On Thursday, Ravens star Haloti Ngata joined a rapidly growing list of pro athletes, including Orioles slugger Chris Davis, who have been suspended for using Adderall.
For nine years, Haloti Ngata has been the bedrock of the Ravens' vaunted defense, the dependable giant around whom the rest of the pieces swirled.
On Thursday, however, the giant was felled for using a drug most often associated with being prescribed to children who can't sit still. Ngata will sit out the next four games — all vital to the Ravens' wavering playoff chances — for using Adderall.
Ngata's suspension without pay follows a similar ban for Orioles slugger Chris Davis, who missed his club's playoff run because he'd tested positive for Adderall, a drug normally used to treat attention deficit hyperactivity disorder (ADHD).
The parallels are unavoidable — two pillars of strength, widely loved by fans and teammates, who took inexplicable risks at times when their teams needed them most.
Like Davis before him, Ngata offered little explanation beyond basic words of regret. "I made a mistake, and I own this," he said in a statement released through the Ravens. "I took Adderall and take full responsibility for doing this. I am deeply sorry and broken up over this. I let down my family, my teammates, Ravens fans and myself. My hope is that the Ravens make the playoffs, and I believe they can do this. And, then I can come back and help us win."
The suspension, which stunned teammates, was the lowest moment in a career packed with highlights. The 6-foot-4, 340-pound Ngata has long astounded fans by chasing down men 150 pounds lighter than he and plucking passes from the air with his enormous paws. Off the field, he has delighted them with goofy dance routines in commercials for Royal Farms. His No. 92 jersey is among the most popular in the stands at M&T Bank Stadium.
If the Ravens, currently 7-5, do make the playoffs, Ngata would be eligible to play in any postseason games.
The franchise started its season under the cloud of Ray Rice's suspension and subsequent release for punching his future wife at an Atlantic City Casino. The Ravens had slowly turned the narrative back to football, helped in no small part by Ngata, who'd played some of the most inspired games of his decorated career. But now it appears they might finish their season under a different shadow.
Ngata, 30, must have known he was risking just this scenario when he took Adderall. So why would he do it?
The simple explanation, doctors say, is that athletes believe Adderall can grant a person unusual focus and quicker reaction times for a concentrated period.
Stimulant use in professional football goes back to the years immediately after World War II, said Charles Yesalis, a Penn State professor emeritus who has studied sports doping for decades. Players learned the substance could mask fatigue and increase their bravado for the combat ahead.
To explain the mentality, Yesalis recalled a conversation with a former All-Pro linebacker: "He said to me, 'Chuck, you think I'm doing this to my body every Sunday in a normal frame of mind?'"
There aren't studies proving that Adderall can help athletes hit a fastball or sack the quarterback, Yesalis said, but a powerful lore has developed around the drug. And not just among sports stars such as Ngata and Davis. College students routinely use the drug to stay up late and focus on important work.
"To seek an advantage in war, business, politics or sports is c," Yesalis said. "I'd be utterly shocked if this didn't take place."
Some athletes might have legitimate reasons for taking Adderall, said Dr. Scott T. Aaronson, director of clinical research programs at Sheppard Pratt Health System, who has not treated Ngata and has no knowledge of his case.
Aaronson said the incidence of professional players with ADHD might be higher than in the general population because hyper children can be drawn to sports. Also, football players who repeatedly get hit in the head may develop trouble focusing and could benefit from medication.
Aaronson questioned how much athletes without a medical need would benefit from Adderall, however. Too much of the drug and an athlete's heart may race "or they would feel like jumping out of their skin."
He said the drug could give athletes a burst of energy, but so could caffeine. He said Adderall might offer a "psychological crutch" more than an actual benefit.
Because it leaves the system quickly, the drug might also seem a reasonable risk for players who essentially bet they won't be tested in that window. The NFL tests every player at least once a season and randomly tests 10 players a week from each team.
Aaronson said Adderall likely wouldn't be detectable through a urine test after 48 hours. A small dose might be undetectable after 24 hours.
"This kind of story does make me wonder what the use is really like given that they are unlikely to just be taking this at game time," he said. "They have to have some other experience with it to make sure it is tolerable. As well, the risk of being caught comes with rather stunning financial penalties."
Ravens wide receiver Torrey Smith said he couldn't guess why Ngata used the drug.
"It's not like it's a big problem around the league but I mean, that Adderall stuff, you never really know who … It's not like people are passing them around like candy or anything," Smith said. "It's been something that you've been seeing around the league a lot. Some people, it helps them focus and some people, they need it and can't get prescriptions. I don't know what his deal was. He probably just made a mistake."
On the Orioles side, Davis hasn't offered much concrete explanation for why he took the drug, though he did address it during a recent radio interview on 95.1 SHINE-FM.
"Basically, in a moment of weakness, I made a decision that cost me greatly," the deeply religious Davis told the Christian station's audience. "It just goes to show no matter how successful you've been in the past, no matter how much stuff you have, no matter how strong you are in your faith, the devil is going to continue to come after you."
As in Major League Baseball, NFL players can apply for therapeutic use exemptions for Adderall. But they must ask a physician to file an application with the administrator of the league's drug policy. ADHD is listed as one of the reasons a player can offer for requesting an exemption. Ngata did not have an exemption.
The NFL keeps confidential how many players have exemptions, but almost 10 percent of MLB players had them last season, more than twice the 4.4-percent incidence rate of ADHD in the nation's adult population.
Davis had a therapeutic use exemption during his years with the Texas Rangers but was denied when he attempted to renew it after being traded to the Orioles. Former Orioles star Miguel Tejada said confusion over his lapsed exemption led to a 105-game suspension for Adderall use last season, when he played for the Kansas City Royals.
"I knew that I was in risk of breaking the rules, but at the same time, I could not stop using the medicine because I suffer from ADD," Tejada told ESPN. "It's not a vice, it is a disease."
When players first began saying they'd been suspended for Adderall use in 2009, many assumed they were lying to cover positive tests for more stigmatized substances such as anabolic steroids. But the NFL now has the power to reveal the substance a player tested positive for if the player lies in public statements.
Ngata is hardly the first Raven or prominent NFL star to be suspended for Adderall use. After successfully appealing a four-game suspension in 2012, Seattle Seahawks cornerback Richard Sherman said "half the league" takes the drug, though he later said he was misquoted.
Ravens cornerback Asa Jackson has been suspended twice for the unauthorized use of Adderall. Earlier this season, Denver Broncos wide receiver Wes Welker was suspended, reportedly for using the drug.
Welker said he'd never knowingly taken a banned substance and called the NFL's testing program "clearly flawed." But Ngata took no such tact, quickly acknowledging he'd used the stimulant.