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Will pain management practices be the NFL's next PR headache?

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In the wake of Prince's death, Eugene Monroe of the Baltimore Ravens slammed the NFL for their inane drug policy. Does he have a point?

Andrew Weber-USA TODAY Sports

As the world mourns the death of Prince, Eugene Monroe of the Baltimore Ravens took the opportunity to call out the NFL for its drug policy. There have been numerous reports that Prince relied on Percocet for pain relief, suffering an overdose of the opoid days before he died, according to TMZ.

As on offensive lineman, Monroe has had his share of aches and pains, many of which were treated with opioid painkillers. News that Prince may have suffered an opioid overdose prompted these tweets:

According to the Centers for Disease Control (CDC), deaths from opioid overdoses have increased 200% since 2000. The street drug heroin and prescrpition opioid pain pills are included in this statistic. Abuse of perscription pain relievers can lead to a heroin use; one in 15 people who abuse opioid pain relievers will end up on heroin, which is cheaper on the street than opioid pills.

Athletes, including Eugene Monroe, often rely on legally prescribed opiates to relieve pain after injuries and surgery. Recently, legislators in Wisconsin introduced the John Thomas Decker Act to educate student-athletes about the dangers of opioid pain killers. Decker was a former Cornell Lacrosse player who developed a heroin addiction after using OxyContin, a pain pill, after an ACL tear as a student-athlete. His father explained, "What bothers me the most is the total waste of a kid who affected so many people positively."

An ESPN Outside the Lines report highlighted the misuse of pain pills among athletes, citing a study that showed rates of pain pill abuse is four-times higher among retired NFL athletes than in the general population. The injury rate in the NFL is nearly 100%; both current and retired players have described the physical toll of the sport. In January, former Pittsburgh Steeler Antwaan Randle El revealed via the Washington Post, "I have to come down sideways sometimes, depending on the day." Anecdotes like Randle El's are commonplace in the NFL.

Other players have fared worse. Mark Tuinei, a offensive tackle with the Dallas Cowboys from 1983 to 1997 died in 1999 from a heroin overdose. While it is unknown how doctors cared for Tuniei during his time in the NFL, it is known that he suffered numerous injuries throughout his long career. 1998 second-overall draft pick Ryan Leaf had a very unsuccessful stint in the NFL that was marked by poor play and injuries. After he left the NFL, he served prison time for breaking into a home to steal narcotic painkillersEarl CambellCraig NewsomeRay Lucas, and many other players have struggled with addiction to painkillers post-NFL.

Professional football is a brutal sport, and pain is a price many athletes pay to have a career in the NFL. The death of Prince has made Monroe think twice about managing his pain with such an addictive substance, one that Prince may have struggled with in the days leading up to his death. Monroe references the NFL's substance abuse policy, perhaps a reference to the NFL's prohibition against marijuana use, widely reported to be an analgesic. There have been limited studies on the effectiveness of marijuana as a pain reliever, but in some states, patients suffering from pain can use marijuana to manage their pain. The American Medical Association has called for further research on marijuana and a reversal of its status as a schedule I controlled substance that makes it difficult to carry out clinical research studies using the drug.

Unlike opioids, many strains of marijuana are not addictive. While some contend that marijuana is a gateway drug, it is not a relative of heroin in the same way that opioid painkillers are. Nonetheless, marijuana is banned by the league, so players who use the substance face sanctions, fines, and suspension. The Steelers Martavis Bryant is currently serving a year-long suspension for repeated violations of the NFL's policy.

Former running back Ricky Williams tested positive for marijuana several times during his NFL career, and now uses cannabis to manage his post-NFL pain. He recounted via the New York Daily News, "I'd go to see the doctor, he'd give me some anti-inflammatories, some pain pills and say just try to rest. That's it... I think there's a better way." Jim McMahon of the Chicago Bears is also using marijuana to manage his pain after he developed an addiction to painkillers.

The NFL Players Association agreed on the current substance abuse policy that is part of the most recent collective bargaining agreement. For at least one player, however, rumored circumstances surrounding the death of Prince have led one NFL player to speak out against opioids and question his willingness to use them to manage his pain.

NFL players are already at risk for medical problems related to repeated blows to the head. Now, Monroe is raising concerns about another problem plaguing the NFL and compromising the health and safety of its players. Will pain management practices be the NFL's next big PR headache? If players follow Monroe's lead and opiate addiction gains even more attention in the media, the NFL could be looking at Concussion: The Sequel.