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The NFL’s Problem with Pain: Part Two

In part two, an unlikely pain medication option proves its case.

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In part one of this article, I discussed the high probability of NFL players getting hurt and requiring medication for those inevitable injuries. So far, the league has focused on combatting chronic pain with traditional western medicine. Anti-inflammatories and opioids are the most commonly used medications in locker rooms today.

Proper use of these prescription meds can help curb many of the maladies NFL players suffer from. Unfortunately, a large percentage of NFL players end up misusing and eventually abusing these medications as their pain steadily becomes unmanageable or they become so addicted, they can not stop without suffering intense and sometimes deadly withdrawal symptoms.

Too much of anything is usually not a good thing, so please don’t take this article as a statement against traditional western medicine or prescription pills. In most cases, doctors prescribe medicines ethically and patients adhere to their doctor’s orders by complying with the doses prescribed to them. There are former NFL players, however, who have ruined their livers, died, or now exist on dialysis because they overused Advil. I’m talking about 10 or more Advil pills a day for years at a time. These are over the counter and can still do that type of damage. I can not over state enough that proper use is paramount for a patient’s safety and recovery.

Today, in part two, I will discuss another pain medication option, marijuana. I also want to stress that all the information I am putting forth is backed by scientific periodicals published throughout the world. I had to search through international research regarding medical marijuana, THC, and cannabinoids because for 45 years and counting, the US federal government has designated marijuana as a schedule 1 substance. This means the feds believe marijuana has "no accepted medicinal use and a high potential for abuse." Cocaine has a lesser federal designation as a schedule 2 substance because it can be used medically for specific nasal maladies as well as during certain surgical procedures.

Why did marijuana receive this designation in the first place? On August 14, 1970, the Assistant Secretary of Health, Dr. Roger O. Egeberg wrote his recommendation for the marijuana plant’s federal designation: "Since there is still a considerable void in our knowledge of the plant and effects of the active drug contained in it, our recommendation is that marijuana be retained within schedule 1 at least until the completion of certain studies now underway to resolve the issue."

OK, so marijuana was labeled as one of the most dangerous drugs in the world without ANY scientific proof. That designation also makes it extremely difficult to do ANY testing on the plant within the US because there are a plethora of bureaucratic hoops to jump through in order to get a testing protocol approved. As former Saints lineman Kyle Turley said, "This [marijuana] could potentially prevent and postpone any damage done from concussions. There is no excuse for us to say we don’t know enough anymore about a plant that has grown from the ground for thousands of years and used as medicine around the world."

Wait…what?! Can marijuana help prevent concussions AND alleviate post concussion symptoms? That’s exactly what Bennet Omalu (the dude Will Smith played in the movie Concussion) is trying to find out. Serving as a scientific advisory board member of Kannalife Sciences, Omalu is working on a study for a product that would treat concussions using cannabinoids as an active pharmaceutical ingredient. Omalu, himself, was the first doctor to discovery chronic traumatic encephalopathy, or CTE, when he conducted an autopsy on former Steelers center Mike Webster. He is, by far, the world’s most renowned authority on the effects of repeated head trauma.

Back in 1964, two doctors from Israel, Dr. Mechoulam and Dr. Yehiel Gaoni blazed the path for marijuana testing by discovering delta-9-tetrahydrocannabinol, or THC, the plant’s primary compound. Their discovery lead to more therapeutic research projects that have since proven that the human brain is profoundly populated with cannabinoid neurotransmitters and receptors. This means our brains have natural, biologically endowed responses to marijuana.

The Israeli duo have found cannabinoids to be "neuroprotective agents" that can reduce brain bleeding, brain swelling, and hippocampal cell death after closed head injury in mice. Remember the movie Memento? The main character’s hippocampus was damaged leaving him with no short term memory. Marijuana can actually limit damage to this specific part of the brain following head trauma, therefore limiting short term memory loss.

Recently retired and former Baltimore Raven Eugene Monroe is unapologetically campaigning for medical marijuana to be used to both prevent and help alleviate post concussion symptoms. Monroe began to speak out about opioid misuse and dependence in NFL locker rooms while still a player in Baltimore. He believes that only after becoming more publicly open to medical marijuana, though he denies using it himself due to the NFL’s substance abuse policy, the team released him as a PR move. Every player in the NFL had to see how he was treated, and that makes it even less likely for another current player to speak out on this issue.

Monroe’s piece in the Player’s Tribune perfectly highlights the ongoing effects of repeated head trauma. "My wife used to joke about the ‘little things I forget,’ but now she’s more concerned about things like me putting my phone in the freezer and then tearing up our house looking for it. Things like that were just a joke around the house until this past winter, when my four-year-old daughter said, ‘Daddy you don’t remember anything!’ Since then, she’s said it a few more times."

