06/18/2009 05:12 am ET | Updated May 25, 2011

Steroids are Just the Tip of the Iceberg in Professional Sports

With the recent outing of Manny Ramirez and the ongoing, seemingly never ending controversy regarding steroids and other performance enhancing drugs (PED) in baseball, little attention has been focused on a much larger problem in professional sports -- abuse of prescription pain medication.

The overuse and abuse of narcotic pain medication in professional sports, especially contact sports, is enormous. The use of performance enhancing drugs is minuscule and almost meaningless in comparison.

If, for a period of time, Major League Baseball utilized a 'don't ask and don't tell' approach to PED/steroid use, the NFL must be in complete denial. Professional football is so damaging to the human body that it is nearly impossible for a regular player to avoid the occasional use of narcotic pain relievers.

There are two unarguable constants in the NFL: 1. some part of your body is nearly always seriously hurting and 2. there is always someone eager to take your place in the line up.

It is a well-known mantra in the NFL that a player can't make the team from the training room (nursing an injury instead of producing on the field). Players quickly learn that a cortisone shot will make it feel better in a few days. A percocet or vicodin will make if feel better right now. It is also commonly said that the letters NFL stands for 'not-for-long' if a player cannot consistently suit up and produce on the field for whatever reason.

After an average 3-year NFL career, daily pain medication is a way of life for many, if not most players. Players with average length careers (about 3 years) are often the marginal players whom are routinely relegated to the most dangerous duties, special teams. Veteran players with significantly longer tours of duty amass injuries due to length of service on the field of play.

Their career will one day end but the pain commonly does not. Year after year of daily physical abuse leads to substance overuse which in turn can often lead to abuse and dependence. The narcotic habit that developed during a player's active career often continues far into retirement.

The NFL season may last from early September till early February but prescription narcotic use has no off-season. The NFL season and careers end but chronic pain and narcotic dependence know no such boundaries.

If the NFL disputes my assertions as to the magnitude of the crisis, they should simply walk into any NFL locker room and demand every player to anonymously provide a urine sample. The goal is not to assess individual blame but to gauge the level of prescription narcotic pain reliever use in general.

Oh yeah, that can't happen because it would violate the collective bargaining agreement which governs the interaction between the teams and the players. It's just the latest version of a failed don't ask and don't tell policy. The teams definitely don't want to know and the players certainly are not interested in telling. But who will pick up the pieces when it all inevitably comes crumbling down?

Don't be naive. This is not just an NFL or MLB problem. There is plenty of dirty urine to go around.