A new word has been added to the pro football lexicon, one that is threatening to become as nettlesome to the NFL's image as "Bountygate."
That word is Adderall, the amphetamine that keeps cropping up in the league's drug suspensions, and which now has allegedly touched the Seahawks.
Their starting cornerbacks, Richard Sherman and Brandon Browner, face four-game suspensions for reportedly testing positive for a banned substance, identified in multiple reports as Adderall.
The players deny using anything illegal, but the increasing nexus between Adderall — a drug commonly prescribed to treat Attention Deficit Hyperactivity Disorder — and the NFL has become impossible to ignore.
At least 10 players have been linked to the stimulant in the past two years, though that number might be misleading. The NFL, by virtue of a confidentiality provision in its contract with the NFL union, never discloses the substance involved in a violation. That has led to suspicions that in some instances, players or their representatives claim Adderall use because there is less stigma attached to an amphetamine with an acknowledged medical purpose than to other banned substances, such as anabolic steroids.
"It is the excuse of the day, because there is no transparency in the NFL," said one official in another sport.
Still, it seems undeniable that the use of Adderall is on the rise, and not just in the NFL. Just Tuesday, Phillies catcher Carlos Ruiz received a 25-game suspension for using Adderall. NASCAR driver AJ Allmendinger also has been connected to the drug, and even actress Lindsay Lohan was reported to be Adderall dependent, according to TMZ.
The potential lure becomes obvious when Dr. Gary Wadler, past chairman of the World Anti-Doping Agency's Prohibited List Committee, begins listing off the benefits of Adderall to an athlete.
"It masks fatigue, masks pain, increases arousal — like being in The Zone," begins Wadler, currently an associate professor of medicine at Hofstra North Shore-LIJ School of Medicine, in a phone interview.
"It increases alertness, aggressiveness, attention and concentration. It improves reaction time, especially when fatigued. Some think it enhances hand-eye coordination. Some believe it increases the mental aspects of performance."
That's not to mention possible increases in acceleration, speed, strength and power that accrue to Adderall users. It's no wonder that Wadler calls Adderall "one of the quintessential performance-enhancing drugs. There's no question it's a performance-enhancing drug."
Adderall has been banned by virtually every sports organization, from the NCAA to MLB to the NFL. But the NFL, like other sports, allows players who have a medical need for the drug to use it without penalty, after they have applied for and been granted a Therapeutic Use Exemption.
The NFL doesn't disclose the number of therapeutic exemptions issued, but MLB in 2011 granted 105. Such numbers were an eye-opener to Wadler.
"I'm an internist, and I see lots of patients," he said. "I can count on one hand the number I've seen over the years who had (ADHD) to such a degree that they required medicine."
He says that ADHD has become "the diagnosis du jour in our society."
Dr. Brett Daniel, chief of primary care at Pacific Medical Centers, says there's a debate in the medical community whether ADHD is over-diagnosed, or doctors are simply doing a better job of recognizing it. The current estimates are that about 5 to 10 percent of kids have it, and about 4 or 5 percent of kids are treated for it.
For those with ADHD, Adderall can be a highly effective remedy.
"With how ADHD sets up in the brain, it (Adderall) helps make things align correctly in the right amount, so people are able to concentrate," Gardner said. "People are able to stay on task, get more focused."
The result, he said, is that Adderall "can make a big difference in people's lives" when they have ADHD, by allowing them to function more effectively.
Adderall recently has become commonplace on college campuses, where it is known as "the brain drug." Students use it to cram for exams, for much the same reason athletes use it.
Dr. Don Catlin, the founder and former director of the UCLA Olympic Analytical Lab, and still a member of the International Olympic Committee's medical commission, likens the effect of Adderall to drinking 25 to 30 cups of coffee
"It's very potent," Catlin said. "It jazzes you up, gets you off the line faster. You start faster, move faster, and it can be habit-forming. It's certainly not good for you. If you take too much, it can get your heart racing, cause rhythm disturbances in the heart, and even, if you go to the end of the line, seizures, though it usually doesn't go that far."
Daniel noted that Adderall "works on the same transmitter as cocaine, so you feel more grandiose, confident."
Catlin added that despite the fact that Adderall doesn't stay in the system long, "It's silly for (players) to do it, because it's so easy to catch them. There's an easy test for the drug. What they're thinking is hard to imagine."
Dr. Charles Yesalis, a professor emeritus of Health Policy and Administration & Kinesiology, at Penn State, perhaps provided a glimpse of the answer.
"It's one of those deals, I said it even about steroids. On an athletic field, at the elite level, even a 1 percent difference, which we very frequently couldn't measure in the lab, is a big deal," he said. "It's a game of inches, right? Look at the complexity of offenses and defenses in the NFL — it's heady stuff."
And, for the NFL, a vexing issue.