But pain is pain; it doesn't honor new rules or stop when the doctor is out. Has the clampdown altered player behavior?
"Nothing has changed. Not a single thing. If anything, it's worse than ever." The speaker is Dr. Alex Stalcup, the co-founder and medical director of the New Leaf Treatment Center near San Francisco. Stalcup knows as much about opioid abuse as anyone connected with the league; he's treated hundreds of players over more than two decades and has a dozen or so currently under his care. "I've gotten the call so often, I can recite it by heart," he says. " 'Doc, I'm sick but I gotta play Sunday – can I swing by your house in the morning?'"
Stalcup has quietly helped players keep their jobs while weaning off Oxy and Vikes. "They get to where they can't find enough pills, or their liver has started bleeding, and they're scared. So they come to me because I'm known around the league as the guy who'll treat off-site and keep a secret."
He describes the current clubhouse as a pharmaceutical swap meet, in which players trade drugs and links to "star-fucking" doctors who are happy to write scrips for famous clients. "Team doctors have gotten cautious about the amounts they dispense, so guys who were getting X now get X-minus-10 and have to go elsewhere to make it up. They either cop from the guy next to them or road-trip to Florida and load up at the legal pill mills."
Florida has the softest opioid laws of any state on the Eastern seaboard and is overrun with walk-in, cash-only clinics that hand out prescriptions to all comers. Despite a recent push to shut down huckster physicians, the state accounted two years ago for almost 90 percent of the OxyContin sold by doctors in the country. "Florida's a sewer: You can see three doctors in one day," says Stalcup. "Each of them will do a bogus MRI to make the visit look legitimate, then give you a scrip to treat whatever they 'found' – and they'll always find something on a player's scan."
Dubbing himself the "anti-Florida doctor," Stalcup switches players to Suboxone and maintains them on the drug for several years. Suboxone, a semisynthetic variant of morphine, is the treatment of choice now for opiate addiction and chronic pain. As Suboxone is a safe but potent painkiller that lasts longer than its cousin methadone, I asked Stalcup about its potential use as game-day analgesic. "No one should ever play in pain, or load up on drugs to try and mask it," he said. "But if you're asking me if guys are taking Suboxone or methadone on game day, the answer, unequivocally, is yes. I know, because I prescribed them myself."
He does so knowing that if he doesn't prescribe, the players will find someone, or something, worse. "A lot of these guys are three game checks from broke, so they're going to go out there regardless. But the newsflash here isn't that football players are junkies: I've been cleaning them up since 1986, and it was going on before I showed up. No, the real news here is that there's treatment that works, no matter how bad your addiction. If we pull you into care once you do stop playing, we'll get you well, with dignity and on an outpatient basis, while you go about the next phase of your life. You don't have to be another guy who loses it all and breaks your loved ones' hearts."