Adderall has become the drug of the moment in the NFL. Richard Sherman and Brandon Browner of the Seahawks are appealing suspensions for using it. Eric Wright of the Buccaneers is just starting his. Aqib Talib, Joe Haden and Tyler Sash recently completed theirs. Some players claimed to have prescriptions. A few players even earned exemptions or had their suspensions overturned. But others admitted outright to abusing the drug.
You don't hear a peep about steroids. Cocaine seems relegated to the classic rock channel. When a suspension comes across the wire these days, it almost invariably involves Adderall.
The confused public and media have interpreted this sudden epidemic in two ways. Perhaps players with prescriptions and preexisting conditions are running afoul of the NFL's overzealous drug policy because they were too foolish or lazy to apply for exemptions. Or, the players are really testing positive for steroids and street drugs and taking advantage of the NFL's privacy policies to blame their suspensions on a "socially acceptable" medication, something so safe and harmless that your nephew takes it.
To the rest of the world, Adderall is a notoriously abused pharmaceutical, a medication that transforms hyperactive children into productive scholars but becomes the upper of choice for stressed undergrads, overworked adults or partiers in search of a cheap, readily available high. In the NFL, as player after player gets suspended for allegedly using it, Adderall is being written off as a convenient excuse or an irrelevant fiction.
This is an NFL Adderall suspension article that takes a very novel approach: that NFL players are being suspended for abusing Adderall because they are abusing Adderall, not because they are trying to hide steroid abuse or cannot fill out forms properly. Prescription abuse has become a plague on college campuses and in the workplace. Recent evidence suggests that it has also become a problem in the NFL. For some reason, we would rather believe a conspiracy theory.
Here is a partial list of players who have been suspended, allegedly for Adderall, since the start of training camp, plus a few points of order to help sort out the complexities of the medication and suspension issues.
Tyler Sash, Giants safety, received a four-game substance abuse suspension in August pursuant to a failed drug test in March. Sash said that he was taking the drug "under a doctor's care for an anxiety condition" and did not know that it was a banned substance. He lost his appeal to the NFL.
Mike Neal, Packers defensive lineman, received a four-game substance abuse suspension and missed the first four weeks of the season. Neal produced a prescription for Adderall to treat an obsessive-compulsive disorder. The NFL accepted the prescription moving forward, but did not reduce Neal's suspension.
Point of Order: Most sources only indicate Adderall as a treatment for diagnosed Attention Deficit Hyperactivity Disorder (ADHD) and narcolepsy. The pill is often prescribed for non-indicated disorders, including OCD and anxiety, but those treatments are not well-established, and many sports governing bodies (including the NFL) evaluate exemption requests based on such treatments on a case-by-case basis.
Joe Haden, Browns cornerback, received a four-game suspension in August. An anonymous report stated that Haden took an Adderall as a "pick me up" during a trip to Las Vegas. Haden called the incident "a very dumb mistake" after serving the suspension.
Point of Order: According to the National Football League Policy and Program for Substances of Abuse, four-game suspensions are part of the Stage Two Intervention process. A player enters Stage Two Intervention by failing a previous drug test, exhibiting behavioral irregularities or simply failing to comply with the Stage One Intervention procedures after the first failed drug test. The policies for steroids and similar performance-enhancing substances are more stringent and subject players to a four-game suspension after the first failed test.
Andre Brown, Giants running back, tested positive for Adderall over the summer. When he proved that he had been receiving treatment for ADHD since 2009, the suspension was lifted.
Brett Hartmann, Texans punter, received a four-game suspension to start the season. That suspension was reduced to three games when Hartmann produced evidence that he was taking prescription Adderall to treat ADHD.
Point of Order: Appendix E of the NFL's Policy and Program for Substances and Abuses specifically addresses prescription medications. It clearly remands players who test positive for prescription drugs to Stage One Intervention and provides appeal language for players seeking a reduced sentence: "A player who is in the Intervention Program and who tests positive a first time due to the abuse of a prescription or over-the-counter drug will be eligible for a reduction from the applicable discipline unless his entry into the Intervention Program was due to the abuse of a prescription or over-the-counter drug."
