Federal drug agents conducted surprise inspections of NFL team medical staffs on Sunday as part of an ongoing investigation into prescription drug abuse in the league. The Post's Sally Jenkins explains what happened and why. (Tom LeGro/The Washington Post)

Federal drug agents conducted surprise inspections of National Football League team medical staffs on Sunday as part of an ongoing investigation into prescription drug abuse in the league. The inspections, which entailed bag searches and questioning of team doctors by Drug Enforcement Administration agents, were based on the suspicion that NFL teams dispense drugs illegally to keep players on the field in violation of the Controlled Substances Act, according to a senior law enforcement official with knowledge of the investigation.

The medical staffs were part of travel parties whose teams were playing at stadiums across the country. The law enforcement official said DEA agents, working in cooperation with the Transportation Security Administration, inspected multiple teams but would not specify which ones were inspected or where.

The San Francisco 49ers confirmed they were inspected by federal agents following their game against the New York Giants in New Jersey but did not provide any details. “The San Francisco 49ers organization was asked to participate in a random inspection with representatives from the DEA Sunday night at MetLife Stadium,” team spokesman Bob Lange said in an e-mailed statement. “The 49ers medical staff complied and the team departed the stadium as scheduled.”

The Seattle Seahawks were subject to an inspection following their game in Kansas City, and the DEA met with the Tampa Bay Buccaneers at Baltimore-Washington International airport following their win over the Washington Redskins at FedEx Field. It didn’t appear a full inspection took place, however.

“Authorities checked in w/our travel party @ BWI & after a 5 min. delay, we proceeded onto our plane w/o incident,” a tweet by the team’s media relations staff said.

Gritting through NFL pain

An NFL official said multiple teams met with federal authorities on Sunday. “Our teams cooperated with the DEA today and we have no information to indicate that irregularities were found,” league spokesman Brian McCarthy said in a statement.

The DEA had reason to look at the teams inspected Sunday in particular, but the investigation is not restricted to them, according to the law enforcement official, who spoke on condition of anonymity because the probe is ongoing. The official said the investigation focuses on practices across the 32-team league, including possible distribution of drugs without prescriptions or labels and the dispensing of drugs by trainers rather than physicians.

Lawsuit triggers the probe

Federal law prohibits anyone but a physician or nurse practitioner from distributing prescription drugs, and they must meet myriad regulations for acquiring, storing, labeling and transporting them. It is also illegal for a physician to distribute prescription drugs outside of his geographic area of practice. And it is illegal for trainers to dispense or even handle controlled substances in any way.

DEA spokesman Rusty Payne confirmed the existence of the investigation and said it was triggered by a class-action lawsuit filed in federal court in May by more than 1,300 retired NFL players. In the suit, they allege that NFL medical staffs regularly violate federal and state laws in plying their teams with powerful addictive narcotics such as Percocet and Percodan, sleeping pills such as Ambien and the non-addictive painkiller Toradol to help them play through injuries on game days.

Agents began “interviewing NFL physicians in several locations,” Payne said, after reviewing material contained in the lawsuit. Players described being given unlabeled medications in hazardous combinations, teams filling out prescriptions in players’ names without their knowledge, trainers passing out pills in hotels or locker rooms and medications handed out on team planes after games while alcohol was consumed.

“The DEA has a responsibility under the Controlled Substances Act to ensure that registrants who possess, prescribe and dispense control substances are following the law,” Payne said. He characterized the DEA actions Sunday as “administrative” in nature, aimed at discerning whether NFL medical staffs adhere to federal regulations governing the dispensing of controlled substances across state lines. He would not speculate on any future action the DEA might take based on what it found. Penalties can range from suspension or revocation of licenses, civil fines or prosecution.

“The NFL team doctors strive to comply with all regulations in prescribing and dispensing drugs to our patients, the players,” Matt Matava, the St. Louis Rams’ team doctor and president of the NFL Physicians Society, said in a statement.

The DEA has investigated individual NFL physicians and teams on prior occasions. In 2010, the DEA inspected the offices of the San Diego Chargers after safety Kevin Ellison was found with 100 Vicodin pills during a traffic stop. Last year the New Orleans Saints agreed to a fine for failing to properly store, control and dispense medication, based on a 2010 incident in which security tapes showed a coach stealing Vicodin from a cabinet by the handfuls and a team official suggesting records be altered to cover it up. Asked to comment on those DEA cases last year, NFL executive vice president Jeff Pash said, “The whole issue of pain meds is a big, important issue in our society well outside the NFL. . . . It is something our doctors are looking at.”

