The NFL and NFL teams have been screwing up science for a long time. It took the league more than a decade to admit the link between football and CTE that Dr. Bennet Omalu published in 2005. Last year, the New York Times found that an NFL committee omitted at least 100 concussions from a database it used to downplay the prevalence of head injuries. Later, the Times found that the NFL was perpetuating unsubstantiated claims that a youth football safety program reduced injuries.
Thursday evening, the Washington Post published portions of court filings in a lawsuit by more than 1,800 former players alleging that NFL teams improperly distributed and administered painkillers, causing long-term organ and joint damage. It’s fortunate that the Post got to see the filings at all. The complaint was sealed from public view because of a protect order, but “because of an apparent technical error in the filing process,” the Post was able to view redacted information.
The result is something unique. Allegations of painkiller abuse in NFL locker rooms have existed for a long time, but they have largely stemmed from players. The court filings claim that team doctors and trainers across the league may have been willfully negligent when distributing drugs like Vicodin and Toradol. According to the filings, “every doctor deposed so far” has testified to violating one or more federal drug laws and regulations.
In past instances when the NFL or NFL teams have been accused of negligence towards player health, they could claim ignorance. The league’s Mild Traumatic Brain Injury Committee published several studies claiming no definitive link between CTE and football, essentially saying that the science is inconclusive. When concussions went undocumented in those studies, the league said that its database was never meant to be comprehensive, making itself out to be hapless.
There is little ambiguity in the court filings, however.
Current Pittsburgh Steelers team doctor and former president of the NFL Physicians Society testified that, “a majority of clubs as of 2010 had trainers controlling and handling prescription medications and controlled substances when they should not have.” Trainers do not have license to distribute and administer prescription medications, and doing so is a violation of federal law.
In 2006, Minnesota Vikings head trainer Eric Sugarman lobbied the team doctor, vice president of operations, and head coach Brad Childress to administer Toradol more often.
“I expressed my concern that [the Vikings] are at a competitive disadvantage ... I feel very strongly about this point,” he wrote. “... I feel that Dr. Fischer is beginning to see my point of view on many issues. I also feel he is willing to change to improve.”
In 2009, Cincinnati Bengals head trainer Paul Sparling seemed to be thumbing his nose at federal regulators when he wrote in an email, “Can you have your office fax a copy of your DEA certificate to me? I need it for my records when the NFL ‘pill counters’ come to see if we are doing things right. Don’t worry, I’m pretty good at keeping them off the trail!”
In 2010 when the Drug Enforcement Agency began cracking down on the league’s prescription drug practices, seven doctors from the NFL Physicians Society had a conference call with league medical adviser Elliot Pellman. On the call, someone made a remark that seemed to acknowledge that doctors had been tacitly breaking the law.
The lawsuit quotes an unattributed remark from the minutes of the conference call: “We don’t want to give them the fodder that we have all been doing this wrong. We don’t want to show our deficiencies.”
The fact that NFL teams use painkillers more frequently than the general population could be assumed, but the extent of their use may be shocking. According to the filings, the average NFL team prescribed 5,777 doses of non-steroidal anti-inflammatory drugs — NSAIDs — and 2,213 doses of controlled medications, which would include opioids, in 2012. The Post estimated that those numbers could average out to “six to seven pain pills or injections a week per player over the course of a typical NFL season.”
The extent of prescription drug use in the NFL may be even greater than reported if teams logs were improperly maintained as the lawsuit alleges. Teams may have gone to other lengths to conceal their activities, too. The lawsuit claims that NFL teams were tipped off in 2014 to a DEA raid that turned up no controlled substances.
The implications of the Post’s report is that NFL team doctors appear to have been participants in a cover up. Not only did they administer prescription drugs outside of their indications, the lawsuit alleges, but they kept NFL players in the dark.
Bud Carpenter, the Buffalo Bills’ longtime trainer, “admitted under oath that he witnessed team doctors give players injections of prescription medications without telling them what the drug was they were receiving or its side effects.
Of particular focus is Toradol, the powerful NSAID that became the NFL’s drug of choice over the course of two decades. The story mentions Dr. Matthew Matava, who was the St. Louis Rams’ team doctor before they relocated to Los Angeles. He led a 2012 task force on Toradol that recommended that teams curb its usage, though the task force did not lead to NFL regulation. Last year, Matava spoke with SB Nation and reiterated that team doctors were free to exercise their own discretion.
In emails unearthed from the court filings, however, Matava was much more critical of his colleagues.
According to the sealed court filing, months after the task force issued its recommendations, Matava emailed Yates, the Steelers’ doctor, questioning the team physicians who failed to respond to surveys regarding Toradol usage. “If these guys want to give Toradol because they think it is needed or acceptable, then they should ... say so. What are they afraid of?” Matava, who did not respond to a request for comment, wrote in the same email that “[c]ontinued use of Toradol in the present climate is not rational.”
There are a number of reasons why team doctors would be so liberal with drug prescriptions. They face pressure from both sides — from NFL front offices and coaches who want to win, and from players who need to stay on the field to maintain their livelihoods — to keep players pain free. For the most part, the NFL has been able to sweep allegations as the result of good-intentioned people screwing up.
The painkiller lawsuit paints an entirely different picture, casting even more doubt on every stance the NFL has ever taken on player health.