A sixth-round pick by the Buccaneers in 2013, James was already living on the NFL's fringe. Even if the league had granted his exemption, there's no guarantee an NFL team would offer him a contract. Over six seasons, he's done two stints each with the Bucs and Lions - career total: 23 games - twice ending seasons on the injured reserve list, and has four carries over the past three years.
His first injured-reserve trip came nine games into his rookie year, when James broke his ankle and required surgery. He was given prescription opioids to manage the pain and said the pills quickly became a problem, turning into a yearlong dependence.
"The routine I had was, my wife would give me some pills and I would try to sneak and get extra, get more," said James, who first detailed his story in a CNN documentary that aired Sunday. "When those ran out, I'd try to search as much as I could to get more - mostly asking around, trying to get it as fast as possible from people that I knew that had it."
His wife, Aubrey James, spotted the growing problem and said James needed to explore marijuana as an alternative to treat his pain. He initially balked. James wasn't certain of the medicinal benefits and only knew marijuana as a street drug. His father had a history of drug-related offenses, and James said he always steered clear of marijuana or any other illegal substances.
"I grew up in a bad neighborhood," said James, a native of Haines City, Florida, who played his college ball at Miami. "I'd seen people using it [and] I thought, 'Oh, if I use marijuana, that means I was unsuccessful, or I wouldn't be living the kind of life I wanted.' My wife kind of chuckled."
In February 2014, he tried the drug and felt he'd finally discovered a healthy, simple way to manage his pain, if not his NFL career.
Marijuana is a banned substance in the NFL. Players are typically tested for it during organized team activities in the offseason or in training camp before the season. If the player passes that test, he's essentially free to use the drug, if he chooses, throughout the regular season without fear of getting caught or further testing. NFL players have made light of this practice; longtime defensive lineman Shaun Smith recently joked about buying marijuana the day he passed his annual test.
But rather than continuing to slip through the drug-testing net himself, James wants the NFL to acknowledge the medicinal benefits of marijuana and to promote it to players as an alternative to addictive painkillers. If his TUE application had been approved, he said, he hoped other players would be able to follow his example.
"We know how the NFL feels about marijuana," he said. "And we know young men's livelihoods are in the balance. They fear losing this [career] and not being able to take care of their family. What I'm trying to do is open the door, open pathways to give guys a plan."
His doctor agrees. Sue Sisley, an Arizona-based physician, has been a major proponent of marijuana research and was eager for a football player to step forward and challenge the NFL's rules and norms.
"When Mike came forward, I realized he was really the perfect candidate. You don't want to have the first TUE to come from somebody who's suboptimal because of their history," she said. "But Mike was incredibly ideal because he's so hard working, has this really compelling background and he's not a candidate for opioids."
Given his family history and James' own experience with opioids, Sisley said "it would be malpractice for me" to encourage him to use painkillers to treat his pain.
The NFL cited multiple reasons for denying his TUE request, James said, noting that marijuana is a banned substance in the NFL, that the league's medical advisers don't necessarily agree with James' doctor that it's essential for him and that chronic pain is not a sufficient diagnosis.
"They're arguing that chronic pain is a symptom, but chronic pain syndrome is a diagnosis," said Sisley, who serves on the board of advisers for the Korey Stringer Institute, which has partnered with the NFL on health and safety issues. "This guy has pain everywhere. In an NFL career, these guys have been playing since they were little and have been injured over and over again. They have pain in every joint. . . . For the NFL is to say chronic pain syndrome is not a diagnosis is absurd."
James has been receiving guidance from Doctors for Cannabis Regulation, a nonprofit advocacy organization that has been actively urging the NFL to revisit its views and revise its policies on marijuana. The group's NFL steering committee includes former players Ricky Williams, Eugene Monroe and current Titans' linebacker Derrick Morgan. Brian Muraresku, the organization's executive director, said the group was in touch with the NFL Players Association before filing the TUE and that it's "fair to say we've been in close coordination" with James' union.
A spokesman for the NFLPA did not return a request for comment. The players' union formed a committee to study pain management and research marijuana in 2017 but has yet to make public any formal recommendations.
The league's front office remains resistant to any changes on its drug policy. Before last season, Commissioner Roger Goodell told ESPN, "Listen, you're ingesting smoke, so that's not usually a very positive thing that people would say. It does have addictive nature. There are a lot of compounds in marijuana that may not be healthy for the players long term. All of those things have to be considered."
Goodell said then that the league's advisers were studying the issue, and "to date, they haven't said, 'This is a change we think you should make that is in the best interest of the health and safety of our players.'"
James is not giving up hope. He suffered a concussion during the preseason with the Lions last year and was placed on the season-ending injured reserve. He's still hoping a new team gives him a chance. James lives in Florida and said he obtains marijuana from a dispensary with a doctor's recommendation. He uses a combination of both tetrahydrocannabinol (THC) and cannabidiol (CBD), extracts that some research suggests could be beneficial in pain management.
James said he couldn't discuss any appeals or recourse that might be available with his TUE formally denied. Muraresku, however, said, "we're in talks with the league to try to resolve this." And Sisley still thinks a TUE for marijuana makes the most sense for her patient.
"As his physician, I definitely would not recommend he continue playing if he's not allowed to maintain his cannabis intake," she said. "He has a very high risk of relapsing onto opioids, and we all know the end-results of opioid dependence is overdose and death."
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