In a sport where pain is a constant companion, it's not that hard to find relief.
It seems self-medication, either with alcohol or pharmaceutical-grade opiates, may be as much a part of the good old hockey game as stitches and a gap-toothed smile.
"I used to go see the guys who had just had surgery and ask them if they had any extra [painkillers]I could have," said retired defenceman Denis Gauthier, who played for four NHL teams during his 12-year pro hockey career.
"Percocets," he insisted, "are golden in the hockey world."
The recent deaths of Wade Belak, Rick Rypien and Derek Boogaard have lifted the veil on the mental and physical toll of being an NHL enforcer, but another issue is emerging as the hockey world grapples with its loss.
Professional hockey, several current and former players say, has a problem with pain pills.
"Of the 17 teams I played on, the majority of the fighters were the ones who dove into those substances," said Brantt Myhres, a former NHL fighter and drug addict who is now a substance-abuse counsellor. "It's a situation that needs attention."
All hockey players endure pain but enforcers often play with more than most.
Gauthier, who played alongside several fighters, including Belak, said people don't "appreciate what a tough guy goes through just to be healthy for the game. Everyone in hockey plays hurt, an enforcer usually hurts more than another guy – and they can't back down, they always have to be physically ready."
Several scientific papers published in the past two decades have established links between chronic pain and depression – and between depression, head injuries and acute stress – few athletes face greater exposure to the main risk factors than hockey players.
Philadelphia Flyers centre Ian Laperrière, who is slated to spend the year on the injured list due to a concussion, said it's not at all uncommon to try and "numb yourself down" from the demands of playing in the NHL.
"The pill issue is a big thing … it's a problem, and people need to start talking about it," he said.
The NHL has a highly-regarded rehabilitation program for substance abuse, but that hasn't prevented situations like Boogaard's, who died after taking the pain-killing drug oxycodone while drinking alcohol.
"I don't know if Belak took these things or not, and I don't want to speculate, but I will say this: Show me a tough guy and I'll show you someone who pops pills," Laperrière said. (It's not known whether Belak, who was prompted to retire by an arthritic hip, ever used pain medication.)
Former Flyers enforcer Riley Cote, now an assistant coach with Philadelphia's top minor-league affiliate, remarked on his Facebook.com page this week that "someone needs to step in and speak up about these very preventable deaths. This absolutely crazy. These [painkillers]are mass produced, way overprescribed and are flooding the black market with pharmaceutically made, very highly addictive drugs. This is a growing epidemic all across North America. We need some action ASAP otherwise there will be plenty more of these sad stories."
Sometimes, hockey players will take pills to ease the pain of an injury, many of which aren't reported to team officials lest the player be taken out of action. But sometimes, they'll take pills to ease a more ephemeral hurt.
"I'll tell you a story," Gauthier said. "When Philadelphia sent me down to the minors, I went from 10 years of five-star hotels and first-class airplanes to riding the bus for 12 hours. It was a huge shock, it was tough. So, sometimes, I'd take a pill to try and relax and get some sleep, forget about everything for a while."
According to a former minor-leaguer, painkiller use may be even more widespread in the lower leagues than it is in the NHL. At the same time, said Justin Bourne, who played in the AHL and the ECHL, they are "100-per-cent essential."
"It's not like you can just take them away for most guys, a lot of players need them to be able to keep playing," said Bourne, who now writes and blogs about the game and recently recounted his own experience with oxycodone.
And that's an uncomfortable truth about the game: certain players can't afford to sit out through injury or lose too many fights.
"If you do, you're not going to have a contract the next year. There are 100 guys lining up to take your job," said Laperrière, who added he understands and accepts those ground rules. "[Phoenix Coyotes head coach]Dave Tippett once told me that I wasn't the kind of guy who could afford not to play 80 games. It was true, and it was advice that's served me well. But I put myself through a lot of things that I otherwise wouldn't have to be out there."
The 37-year-old Laperrière, who has been in more than 200 fights in his hockey career – his first was at a major-junior training camp when he was 16 – was candid about the stress associated with being a physical player.
"Anyone who says he isn't scared is a liar," he said. "When you know you're going to have to fight, you don't sleep well the night before. You don't get your rest in the daytime."
Saul Miller, a Vancouver-based sports psychologist who has worked with several NHL players, cautioned against trying to detect patterns in the three most recent incidents, calling them "a unique cluster." Still, Miller believes information needs to be gathered from players past and present.
"One of the things the NHL and the NHLPA can do together is to conduct a large survey of current and former players, say going back 10 years, and to look at parameters like players' roles … the prevalence of mood disorders, concussions, and thing like prescription painkiller use to try and come up with some correlations," Miller said.
The immediate challenge, according to Miller, is for the league to educate its players, trainers and teams on how the program works and to facilitate access to it. That's why people like Laperrière are loath to point fingers at the NHL or its substance-abuse program for rampant self-medication.
"There's no machine to make a guy walk under and it tells you if he's okay. The first step in any recovery is admitting you have a problem, and you can't force people to do that," he said. "The program is a great program, it's one of the best, so it's not even really a league issue; it's a societal issue. And we need to get these drugs off the streets."
But not everyone is so sure about the extent of painkiller use.
Lyndon Byers played 279 NHL games, most of them with the Boston Bruins, and rang up more than 1,000 penalty minutes. He can recall the hours before a game against the Flyers where he had to will himself into fighting.
"I had five cups of coffee and four Vivarin [a stay-awake medication] I sat there thinking, 'Are you a man or a mouse? What are you going to do when a guy looks at you and you know that look?' "
Byers said he had 11 hockey-related surgeries in his career and questioned players who got hooked on medication and blamed the game for their troubles.
"I put my body through the wringer. It's ridiculous to think you'll come out the other end the same way," said Byers, now a radio personality in Boston. "I didn't see [heavy pain-pill usage]when I played. Maybe the game has changed. If it has, then maybe they'd better start drug testing."
Myhres's career ended soon after he lost a fight against Georges Laraque, then of the Edmonton Oilers. Ironically, the two former foes want to join forces to help those in the game who may feel there's no one who can relate to them.
"Georges and I have talked about a system where guys can call us and we can talk to them in confidence – one player to another player, one addict to another addict," Myhres said. "I think that would form a special bond for guys who need it."