The consequences of injuries sustained by NFL players have gotten more attention lately, in part due to the tragic death of Junior Seau and others who were found to have chronic traumatic encephalopathy. That’s started a debate about safety and the care players receive. The $765 million settlement the league reached with some of the retired players acknowledges past problems, but revising how injuries are treated can help now.
The NFL Is in the process of updating its 2010 Policy and Program for Substance Abuse, which currently says any player who tests positive for medical marijuana shall forfeit pay during their suspension. In the December 23 issue of ESPN The Magazine an article by Howard Bryant suggests that the NFL embrace medical marijuana. At Americans for Safe Access, we could not agree more. The following is an open letter to the two most powerful people in football to explain why and to provide policy suggestions they should consider when drafting the new NFL Policy and Program for Substance Abuse.
Dear NFL Commissioner Roger Goodell and NFL Players' Association Executive Director DeMaurice Smith,
No one needs to tell you that players in the National Football League get hurt, or that managing pain is a part of the game. Or that long after they’ve left the field, nine out of 10 players continue to suffer. You’ve seen the studies that track injuries and the abuse of painkillers, not to mention the devastating effects of concussions. You’ve funded care and reached financial settlements.
What you may not realize is that a proven botanical medicine can help trainers keep active players on the field while staving off the worst long-term health problems retired players face. And it can do it without the dangerous side effects of many of the current treatments teams are using. That medicine is marijuana, listed in the American Herbal Pharmacopeia as cannabis.
The great utility of medical cannabis is, in part, the remarkable safety of the medicine and lack of serious side effects; the other is the unique breadth of its therapeutic actions. Because it is simultaneously a pain killer, anti-inflammatory and neuroprotective agent, a single dose of cannabis can replace a handful of pharmaceuticals.
For muscloskeletal injuries, medical cannabis works as well as codeine and other opiates. It also has a synergistic effect that makes smaller doses of opiates more effective, lessening the chance of side effects and addiction. Using medical cannabis to lower doses or substitute for opiate painkillers can help reduce the misuse that leaves former players addicted at four-times the rate of non-players. For the difficult-to-treat neuropathic pain that can result from tissue and spinal injuries, low doses of medical cannabis have been shown to work when even handfuls of Vicodin won’t.
Medical cannabis also offers powerful anti-inflammatory properties without the damaging side effects of non-steroidal anti-inflammatory drugs (NSAIDs). Overuse by players of NSAIDs has been tied to kidney failure and liver damage, as you know, because former Seahawks Safety Kenny Easley sued the NFL shortly before receiving a kidney transplant in 1990.
But it’s not just ibuprofen that’s causing problems. Physicians for 28 of 30 teams reported giving an average of 15 game-day injections of Toradol, a pain-killing NSAID that thins the blood, increasing the risk of serious head injuries. After a dozen former players sued the NFL in 2011 over long-term side effects, the NFL physician task force last year recommended changing how Toradol is used, but that leaves them looking for safer alternatives. Medical cannabis is a prime candidate.
Beyond pain management and anti-inflammatory properties that can help players manage bodily injury, medical cannabis offers something no other drug can: protection for players’ brains. The powerful neuroprotective properties that fight head trauma such as the concussions that are the most serious consequence of the game have been documented by medical researchers since 1998. More recent studies show how activating the body’s endocannabinoid system in the same way cannabis does reduces the effects of serious traumatic brain injury (TBI) and can help keep seriously head-injured people alive. Cannabinoids, the active chemicals in cannabis, also have uniquely powerful ways of fighting Central Nervous System diseases that may be the result of trauma, such as Alzheimer’s, Parkinson’s and Amyotrophic lateral sclerosis (ALS), all of which disproportionately affect NFL players. That means the powerful antioxidative, anti-inflammatory and neuroprotective qualities of cannabis can help active players recover quicker from concussions while mitigating the long-term damage that may result in these deadly diseases.
The NFL has taken steps to address ALS by adding it to benefits former players receive under the 88 Plan that also covers Parkinson’s and dementia, but if players such as the New Orleans Saints’ Steve Gleason had access while he was playing and sustaining the trauma that may have triggered his ALS, the progression of the disease may have been very different. The remarkable story of Cathy Jordan, a woman given 3-5 years to live when she was diagnosed with ALS in 1985, but has now used cannabis to successfully fight the disease for nearly three decades, should give hope to everyone.
Historically, the NFL may have treated cannabis as a PR problem, but times have changed. Just last month you had to deal on two successive days with the fallout from Atlanta’s Jason Snelling and Kansas City’s Dwayne Bowe each being arrested for marijuana possession. But Bowe’s hometown paper was quick to point out that “the case for marijuana use by NFL players is straight-forward”, noting your sport is one of pain and stress, and the drug can help with each. Howard Bryan made the case in ESPN The Magazine, beginning with the headline “It's time for the NFL to embrace a new pain reliever: marijuana.” With eight in 10 Americans saying doctors should be free to make cannabis a treatment option, extending that opportunity to players is unlikely to cause much of a kerfuffle.
The biggest challenge may be figuring out how to change the rules to allow it. Many sports provide "Therapeutic Use Exemptions" for approved medical treatment with drugs that are otherwise banned. If the NFL adopted a similar policy for medical cannabis, players with medical clearance would no longer need to fear a season-ruining suspension, and neither would their teams. For that to work well, the federal government needs to clear the way for trainers to dispense it. Until then, that approach could create unfair advantages for teams in medical cannabis states.
Alternatively, the NFL could follow the lead of Olympic sports and only worry about players using the drug while on the field. The World Anti-Doping Authority last year raised the threshold for a positive test for marijuana by a factor of 10, from 15ng/ml to 150ng/ml, with the stated intent of only targeting athletes who are using it in competition. That’s what the UFC and the Nevada State Athletic Commission have done.
Athletes who succeed at the NFL’s level of competition are driven, disciplined people whose pursuit of excellence entails careful choices and enormous personal sacrifices. Love of the game and a will to win propel them, but millions of dollars in salary are also at stake in careers that can be cruelly short. Playing an extra season or two can mean the difference between supporting their families well in retirement or not. Those who are choosing to use cannabis to recover from what the sport demands are doing so because they’ve determined it works better with fewer side effects than other options.
Medical science backs them up on that. It’s time the NFL did, too.
Americans for Safe Access