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)

Former NFL linebacker Scott Fujita said he still has the pill bottle, nearly the size of a soda can. “It was the craziest big pill bottle you’ve ever seen,” he said. It was given to him by an NFL team physician to treat a single knee injury, yet it contained, he estimates, somewhere between 125 and 150 pills of Percocet, the addictive oxycodone-based painkiller. On another NFL team Fujita played for, he says, an assistant trainer passed out narcotic painkillers in unlabeled small manila envelopes before games to whoever raised a hand.

Ex-offensive lineman Rex Hadnot described the moment he joined a class action accusing NFL teams of misusing narcotics and other pain medications to keep players on the field despite injuries. It was the day a lawyer explained to him that the powerful anti-inflammatory Toradol should not be used for more than five days under Food and Drug Administration guidelines, at risk of kidney damage. By Hadnot’s estimate, medical staffs from four NFL teams gave him Toradol injections or Toradol pills virtually once a week — for nine years, from 2004 until he retired after the 2012 season, without explaining potential side effects.

“Sometimes I got the shot and the pill,” he said.

Accounts such as these have spurred a federal investigation into NFL painkilling practices, which has grown to include interviews with NFL physicians, former players and even pharmacies that supply teams, according to law enforcement sources. The investigation was triggered by the class action lawsuit filed in federal court in May, in which more than 1,300 former players said NFL medical staffs routinely violated federal and state laws in plying them with powerful narcotics to mask injuries on game days. One law enforcement official, who spoke on the condition of anonymity because it is ongoing, called material contained in the suit “compelling.”

Asked to respond to accounts of irregularities in handling prescription painkillers, the multiple NFL teams named in this story declined to comment because of “pending litigation.” League spokesman Greg Aiello said the NFL couldn’t comment for the same reason, “but we are confident that our physicians understand their obligations under the law.”

Coping with injuries and pain in pro-football has fostered a culture of painkiller use and abuse. One drug in particular, Toradol, has received increased attention for its potentially ruinous side effects. (Nicki Demarco/The Washington Post)

Asked last year whether the league is satisfied its 32 teams are following federal drug laws, NFL Executive Vice President Jeff Pash told the Post: “Our goal is full compliance across the board. I think you have very substantial compliance across the board.”

The investigation is being led by one of the most aggressive and effective prosecutors in the country, Preet Bharara, the U.S. Attorney for the Southern District of New York, in concert with Drug Enforcement Administration agents. Bharara’s office would not comment about an ongoing investigation, but DEA spokesman Rusty Payne confirmed NFL physicians were being looked into after agents surprised at least five teams with spot checks of medical staffs at stadiums and airports following their Nov. 16 games. According to law enforcement sources, investigators are focused less on individuals than on a broad range of alleged illegal dispensation practices in the NFL, which may facilitate addictions, abuses and pill trafficking.

The investigation is being conducted by the civil side of the U.S. Attorney’s office and is characterized as “administrative,” but criminal charges are not out of the question “if major violations” are found, law enforcement sources said.

Two people familiar with the investigation said six former players have been interviewed, and the list is expected to grow. At least 100 of the plaintiffs in the lawsuit retired in the past five years, and a law enforcement official said investigators are focused on what they suspect to be current practices. Fujita and Hadnot retired in 2013 after playing for four teams apiece over their respective careers. Neither has spoken with federal investigators, but in interviews this week, each offered similar accounts of team practices with painkillers that would appear to violate federal law. While Hadnot is a plaintiff in the suit, Fujita is not.

‘What do you need?’

Both Hadnot and Fujita described athletic trainers distributing drugs to players while traveling — an apparent violation of federal law. Under the Controlled Substances Act, only properly licensed doctors and practitioners can dispense drugs and only in states where they are registered to practice. The act also contains strict requirements for acquiring, logging, storing, labeling and transporting drugs.

On Oct. 24, lawyers for the plaintiffs filed a discovery motion that included reference to a subpoena issued to CVS Pharmacy, seeking information about alleged irregularities in prescriptions filled for the Miami Dolphins “in the name of team trainer(s) as the ‘patient(s).’ ” A CVS corporate spokesperson declined to comment or furnish any additional information on the subpoena.

