implementing such changes will decrease the use of and demand for these drugs.
Finally, the league, teams, and players union need to work together to provide addicted former players with treatment. This is something the players’ association is beginning to address. Holding NFL teams accountable may help to get them on board with this plan.
Each week during the football season, legions of fans tune in to see modern-day gladiators in action. They should be able to cheer, knowing that every man on the field is in top form without the crutch of drugs. Reforms are slowly being implemented (for example, the distribution of prescription pills in the locker room has been tightened), but more needs to be done. For America’s collision sport, this would be the real game changer.
Phoenix House Hill A. Feinberg Academy
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