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For N.F.L. Retirees, Opioids Bring More Pain

A brutal game got them hooked on painkillers. In retirement, they battle addiction. The opioid crisis courses through football.

Ken Belson, The New York Times, Feb. 2, 2019; original article contains links and additional illustrations

Image from article, with caption: Randy Grimes sought help when all the trappings of his N.F.L. life were gone, and now works at a rehabilitation center in Delray Beach, Fla.

Earl Campbell, a former All-Pro running back in the N.F.L., said the first painkillers he took came in a small brown packet that a trainer gave him on the team plane. The former lineman Aaron Gibson received his first painkillers in his rookie year after undergoing shoulder surgery. Randy Grimes, a former center, started taking Vicodin and Halcion, a sleeping pill, in his second season to get through full-contact practices.

Like hundreds of former N.F.L. players, Campbell, Gibson and Grimes said they never took painkillers in college, or at any time before they entered the league. Yet as professionals, they regularly used the pills to continue playing, and even in retirement, their pill-popping habits persisted, sending them on haunting, shattering journeys into opioid addiction. It has taken years of struggle, money and anguish in order to heal.

Putting up with pain — a lot of it — has for decades been central to the bargain of playing for glory and money in the N.F.L., the biggest stage in American sports. To do that, countless players have long ingested far more pills than they should. In recent years though, N.F.L. players, especially linemen, have gotten significantly larger, and pain medication has become far more potent and addictive, with devastating consequences.

A study published last year in the Clinical Journal of Sport Medicine found that 26.2 percent of retired players said they had used prescription opioids within the past 30 days. Nearly half of those players said they did not use them as prescribed.

Seven percent of retired players — equal to about 1,500 men — said they had misused painkillers in the past month, according to a study conducted in 2011 by researchers at Washington University School of Medicine in St. Louis. That was more than three times the national rate for adults 26 and older at the time. Seventy-one percent of those surveyed had misused drugs during their N.F.L. careers, and some of them continued to do so after they left the league, the study found. Players who abused opioids in retirement were also more likely to be heavy drinkers.

In the past, players might have tried to manage their pain with a handful of Percocet, or by indulging in the over-the-counter medicines that used to be left in bowls in trainer’s rooms. Now, supersize men with crippling injuries and high tolerances for pain medication, such as Grimes and Gibson, seek out far stronger and more dangerous drugs, like high-dosage OxyContin, which cost about $500 for roughly 50 pills.

“I was running through those like nothing,” Gibson said. “One doctor who thought he was the only one treating me said, ‘Aaron, what I’m prescribing you is what I’d give a Stage 4 cancer patient.’”

The problems often grow worse after careers end, when the effects of injuries sustained while playing require interventions that can include multiple surgeries.

“When you get out of pro football, you start having these operations,” said Campbell, a running back for most of his career with the Houston Oilers who was confronted a decade ago by his family about his drug use. “I didn’t realize what I had until I got out of rehab.”

For decades, players have justified taking painkillers because the medication helped them earn big N.F.L. paychecks. Now, a growing number are saying the easy access to pills turned them into addicts.

“I absolutely said, ‘When I’m not playing, I’m not going to have to do this,’” said Gibson, a 6-foot-6 first-round draft pick who played in the N.F.L. from 1999 to 2004. After he retired, he took as many as 200 pills a day before he stopped taking painkillers three years ago. “If I didn’t play in the N.F.L., I know I wouldn’t have been in this situation,” he said, referring to his life as a “full-on pill addict.”

Asked what the N.F.L. was doing to reduce the reliance on highly addictive painkillers, Roger Goodell, its commissioner, said the league’s executives were consulting with pain management experts and seeking recommendations.

“We obviously put this as a huge priority for us, making sure that we are taking care of our current players as well as our former players,” Goodell said at a news conference during the lead-up to the Super Bowl. “Our players are cared for by the world’s finest medical professionals. The dedicated medical and training staffs of every N.F.L. club are and always have been committed to providing their patients with the best possible care.”

What Goodell did not say is that the distribution of drugs by team doctors and medical professionals has come under repeated scrutiny from federal regulators. It is also central to at least two active lawsuits brought by former players who accuse N.F.L. teams of, among other things, not warning them about the destructiveness of the painkillers they were given.

In the first case, led by the former Chicago Bears defensive end Richard Dent, a federal judge initially dismissed the suit on the grounds that the league’s collective bargaining agreement required the parties to contest this kind of dispute in arbitration, not the courts. The players appealed, and the United States Court of Appeals for the Ninth Circuit in San Francisco ruled in their favor, reinstating the case.

“The parties to a C.B.A. cannot bargain for what is illegal,” the appeals court panel wrote.

In the second case, the players sued the clubs that employed the team doctors, not the league, for improperly distributing painkillers. The same judge who dismissed the first case ruled that the statute of limitations had passed. The Ninth Circuit heard arguments in an appeal in December.