In other words, the mechanism is in place to reduce a player's suspension in the event of a first offense for prescription medications, but the suspension presupposes that the player was already in the Intervention Program for something else.
The language of Appendix E appears to contradict language in the league's Steroid Policy, however, which lists Adderall among the "certain stimulants" included in that policy. According to some sources, the exact classification of Adderall is causing some confusion, as both the league and the NFLPA try to come to grips on a suddenly prevalent problem.
Aqib Talib, Patriots cornerback, received a four-game suspension in October, when he played for the Buccaneers. "Around the beginning of training camp, I made a mistake by taking an Adderall pill without a prescription," Talib said.
Will Hill, Giants safety, received a four-game substance abuse suspension just as teammate Tyler Sash was about to return from his suspension. Hill said that he started taking Adderall to treat ADHD last spring. "I know there are other people who do take it for like, to be up, to have fun, things like that, but some people really need to take it because if they don't take it, then what? " He also said that the team specifically warned him about Adderall when it signed him, but by then he had already been tested. Hill lost an appeal but is filing for a future exemption.
Eric Wright, Buccaneers cornerback, received a four-game substance abuse suspension after his appeal was denied this week. Wright said that he began taking Adderall in July to treat "health issues."
Point of Order: Players can obtain a Therapeutic Use Exemption for medications like Adderall, but it is not as easy as waving a prescription around. "The way our system works, it is difficult to obtain one," said NFL senior vice president of labor law and policy Adolph Birch in a recent USA TODAY interview. "There are certainly legitimate uses for Adderall, and if people have a condition that legitimately necessitates it, our doctors and advisers will give it. But it is a very, very detailed process to obtain one." The league requires players to seek second opinions and assigns specialists to review claims, necessary precautions in a world where scripts can be too easy to come by.
Richard Sherman and Brandon Browner, Seahawks cornerbacks, are currently appealing four-game suspensions. An initial report stated that Sherman ingested a cup full of diluted Adderall that belonged to a teammate. Sherman denied the report, and both players are claiming innocence, citing drug-testing irregularities.
Point of Order: The NFL Policy and Program of Substances and Abuse spells out the league's confidentiality protocols in precise detail. The NFL itself only announces suspensions, not the substances or infractions that led to those suspensions. Specifics invariably come from players, their agents or unnamed, and rarely unbiased, sources.
That last fact, coupled with the sudden explosion of Adderall cases, has led skeptics to write off "It was Adderall" as a convenient lie to hide steroid abuse.
There's a simpler explanation: Players are claiming to take Adderall because they are in fact taking Adderall. Some have a long-time prescription, others acquired recent (perhaps spurious) ones, and the rest are doing what a frightening percentage of our society is doing: abusing a pharmaceutical for professional or recreational purposes.
Brake Fluid for the Brain: Adderall is the brand name for a psychostimulant used primarily to treat Attention Deficit Hyperactivity Disorder (ADHD), often in young adults. It consists of a combination of four amphetamine salts. Chemically, it is classified as an amphetamine, but there are several key differences between Adderall and the "greenies" of yesteryear. The biggest difference: Adderall's stimulants target a specific part of the brain. "If you smack your forehead," according to Dr. Russell Carleton, a former ADHD counselor with a doctorate in clinical psychology, "it's that part of your brain. The frontal lobe."
Using stimulants to treat hyperactivity sounds counterintuitive, but Adderall stimulates the part of the brain that controls the other functions and keeps them from going haywire. "The problem with a hyperactive person is not too much on the gas pedal," Carleton explained, "it's that there's not enough brake fluid."
Used as prescribed, Adderall is an incredibly beneficial substance. Young people with attention and behavioral issues become productive students; distracted, fidgety adults can focus on their jobs. The phrase "used as prescribed" is key, of course. Many of us have used Percocet safely and effectively after surgery, but we also knew people eager to buy our leftovers when we felt better. Prescription cough medicine can get you through a bronchial infection, or it can turn JaMarcus Russell into a cautionary tale. Like any powerful medication, Adderall can be abused.
