The NFL is being sued by 1,300 former players for the way it distributed prescription pain medicines so players can get back in the game. The former players claim that they were not informed of the side effects of potent pain killers such as Percodan, Percocet, Vicodin, and Toradol. Percodan, Percocet and Vicodin are all opioid painkillers and Toradol is a strong non-steroidal anti-inflammatory (NSAID) drug.
Many of the former NFL players involved in the lawsuit played during the 1980s and 1990s when practices for administering powerful painkillers, both opioids and NSAIDs, were cavalier. Today they are, in theory, more regulated. The players state that the “NFL medical staffs routinely violated federal and state laws in plying them with powerful narcotics to mask injuries on game days.” They also claim that medical staff was negligent by keeping important information on the players’ medical conditions from them, such as markers for kidney disease or broken bones.
At issue are 1) whether doctors and trainers violated the law by illegally administering prescription drugs, and 2) whether players were adequately informed of the side-effects of the drugs as well as informed of any medical issues that doctors found that might affect their decision.
Doctors Behaving Badly?
In an attempt to investigate whether illegal practices were going on, the DEA paid unannounced visits to several professional teams in November (2014) in which they questioned team doctors and trainers after the game. This investigation was to ensure that doctors were prescribing and distributing drugs appropriately, that they were handling controlled substances properly when crossing state lines, and that they had a license to practice in the state. Thus far, the DEA has not found evidence of illegal activities in their investigation.
However, an investigation from Vice Sports into how and where NFL doctors acquired such large amounts of prescription drugs, shows that, at least in the past, they were likely obtaining drugs illegitimately. From 2009 to 2010, several NFL teams, as well as other professional and college sports teams, acquired large amounts of opioids and NSAIDs from a company called SportPharm, an illegal drug distributor operating behind the legitimate company, RSF Pharmaceuticals. RSF Pharmaceuticals eventually shut down, and SportPharm was re-branded as a subsidiary of Champion Health Services, which is still in operation. Many teams would fill prescriptions in player’s names without the player knowing so that the actual quantities would fly under the radar.
The second issue has to do with players’ rights, and whether they were adequately informed of what drugs they were given, their medical options given their current medical situation, and the long-term side effects.
Many of the players received opiate drugs without being told about their addictive nature, and were often told to take them for longer or in higher dosages than what is recommended by the FDA. Furthermore, many players were given prescription pain medicine without a doctor’s evaluation or monitoring. One former player reports that while playing for one team, an assistant trainer would pass out unlabeled manilla envelopes with pain medicine for any player that raised his hand and said he needed them. Another former player said that envelopes with prescription pain medicine would be waiting in the seats on the airplane for the players.
Player testimonies from the class action law suit website show that many players were given powerful pain medicine instead of being told that they needed rest and recovery or that the problem was actually much worse and required surgery. Several players said that NFL doctors knew of existing health issues, but did not inform the players. Two players’ testimonies state that NFL doctors knew that they had indicators of kidney problems but did not tell the players. Both former players now have renal failure.
Another former player, Rex Hadnot, said in a Washington Post interview that he was given Toradol pills and/or injections once-per-week for nine years. He was never told that Toradol should not be administered for more than five days due to risk of kidney damage, heart attack, and stroke. He said that sometimes he would receive both a shot and a pill on the same day, a much higher dosage than the FDA recommends.
The Mountain Climber Problem
Part of the problem with discerning the ethics of safety for football players is exemplified in what H. Tristam Engelhardt calls “the mountain climber problem.” In general, climbing a mountain is more dangerous than not climbing a mountain, but we do not consider it unethical to allow a mountain climber to scale a mountain if he so desires. Similarly, playing sports is inherently more dangerous than not playing sports. Football players take on additional risks by choosing to play the sport. Therefore, what protections, if any, are football players owed?
There is a tension between restricting someone’s freedom and allowing them to put themselves in harm’s way. Typically, with the mountain climber problem, ethicists will say that it is unethical to allow additional harm to come to the person such that he or she could not accomplish the stated goal of climbing the mountain. For example, while mountain climbing is inherently dangerous, the climber should still use a harness and ropes. In the case of football players, while it is an inherently dangerous sport, one can enforce safety precautions to ensure that players are not injured in such a way that they cannot play the sport. This is the motivation behind stricter rules to prevent concussions, helmet design, and padding.
The difference between the mountain climber and the football player is that collisions are part of the sport. Pain is a given. The former players who are suing the NFL claim that their health was sacrificed in the name of sales. But, other players criticize the lawsuit as nothing more than a money grab on behalf of former players because they knew what they were risking by playing the sport.
Despite whatever motivations are behind the lawsuit or the NFL’s medical decisions, it is unethical to de-humanize athletes, even if they willingly chose to engage in de-humanizing activities. Let’s take a non-football example: If a woman choses to trade sex for money, she is willingly commodifying herself and ultimately engaging in a de-humanizing activity. While this may have been her free choice, it does not mean that if she goes to a doctor, the doctor is no longer ethically obligated to treat her with human dignity. In other words, even if she chooses to engage in activities that are de-humanizing, that does not mean it is okay for medical health professionals to treat her as less-than-human.
In the case of football players, even if they may choose short-term returns at the expense of long-term injury, they need to be given the opportunity to make an informed choice on the matter because, ultimately, they are the ones that have to live with the consequences.
In the latest issue of Salvo Magazine (Winter, 2014) I cover the larger issue of prescription pain medicine addiction, what opiate drugs actually do to the brain, and how one becomes addicted. The former NFL players’ claims about the over-prescribing of prescription painkillers may be part of a larger national problem that saw a peak in opiate drug prescriptions during the years that many of the former players were active in the NFL.