In 2017, the N.F.L. Players Association filed a grievance against the league for overprescribing painkillers, not keeping accurate records of the drugs that teams distributed and denying the union's medical director access to meetings and documents relevant to the distribution of painkillers. The two sides are locked in arbitration.

Even before the legal action, the league’s pill culture had been well documented in tell-all books by former players and team doctors, and portrayed in books and films like “North Dallas Forty.”

What happens to players like Gibson when they leave the N.F.L. cocoon has been less explored. Like many players, his departure was abrupt, involuntary and wrenching. Although he no longer abused his body every week in practices and games, he could no longer rely on team doctors to help him cope with the lingering injuries he had to his neck, back, shoulders, knees and ankles that made getting out of bed in the morning a 30-minute ordeal.

So he coped on his own. He found new doctors, visited pain clinics and bought painkillers on the street and even from residents at retirement homes.

Addiction is expensive. Most pills are not covered by insurance. So like other addicts, retired N.F.L. players with addiction problems reach into their pockets. Spare cash disappears. Possessions are pawned. Homes are sold. Players are abandoned by their families, leaving men like Grimes sleeping alone on the floor in an empty house, as he recounted, with the utilities turned off, consumed by the pain of withdrawal.

An ingrained warrior mentality can prevent them from admitting weakness. Grimes finally sought help 17 years after his career with the Tampa Bay Buccaneers ended in 1992, when all the trappings of his N.F.L. life were gone.

“At that point, I had no excuse not to do it,” said Grimes, who has been off pills for almost a decade and now works for Transformations Treatment Center in Delray Beach, Fla., which helps former players and others battle substance abuse. “I was jobless, desperate, my family wanted nothing to do with me. I thought I hit a lot of bottoms, but that was the real bottom.”

The Player Care Foundation, which is run by the league; the union’s Player Assistance Trust Fund; and Gridiron Greats, a nonprofit group started by the former coach Mike Ditka, help retired players with substance abuse problems.

In addition to the chronic pain from years of playing football, the shock of leaving the league — his coach simply tapped him on the shoulder and told him he was cut — and the struggle to find a job that could match the elation of running onto a field on Sundays sent him into an emotional tailspin.

“I just wanted to numb up because I couldn’t move on to the next step, and I didn’t know what that next step was,” Grimes said.

The injuries did not heal, and Grimes’s tolerance for Hydrocodone, Percocet, Vicodin and other painkillers grew. To feed his addiction, he visited an array of doctors with the X-rays from his playing days.

Later, he visited pain clinics where, he said, doctors requested only the briefest justification for writing prescriptions, at a time when many physicians accepted a sales pitch from drug companies, such as Purdue Pharma, the maker of several potent painkillers, that their pills were a safe and effective way to treat pain. These pills required more and more cash, though.

“He’d go to these loan places, and all of a sudden he’d have money,” Grimes’s wife, Lydia, said. “Before I knew it, my jewelry was missing. He was pawning things. Things were missing off the wall.”

Eventually, they sold the house and Lydia moved in with her parents. That’s when Grimes finally sought help, 10 years ago, at a treatment center in New Jersey.

Gibson, the former lineman, had a similar tale. He spent six years in the N.F.L. and several more in an indoor football league, where painkillers, he said, were even easier to get. In retirement he was left with a battered 400-pound body that he medicated with opioids. The abuse he endured in his career and his struggles with obesity left him with shoulders that barely move, chronic knee and back pain, and feet that are missing the big toe.

He also ran a company that provided bodyguards. But trying to find pills soon became his full-time job. Like Grimes, he found doctors willing to write prescriptions. When they realized he was also getting painkillers from other doctors, he found new doctors, then pain clinics. He was so hungry for painkillers, he found a senior center where the residents were willing to sell their pills to him.

“They can easily make $600, $700, off this one bottle of pills, so that would double their social security for the month,” he said.

Gibson tried to quit cold turkey, but the withdrawal symptoms overwhelmed him. Then he met Brigitte, a sports massage therapist who became his wife. She worked on addressing the pain that was driving him to take pills. Several times a week, she stretched his muscles and tendons in his neck, back and legs. As the pain eased, Gibson took fewer pills. After he stopped entirely, he leaned on Brigitte when he had cravings.

“There were a lot of talks at 3 a.m.,” she said.

Off painkillers, Gibson now sleeps better and eats healthier food. He has lost about 100 pounds. He has had surgery on his hip, feet and mouth, but has endured the pain without prescription drugs because he fears a relapse.

“It was an everyday battle to say no, I don’t want the pills,” said Gibson, who had a sign in his hospital room telling nurses and doctors not to give him painkillers. “They are a road that I will never go down again.”

Ken Belson covers the N.F.L. He joined the Sports section in 2009 after stints in Metro and Business. From 2001 to 2004, he wrote about Japan in the Tokyo bureau.