The NFL's New Drug Policy Could Help the Home Team

While the vast majority of the NFL media breathlessly covered the most farcical "scandal" in recent sports history, Jenny Vrentas of the MMQB wrote about a story that actually matters. It can be found, naturally, some 3,000 words deep into Peter King's weekly Monday column. It's worth the dig.

Last winter, the DEA raided several NFL stadiums in response to a recent class action lawsuit by former players alleging improper handling and distribution of controlled substances, including painkillers. "We have no information to indicate that irregularities were found," league spokesman Brian McCarthy said in a statement. According to Vrentas, however, the NFL subsequently has changed its in-stadium drug policy, which will change the way medication is distributed on game days. This is a big deal, and not just because it could influence wins and losses.

First, controlled substances will no longer be stored at NFL stadiums. Teams previously had been allowed to store powerful painkillers such as Vicodin and Percocet at stadiums, so as long as they complied with stringent DEA security and distribution guidelines—something NFL clubs haven't always done, according to the lawsuit filed against the NFL by former players. (The suit ultimately was dismissed under labor law preemption, without testing the players' allegations.) The Controlled Substance Act requires that team physicians write a prescription for each controlled substance distributed and keep track of every pill, a laborious, time-intensive process that many NFL players claim does not occur on game days. This isn't just a paperwork issue. Teams have strong incentives to skirt these regulations on game day so that players feel as close to healthy as possible before running onto the field.

The second major change may strongly relate to the first. As Vrentas reported, the NFL has created "a visiting team medical liaison, an emergency physician from the local area certified to practice medicine and prescribe controlled substances in that state." Essentially, this doctor will be the one to prescribe and distribute controlled substances on game day, since team doctors don't have the required licenses to write prescriptions or distribute controlled substances in another state. The NFL claims team doctors didn't distribute controlled substances out-of-state before—a necessary if not necessarily believable claim, given that otherwise they'd be admitting to breaking federal law. The lawsuit alleged doctors (or team trainers, which would be even worse) did just that.

The upshot of these rule changes is that, in all likelihood, home teams will be receiving medication from their team doctors, whereas away teams will be getting drugs from an independent medical liaison, a doctor practicing in the local community with no incentive to violate the Controlled Substances Act for the benefit of a football team. If you listen to what former players have to say about their dependance on illegally receiving controlled substances on game day in order to perform on the field, this could drastically impact the game—far more than, say, deflated footballs.

I asked Dr. Matthew Matava, President of the NFL Physicians Society and team doctor for the St. Louis Rams, to provide more details on the backgrounds of these medical liaisons and what their role will be on game day. Matava told me, "These physicians will work in concert with the team's medical staff in order to optimize the care of the players while respecting all laws regarding the use and distribution of controlled substances."

Some who have played in the league see rigidly abiding by the distribution of controlled substances as drastically different than NFL habits in the past. "The league would look completely different if they followed just the basic medical guidelines, because you wouldn't have [injured] players coming back to play that soon," Mel Owens, a former NFL player and one of the lawyers who filed the lawsuit, told the Washington Post shortly after the DEA raids. "The only reason they play is because they are heavily medicated." A VICE Sports series on painkiller usage in the NFL echoed these sentiments.

Here's a hypothetical of how things might work under the new rules: The home team has its normal doctor, who is well aware of what he can and can't do. Meanwhile, the away team has a local emergency room doctor on the sidelines, likely trained in treating both traumatic and non-traumatic injuries. He's the one distributing controlled substances to the away team. He doesn't know the players' medical histories, or their prior treatments; he's not their doctor, after all. The trainers will be around, but if the medical liaisons are truly independent, then the trainers can't tell them what to do.

Players will walk up to the medical liaison before the game and ask for, say, Toradol. The doctor will tell them he can only provide 10mgs, because that's the most a doctor can give without writing a prescription; he cannot justify a prescription given that Toradol is used for acute, severe pain, not pre-game soreness. This, of course, assumes the doctor is willing to give the player Toradol for off-label usage at all. It all depends on what the medical liaison is willing to do.

Well, 10mgs won't do NFL players much good, because they are huge humans with equally sizable, long-developed tolerance for this drug. NFL players have been taking Toradol pregame for years—colleges do it, too. Now you have a locker room full of players who can't get their typical—if off-label—pregame medical treatment. They're running onto the field feeling worse than the other team, not to mention lacking the psychological boost of having a needle stuck in your ass before the game, which several former NFL players have told me pumps them up.

Of course, all of the above is purely speculative. But if I was working the sports books in Las Vegas, I would be paying very close attention to the home/away splits this season. Not because NFL team doctors are inherently corrupt, but simply because the rules are now different for home and away teams. Which team would you bet on—the home club with its normal doctor, or the away club with some third-party physician who owes the team nothing, doesn't know the patients, doesn't care about wins and losses, and just might put his or her professional ethics ahead of the painkilling needs of professional football? When the rules aren't uniform, there's an opportunity for one team to find an edge.