Those with knowledge of the case said the DEA is working with the office of the U.S. Attorney for the Southern District of New York and met with investigators from that office recently.

Stephen A. Miller, a former federal prosecutor for that office, said the Southern District is historically a popular destination for investigators with complex and high-profile cases. “That office is known for being aggressive and having very talented, highly motivated people,” Miller said in an interview.

The former prosecutor said it was not unusual for NFL teams to have no knowledge of the investigation until the DEA showed up. “All of the stuff they would do is behind the scenes, where the targets wouldn’t know,” Miller said.

Those familiar with the probe said the DEA is investigating, in addition to NFL doctors, all other staffers on the NFL teams who may have access to prescription medications who should not — especially trainers, who regularly treat players’ ailments and injuries.

Sunday’s inspections were based on information the DEA had gathered over the past few months in interviews about the NFL’s practices.

A blueprint for the DEA’s lines of inquiry can be found in the specifics of the class-action lawsuit filed in northern California. Prominent plaintiffs such as former Chicago Bears quarterback Jim McMahon, former 49ers center Jeremy Newberry and former defensive end Marcellus Wiley, who is now an ESPN commentator, detailed physicians and trainers handing out addictive painkillers without prescriptions, in dangerous combinations, to mask injuries. The NFL last month asked U.S. District Judge William Alsup to throw out the lawsuit, arguing that teams — not the league — are responsible for the medical decisions and that litigation isn’t the proper mechanism for an NFL grievance under terms of the collective bargaining agreement between players and owners. Alsup has yet to rule on the NFL’s request.

The DEA’s investigative interest in the NFL is partly based on the agency’s conviction that lackadaisical prescribing practices creates addicts. McMahon, who played from 1982 to 1996, said in the lawsuit that he received “hundreds, if not thousands” of injections and pills from NFL doctors and trainers, including Percocet, Toradol, Novocaine, amphetamines, sleeping pills and muscle relaxers. He said he became so hooked on pain meds that at one point he took 100 Percocets a month.

Steven Silverman, a Baltimore-based attorney who helped file the suit, said some of his clients have spoken with investigators and will continue to cooperate in the case.

“We are pleased the DEA and the Department of Justice are continuing to pursue our clients’ allegations,” he said. “Our clients’ goal has always been to change the game for the better and the involvement of the federal government enforcing controlled dangerous substance laws will only help with that.”

DEA steps up efforts

In the past year, the DEA has significantly stepped up efforts to reduce a national epidemic of painkiller abuse, which it says has contributed to increased heroin use. In August, it toughened the rules for prescribing and storing hydrocodone, requiring that it be kept in special lockers and making refills much harder to obtain.

“Doctors and nurse practitioners are held to very high standards when handling and dispensing controlled substances,” Payne said. “Prescription drug diversion, abuse and addiction has skyrocketed in the U.S.”

A 2010 study of 644 league veterans from the Washington University School of Medicine found that retired NFL players misuse opioids at a rate more than four times that of their peers. A significant percentage reported either overusing painkilling opioid drugs within the past 30 days or taking the drugs without a prescription — or both.

The DEA also may be looking at physicians prescribing medications beyond recommended dosage or for significantly longer periods than necessary. An attorney for the players, Mel Owens, who played in the NFL from 1981 to 1989, said his clients were not warned of the dangers of “stacking” or “cocktailing” medications.

Newberry said the drugs he was administered left him with kidney failure, high blood pressure and violent headaches. Wiley, who is 39, also has suffered from renal failure, a result, he says, of multiple injections of painkillers while playing injured for the Chargers.

“The league would look completely different if they followed just the basic medical guidelines, because you wouldn’t have [injured] players coming back to play that soon,” Owens said. “The only reason they play is because they are heavily medicated.”

The DEA likely will be especially interested in the record keeping of NFL medical staffs. Any facility where prescription drugs are dispensed must have a proper pharmacy registration and maintain effective security over controlled substances. The law also requires a complete and accurate record of each pill that is received, sold, delivered or otherwise disposed of.

“But my understanding is that doesn’t happen, or if it does, it’s really haphazard,” Owens said.

An investigation of NFL medical practices by The Washington Post last year documented painkiller abuse in the league. In a Post survey of more than 500 retired players, one in four said he felt pressure from team doctors to take medication he was uncomfortable with. Players told The Post that they swallowed prescriptions on an almost daily basis, frequently without documentation.

In the Post survey, nine in 10 former players said they played hurt during their careers, and more than two in three said they felt they had no choice.