Adderall stimulates the mesolimbic reward pathway of the brain, which is a clinical way of saying that it can get you high, and can be addictive if not used as directed. It is classified as a Schedule II substance in the United States, which means the Drug Enforcement Administration considers it a high abuse-potential drug and restricts the size and scope of prescriptions. Abusers of Adderall, writing on drug counseling and therapy websites, describe an initial euphoria similar to 50 cups of coffee, or even the designer drug Ecstasy, especially when Adderall is used to excess or "prepared" for abuse by crushing and/or snorting.
These same abusers invariably go on to recount tales of habituation and dependence. Many start as prescription users. "My life has turned into an unhealthy, hellish cycle," reads one account at The Experience Project, "fill my script, binge until its gone, crash into a dark and debilitating state of withdrawal, recover to a basic functioning level, refill RX a.s.a.p., repeat." There are other harrowing tales: college roommates borrowing, buying and stealing from each other; harried parents turning to their children's meds for an occasional jolt, then losing control.
This brake fluid for the brain is sometimes called a "mental steroid" when it helps abusers zero in on otherwise-monotonous tasks for hours on end. It's a performance enhancer when it comes time to study (say, a playbook), and again when the weary user needs to be peppy and hyper-alert (say, when covering a wide receiver). It also has one additional appeal to potential abusers: "It washes out of your bloodstream, just like that," Carleton said.
Adderall is powerful, dangerous and ubiquitous, particularly among teenagers, who are often diagnosed (many would argue "over-diagnosed") with ADHD and similar syndromes. The rise of powerful prescription medications has led to the rise in "pharming," chemical experimentation that finds young people eschewing street drugs in favor of the easily obtained alternatives from the medicine cabinet.
It's a problem that has become prevalent everywhere in society, and it's naïve to think that the NFL is exempt. Quite the contrary: In a culture where men who think themselves indestructible take extreme risks in search of an edge or a high, the stuff doctors give 11-year-olds seems downright benign, even if it is on the NFL's banned list. "Some of these guys think it's candy," says sports medical expert Will Carroll, who does not buy the "didn't file the paperwork" excuse in the vast majority of cases. "The prescription is a red herring. There are guys who are either just dumb or just trying to get around the rule."
Adderall Suspension Myth Debunking, Part One: Most of the players suspended for Adderall were prescription users who did not realize that they had to petition the NFL for an exemption.
Prescription medication declaration and management is not a surprising new problem that faces an athlete when he turns pro. Here are the NCAA's guidelines for obtaining an exemption:
"The NCAA allows exception to be made for those student-athletes with a documented medical history demonstrating the need for regular use of such a drug. Exceptions may be granted for substances included in the following classes of banned drugs: stimulants (including those used to treat ADHD) … The institution should maintain documents from the prescribing physician in the student-athlete's medical record on campus that include the diagnosis, course of treatment and current prescription. In the event that a student-athlete tests positive by the NCAA, the institution will be notified of the positive drug test, and at that time the director of athletics may request an exception by submitting required documents."
So any athletes who took prescription ADHD medicine entering college knew that they had to clear their prescriptions with their athletic director.
What about high school, when Adderall is so often prescribed? Both the school nurse and the special education director are informed of every ADD or ADHD diagnosis and prescription. The special education director is likely to have been the person who sent the child's parents to a doctor in the first place. The nurse needs to know about prescription medication because the nurse administers the medication -- responsible users don't walk around the hallways with Adderall in their pockets (that is almost universally against school policy). By high school, most young adults are active participants in the diagnosis, special-education classification and medication procedure. They know that ADHD medication is a "handle with care" and "report to authority" substance.
So the NFL player who was prescribed Adderall in middle school, sat through classification meetings about it in high school and submitted documentation to his athletic director in college, somehow neglected to inform the NFL about the medication and pursue an exemption? Shenanigans.
Players like Andre Brown (whose suspension was overturned) and Neal (who earned an exemption moving forward) were prescribed Adderall as adults. In such cases, the player does not have a lifetime of medication management to inform him, only the common sense to read a contract, consult his NFLPA rep or call the league's hotline before ingesting a stimulant. The language of Appendix E indicates that the mechanism is in place for players like Brown and Brett Hartmann to get their suspensions reduced.
At the same time, the NFL appears to be taking a skeptical approach to prescriptions that fall outside the range of conventional diagnoses, perhaps wary of an open floodgate of players who cajole stimulants from lenient physicians. A 12-year old who cannot focus on basic tasks may need medication. A 24-year old who doesn't like public speaking might have to gut it out in the name of a policy written to protect his long-term health.