A 6-foot-2, 325-pound guard from Lufkin, Tex., Hadnot was drafted in the sixth round out of the University of Houston in 2004 by the Miami Dolphins. He went on to play for the Cleveland Browns (2008-2009), Arizona Cardinals (2010-2011) and San Diego Chargers (2010). While each franchise had varying team rules governing everything from player conduct to dress, he said the basic handling of prescription drugs was essentially the same.

“Different teams would have issues about how much apparel they’d want to give out, but with the prescription drugs, it was the same everywhere,” Hadnot said. “I was never told ‘No.’ ”

He got meds from doctors and trainers alike.

“I could get ’em from whomever,” he said. “Even trainers that were not the head trainers.”

He said trainers would ask, “What do you need?”

“Where I grew up, that’s a drug dealer’s question,” he said.

Meds were passed out on airplanes, Hadnot said, and even on a bus in Cleveland on a short road trip to Pittsburgh. “And alcohol was always around, and everybody knows it,” he said.

Asked to respond to the two player accounts of irregularities in how players received painkillers, a Cleveland Browns spokesperson said in an e-mail: “Similar allegations have been made against the league and denied as part of pending litigation. . . . Our medical staff prides themselves in taking great care of our players with their health and safety being of the utmost importance and of course complying with the law while delivering that care.”

Fujita also spent time with the Browns but declined to name the medical staffers on specific teams who provided medications to him, except to say the incidents he described took place “within the last five years.” He entered the league in 2002, a fifth-round draft pick out of California Berkeley, and played for four teams over 12 seasons, spending the majority of his time with the New Orleans Saints (2006-2009) and the Browns (2010-2012).

When he received painkillers, Fujita said, it was often from a trainer, and sometimes it was a second assistant trainer or even a third assistant trainer. He recalled one team distributed prescription medication on airplanes on road trips “at 35,000 feet” before a game was played. A trainer would ask, “Who’s going to need something?” he said, and hands would go up. The trainer would then pass down the aisle and hand out small, 2-by-3 inch manila envelopes, unlabeled, Fujita said.

Playing through pain

In playing through dozens of injuries during his 11-year career — separated shoulders, torn muscles — Fujita estimated he was given prescription painkillers four to five days a week, in addition to Toradol on game day. He and teammates joked about trying to have a Drug-Free Wednesday. Yet he estimated that only “about one third” of what he was given wound up noted or logged in his medical records.

That mirrors Hadnot’s experience. Over the course of his career, Hadnot suffered four torn ligaments in his left knee alone and one in his right, as well as a torn labrum in his left shoulder and multiple neck stingers. He said meds helped him play through back spasms, sore hamstrings, high ankle sprains, wrist and elbow injuries and countless concussions. To do so, he would take “five to six prescription pills during the week and then have a shot and take pills in game day. And that’s not to mention the Tylenol.”

The pressure to perform, he said, “was dire.” He was only as good as his last game “and if the last game was a loss, you are expendable. When you put that pressure on people, they go to great lengths, and it was a trickle-down effect, even to the trainers and doctors.”

The Toradol made him feel relatively pain-free until the next day, when “I’d feel like I was drug through the street.” It was hard to get out of bed and walk down a flight of stairs or even pick up his small daughter, Kalyn. “She’d say, ‘Daddy can you carry me?’ I’d say ‘Sorry, baby, I cannot,’ ” he said.

Before 2010, he said, the line for Toradol shots on game day would be so long, with 20 to 25 players awaiting shots, “that you had to budget it into your game day.” He said no doctor explained the potential side effects of Toradol to him until around 2010 or 2011, when stories of Toradol overusage began appearing in the media. There were suddenly team meetings in which doctors informed players it carried risks and required them to sign for the shot on an iPad in the locker room. In 2011-12, the NFL Physician’s Society issued a set of recommendations that Toradol shouldn’t be used prophylactically, should be used only for a known injury and shouldn’t be used for more than five days.

Hadnot said by that point he already had been administered Toradol more than 100 times.

Hadnot retired before the 2013 season after visiting the Tulane Institute of Sports Medicine for chronic pain in his left knee. As he sat in an office with his wife, a doctor told him that he had the knee of an elderly man in need of a joint replacement. He was 32.

Today, his body aches all day every day, and his fingertips go numb from his neck injuries. He gets headaches behind his eyes, and his vision is not what it should be. He still needs that knee replacement.

Asked whether he had felt especially uncomfortable with some of the things he put in his body as a player, he replied, “Looking back on it now? All of it.”