"That’s why one of the first things I’m planning to do is to go to the doctor. I need to take stock of my current health, and I don’t want to miss a thing. I’m going to get brain and body imaging scans, mental health assessments — anything that might help me get a handle on the state of my body and my mind. My health is critical to the future of my family."

Marijuana’s medical benefits stretch much farther than treating symptoms of head trauma. Through controlled studies, the therapeutic effects of cannabinoids have been revealed in the treatment of chronic pain, rheumatoid arthritis, neurodegenerative disorders (Tourette’s syndrome, Parkinson’s, Huntington’s, and Alzheimer’s diseases) schizophrenia, cancer chemotherapy side-effects, asthma, glaucoma, AIDS wasting syndrome, obesity, metabolic syndrome-related disorders, and seizure disorders like epilepsy.

In addition to being one of the most useful medically therapeutic treatments, marijuana is also probably one of the safest. While 190,000 people have died from opioid drug overdoses since 1999 alone, ZERO deaths from marijuana overdose have been documented, ever. Compared with opioids like OxyContin, marijuana poses little to no propensity for addiction or withdrawal after discontinuing its use. In fact, states with pro medical cannabis legislation had a 24.8% lower mean annual opioid overdose mortality rate compared with states against medical cannabis legislation.

Since 50-60% of NFL players are using marijuana both for recreational and medicinal purposes anyway, why has the NFL been so slow to acknowledge its vast medical benefits along with its relative safety? In his interview with ESPN, "Instead of saying no, Goodell offered the following, ‘I don’t know what’s going to develop as far as the next opportunity for medicine to evolve and to help either deal with pain or help deal with injuries, but we will continue to support the evolution of medicine."

Goodell sounds more open-minded than his cohorts in the league office. "The NFL, however, is not currently reconsidering the marijuana policy," spokesman Brian McCarthy said in an email. "We are guided by medical advisers. They have not indicated a need to change."

It’s hard to change public perception, but Monroe believes the best way to explore other options is to start talking about them. "I’ve had conversations with my teammates and have been in conversations with players, and at the very least, they believe more research is needed to find a better option," Monroe said. But "there is also a great amount of reluctance for people to jump out and do the same thing, and say they believe there are issues."

All I’m saying is that marijuana deserves further un-inhibited testing. It is unfair for a plant with proven therapeutic effects to be underutilized because of limited testing and negative social perception. Because of its stringent federal designation, only 6% of current marijuana research analyzes its medical benefits. The other 94% are still trying to prove its dangerousness.

With so many resources allotted to finding the negative effects of marijuana, there must be a laundry list of terrible things that happen when one smokes, vaporizes, or ingests marijuana, right? Wrong. "It cannot be over-emphasized that there has never been a death from overdose attributed to cannabis. In fact, no deaths whatsoever have been attributed to the direct effects of cannabis. Cannabis has a safety record that is vastly superior to all other pain medications."

So you can’t die from it, big whoop. Inhaling something into one’s lungs has to be dangerous, right? Wrong. "Many physicians worry that cannabis smoke might be as dangerous as cigarette smoke; however, epidemiologic studies have found no increase in oropharyngeal or pulmonary malignancies attributable to marijuana." Obviously, as I stated earlier, too much of anything can be a bad thing. But with recent improvements in medical marijuana including vaporizers and edibles, marijuana can be used with limited pulmonary health risks.

Well, then it must be crazy addictive to be designated as more dangerous than cocaine, right? Wrong again. "Cannabis is relatively non-addicting, and patients who stop using it (eg, while traveling) report no withdrawal symptoms."

Again, all the facts and figures included in this article come from respected and accredited research studies. Even CNN’s medical adviser Dr. Sanjay Gupta has reversed his position since doing more independent research. "I apologize because I didn't look hard enough, until now. I didn't look far enough. I didn't review papers from smaller labs in other countries doing some remarkable research, and I was too dismissive of the loud chorus of legitimate patients whose symptoms improved on cannabis. Instead, I lumped them with the high-visibility malingerers, just looking to get high. I mistakenly believed the Drug Enforcement Agency listed marijuana as a schedule 1 substance because of sound scientific proof."

Doctors and patients the world over have been able to record and experience the therapeutic effects marijuana can offer. In addition to potentially helping athletes deal with pain, marijuana’s removal from the NFL’s substance abuse policy would drastically decrease the amount of players disciplined for breaking it. More players on the field equals more dollars, so even if the NFL can only manage to look at this issue from a financial standpoint, it still has much to gain for rethinking its policy. Will the NFL be able to shift its consciousness and join the growing masses?