AP Photo/Mary Schwalm
Due to the intense nature of the game of football, it is no surprise that football players are no strangers to injuries. Injuries ranging from anxiety and depression to broken bones and nerve damage are among the daily injuries football players are at risk of. The opioid use statistics in the NFL are frightening and only increasing. 52% of retired players surveyed report opioid use during their career, with 71% reporting misuse of opioids.  These professional athletes will seldom find relief with over-the-counter pain medication like ibuprofen and Advil, so opioids have become the most effective treatment for pain related to football injuries and surgeries. Due to the frequency and severity of injury risks in the game of football, opioids are at this point, what will help players find the most relief, forcing many to take them regularly. Players can justify the painkiller habits due to the relief it provides allowing them to continue playing. If the players can keep playing, they can keep getting paid. Along with dependency, a problem with the overuse of painkillers in the NFL is the potential for the development of opioid-induced hyperalgesia.  This is a condition where people experience increased sensitivity to pain that is a result of taking opioids too often or for too long.  It is an issue that isn’t commonly addressed, but it is a growing concern. This condition will force these players to take more medication to combat the pain from taking the medication in the first place, a terrible catch-22.
Recently, a federal judge in San Francisco declined to certify a nationwide class in a lawsuit accusing the National Football League of failing to regulate teams’ use of painkillers, stating that a trial involving the conduct that affected the players in the league over a 35-year period would be a “sprawling train wreck.”  The eight retired players who brought the case including Hall of Fame defensive end Richard Dent, proposed a class of all National Football League players between 1973 and 2008 who received opioids, anti-inflammatory drugs, local anesthetics, or other medications.  Richard Dent and other plaintiffs initially sued the National Football League in 2014, alleging that the league introduced a “return to play” policy in which injured players were given painkillers and sent back into games which led to further injuries.  Players were allegedly faced with a pain management culture that encouraged them to play before their injuries were fully healed, which increased the risk of further injury and damage to their long-term health.  Dent and the other plaintiffs claimed that teams and the NFL distributed opioids, NSAIDS, and local anesthetics without a prescription and without regard to individual players’ medical histories – in violation of federal drug laws.  Former offensive lineman Keith Van Horne, who joined Dent in the class action lawsuit, stated that he played an entire season on a broken leg with the help of pain medication. Van Horne did not realize that his leg was broken until five years later. 
The district court judge initially dismissed the case, finding that the players union’s collective bargaining agreement with the National Football League precluded them from bringing the claims to court, however, the 9th Circuit reversed in 2018, on the grounds that the National Football League was not a party to the Collective Bargaining Agreement, which was signed by the individual teams, not the league.  On remand, the plaintiffs filed an amended complaint and removed everything except the negligence claim.  In 2019, the district court found that the league could not be held liable because it was not directly involved in distributing or administering medications.  However, the 9th Circuit again disagreed with the district court, ruling that the players could succeed because the National Football League voluntarily took on the duty of overseeing the administration of drugs by regulating their use by the teams.  After the players moved for class certification, the “voluntary undertaking” claim was denied due to too many variations across teams, states, and the National Football League’s supervision of each team over time to support a nationwide class. 
This problem is still prevalent in the National Football League. Combating the issue and finding a solution is something that won’t happen overnight. However, it should be a top priority for the league to find alternative pain management and rehabilitation programs that do not include the use of opioids. If the use of opioids is the only option for these players, then a program with strict management needs to be implemented to combat the future addictive problems that opioids pose to players. Exploring the options of massage therapy, acupuncture, and high-tech treatments using radio waves and electrical signals are options that may need to be considered. Injections and nerve blocks are very common and may not be enough to relieve prolonged pain but may be better options in the long run. It is interesting to note that the NFL and the NFLPA recently invested $1 million in research funding to determine the potential for using CBD and cannabis on pain management. Clearly, it is important to explore options that will allow players pain relief without further damaging their bodies and opening themselves up to the possibility of life-time addiction to play the sport they love.