The NFL can’t treat players for pain just by aligning their chakras, everyone understands that. But there is simply no legitimate rationale for some of the league’s crude, expedient and abusive drug practices revealed in court filings obtained by The Washington Post. Medicine in the league is a matter of competing pressures and opposing priorities, and until those conflicts are resolved, the league will continue to be at risk of looking like drug lords.
The NFL likes to pretend that its drug problems are all in the past, a relic of the wild 1960s, and that we’re in the “health and safety era” now. But material from the NFL’s own doctors and trainers, submitted by lawyers for 1,800 players suing the league, reveal that the problem is in fact persistent. Everyone from Commissioner Roger Goodell to owners to assistant trainers knows this, just as they know that the chronic painkiller abuse is driven by a compromised medical system in which concern for profits competes with concern for players. Among the redacted material cited in the court filing is a memo written in 2014 by Thomas McLellan, an associate of league medical adviser Lawrence Brown. It’s entitled, “The Role of League-Wide Incentives in Promoting the Opioid Use Problem: The Need For League-Wide Collaboration to Solve the Problem.”
Obviously, the players have to be part of the solution, too. But here’s the thing: They have the least power in this equation, because of the unguaranteed structure of so many of their contracts, and the pressure to play to get paid. They trust their doctors to take good care of them. Just as you trust yours. You might think you need 20 Vicodin to do your work. That doesn’t mean your doctor should give it to you.
Here is one allegation from the suit: In November 2003, Seattle Seahawks offensive lineman Jerry Wunsch was out because of an injury to the right side of his body. When then-coach Mike Holmgren asked him if he could play, Wunsch replied, “I can’t play, Coach. I just can’t do it.” According to Wunsch, Holmgren then called a trainer and asked, “What can we do to help Mr. Wunsch play today?” The trainer then allegedly gave Wunsch 750 milligrams of Vicodin as well as Tylenol-Codeine, though Wunsch was already on anti-inflammatories. Wunsch played until halftime, when the meds wore off. The trainer allegedly gave him a second 750 mg dose of Vicodin, saying, “Don’t sue me personally for this.”
It’s understandable that NFL doctors and trainers might have difficulty sorting out what’s best for an injured player worried about losing his roster spot. But some of the worst material in the lawsuit turns on evidence of deception, whether NFL teams willfully hid the risks, side effects and toll of their painkiller practices from players intentionally, not just negligently, to hurry them back on the field for the sake of business. Federal court Judge William Alsup remarked on this in a ruling he made in July, when he rejected the NFL’s request to dismiss the case:
“When asked about side effects of medications, club doctors and trainers responded, ‘none,’ ‘don’t worry about them,’ ‘not much,’ ‘they are good for you,’ or, in the case of injections, ‘maybe some bruising,’ ” Alsup wrote. “These answers misrepresented the actual health dangers posed by these drugs.”
There is no provision in any collective bargaining nor employment contract that covers such conduct. Players did not sign up for this. Ex-players still in their 30s are complaining of kidney and liver damage. Young men in their early 20s are consuming the same number of painkillers as elderly people with chronic arthritis. In 2011, according to a team memo cited in the suit, the New York Jets went through 1,564 doses of Vicodin and 1,178 doses of Toradol. Do the rough math. It’s a 20-week season, and there are 53 men on a roster.
And none of this is counting the pills that were never written down.
Sensational as some of the drug logs and memos contained in the lawsuit are, it’s what’s not in the record that’s most disturbing. For years, I’ve heard from workers’ compensation lawyers who say NFL teams systematically undercut claims by withholding drug and injury notations from players’ medical records. But I’d never seen firm evidence to back up that contention, until now.
The suit reveals a survey of medical records from 745 players used by clubs in workers’ compensation claims. Of those, 164 had no records at all. To repeat: no records at all. Another 196 contained no mention of any drugs. None. A total of 64 mentioned drugs — but not dosages. And 321 mentioned only some dosages.
Now, either the NFL’s doctors and trainers are so incompetent they can’t write. Or this is a scheme.
The NFL’s shoddy record-keeping doesn’t just potentially deprive players of fair injury compensation. It potentially injures them further. Put yourself in the position of a former player who is in renal failure even though he’s not yet 40, with no history of kidney disease in his family. He’s being treated by a specialist, and has complications such as high blood pressure and violent headaches. It would seem important — even critical — to have reliable records of his treatment in the NFL.
Think of it that way, and it makes it difficult to shake the hand of an NFL owner or physician ever again.
The NFL long has been urged to make some fundamental changes that would relieve medical conflicts of interest and improve players’ long-term health. Congress has held hearings on the subject. A 2008 congressional Research Report observed that it was unclear whether “it’s the patient-doctor relationship or the doctor-owner relationship” that matters. One item contained in the lawsuit is the latest contract of Dr. Arthur Rettig, physician to the Indianapolis Colts, which states that he is supposed to report all medical matters in a timely fashion to the head coach, general manager, and head trainer. There’s no other situation in which such a thing is ethical. According to the suit, when Rettig was asked in his deposition in what other cases would he report to third parties about care, he answered, only for “minors, and persons with mental issues that rendered them unfit to care for themselves.”
Just last month, a Harvard study concluded that “the intersection of club doctors’ dual obligations creates significant legal and ethical quandaries that can threaten player health.” It recommended that players’ physicians should not be in direct pay of teams, nor report directly to team execs. Rather they should forward a “Player Health Report.” This is nothing but good moral-medical sense.
Everyone knows what other changes should be made, too. Expanding roster sizes and providing more guarantees in contracts would reduce pressure on physicians to heavily medicate and rush players back to the field — and on players to compete hurt, and drugged. All of these things would allow players time to heal, and doctors room to explore safer alternatives to painkiller overuse. But, of course, they require owners to give up some of their $14 billion in annual revenue, and control.
At some point, surely, owners must begin to see that these things are in their best interest. The league did itself no favors with its denial of the concussion crisis, and has struggled ever since to redefine itself as proactive and responsible to its audience. The painkiller lawsuit similarly exposes it.
Once again, the league lingers behind the times, hypocritically shaming players with penalties for smoking pot, while allegedly fostering an opioid problem on a par with heroin. The league wants us to believe that this is the era of “health and safety.” It won’t be until it makes the changes that put player health before profits.