Adderall Suspension Myth Debunking, Part Two: Most of the suspended players are just steroid users. Adderall is a socially acceptable drug, and since the NFL does not reveal the substance that caused the suspension, players can say whatever they want.
Certainly, having a prescription for Adderall qualifies as socially acceptable drug use. But take a look at the list of players earlier in the article. Only a handful claimed to have a prescription.
Aqib Talib explicitly stated that he was using Adderall without a prescription. That he was obtaining it illegally and, by definition, abusing it.
Joe Haden admitted that he was using the drug recreationally. As attempts to get out of trouble go, I took a pill to stay wired while partying in Sin City does not pass the grandma test.
Garrett Hartley, Saints kicker and Test Patient Alpha for Adderall suspensions, served a four-game penalty in 2009 after washing down half of a pill with Red Bull to stay awake during a long drive. He got the pill from some college friends. Again, driving under the influence of an illegally obtained stimulant is not a story you make up to elicit sympathy.
The Richard Sherman "crushed pill" story, whether true or not, is taken straight from the milieu of pharmaceutical abuse. Crush a pill, and you speed its absorption into the bloodstream and turn a time-release medication into something that packs a wallop. This is not the story you float to make the Seahawks locker room sound like a collection of ADHD sufferers victimized by the league's over-stringent policies. It sounds as bad as steroids, maybe worse.
If a player wishes to deflect blame, he could remain silent. He could claim a testing irregularity, as Sherman and Browner are now doing, or as Broncos linebacker D.J. Williams did when suspended for performance-enhancing drugs in the offseason. Heck, if they're going to lie, they could claim that the substance was marijuana, eliciting the kind of shrug that the 2011 suspensions of Redskins Fred Davis and Trent Williams received.
There is no socially acceptable reason for a player, or his agent, to conjure images of wired driving, Vegas all-nighters or pill-crushing, unless those are the ways this chemical is being used. NFL locker rooms, like high schools, colleges and offices, appear to have a handful of legitimate Adderall users and a disturbing, uncounted number of abusers.
The Wired Truth
Contrary to popular belief, most people do not "grow out of" legitimate hyperactivity disorders. "They just learn how to deal with it," Carleton said. "They learn how to correct for it in other parts of their lives." Many young adults are weaned from drugs like Adderall as they learn coping mechanisms that allow them to better focus and study.
But some people need medication through adulthood, and an NFL player that needed Adderall in 10th grade may well need it to memorize his first playbook and sit through position meetings. The Therapeutic Use Exemption process is a necessary part of league policies. "It's a loophole that has to remain open," Carroll said. "It's a real medical diagnosis. But there needs to be a credible process for a waiver."
That credible process must also remain stringent: second opinions, careful reviews, assurances that the latest prescription did not come from Doctor Vinnie Boombatz with a nod and a wink. This is a drug that can be abused to get amped or get high. It can be addictive. And if you review the lists of suspended players with open eyes, you see that some teams appear to be awash in it. Teammates at the same position, whose lockers are very close to each other's, have an odd habit of getting suspended at about the same time. Adderall spreads from locker room to locker room in high school, dorm room to dorm room in college, sibling to sibling to neighbor to (all too often) parent in households, one unused or improperly used prescription feeding many. Why would we assume that the NFL is different?
The rise in suspensions, and admissions, may simply be the result of rises in prescription use, recreational abuse and awareness. Pharming has a long history, but it only came into national vogue about a decade ago. "It's fashionable," Dr. Carleton said, noting that recreational drugs rise and fall in popularity. Today's NFL player grew up in an environment where young people swapped pills the way kids in the 1970s shared joints. When caught, they admit it, not because they're hiding steroids or trying to get sympathy, but because it's a truth that they don't find exceptional or shocking.
The players aren't taking the easy way out by admitting to Adderall abuse. We are taking the easy way out by disbelieving and trivializing their admissions.
The quicker we stop rolling our eyes about overlooked paperwork and steroid excuses, the quicker we can acknowledge prescription abuse as a serious problem, in our sports leagues and in our neighborhoods.