Richard Sherman's Suspension Appeal: The Science of Adderall and Urine Testing

Dave Siebert, M.D.@DaveMSiebertFeatured ColumnistDecember 27, 2012

GLENDALE, AZ - JANUARY 01:  Cornerback Richard Sherman #25 of the Seattle Seahawks during the NFL game against the Arizona Cardinals at the University of Phoenix Stadium on January 1, 2012 in Glendale, Arizona. The Cardinals defeated the Seahawks 23-20 in overtime.  (Photo by Christian Petersen/Getty Images)
Christian Petersen/Getty Images

Richard Sherman's pending appeal of a four-game suspension following a positive urine test for Adderall kept the scorching Seattle Seahawks (10-5) from celebrating their Week 16 dismantling of the San Francisco 49ers (10-4-1) as they would have liked.

Four days later, Sherman's distracting off-field story came to a close.

According to's Dan Hanzus, Sherman won his appeal and will not be required to serve any suspension whatsoever.

The decision stems primarily from the fact that testers did not collect Sherman's drug sample according to proper procedure.

In other words, Sherman went Ryan Braun on the NFL.

Back in February, Braun, outfielder for Major League Baseball's Milwaukee Brewers, won an appeal under similar circumstances. The MLB voided his 50-game suspension when investigators determined that testers inappropriately handled his urine sample that tested positive for elevated levels of testosterone.

A comparable sequence of events also exonerated Sherman, who, as mentioned, came under suspicion of Adderall abuse last month.

Adderall is a combination of four stimulants that belong to the class of drugs that also includes the illegal methamphetamine (aka "meth"). However, it is a much milder, safer concoction.

Adderall enhances the cell-to-cell transmission of the two neurotransmitters dopamine and norepinephrine—chemicals responsible for sending excitatory signals from neuron to neuron—within the brain. By doing so, it increases a user's ability to focus as well as decreases reaction time.

It is most commonly used to treat Attention Deficit Hyperactivity Disorder, or ADHD, a condition characterized by difficulties focusing and concentrating, among other symptoms.

As A.J. Perez of Fox Sports suggested in November, that theoretically means that Adderall allows a defensive back to more efficiently recognize and react to a specific offensive scheme.

However, improper or unregulated Adderall use can lead to extreme consequences. For instance, Adderall has the potential to be addictive. Other common side effects include, but are not limited to, loss of appetite, difficulty sleeping, headache and dizziness.

Unfortunately, in rare instances Adderall abuse can also be life-threatening.

Along with their cognitive effects, all stimulants increase the heart rate to some degree. As Arian Foster now knows all too well, an increased heart rate can result in an irregular heartbeat—though Foster's almost certainly stemmed from something simple such as dehydration.

If severe enough, an irregular heartbeat prevents proper blood flow to the organs and muscles of the body, including the brain.

Additionally, Adderall and other stimulants elevate blood pressure. They do so by constricting the body's blood vessels, as the same amount of blood flowing through now-narrower tubes produces increased pressure.

Narrowed blood vessels can decrease blood supply to organs such as the brain, which can cause seizures, and the heart, which can cause heart attacks.

In other words, Adderall use or abuse should not be taken lightly.

That is also why it has been deemed a banned substance by the NFL.

However, it can be difficult to properly detect under certain circumstances, as proven by Richard Sherman and his representatives on Thursday.

When scientists test a urine sample, they are usually not looking for the drug per se. They are actually seeking the breakdown products of the drugs, called "metabolites."

After a drug such as Adderall is ingested, the body immediately begins to break it down and eliminate it from the blood stream. This can be done by the liver or kidneys.

In Adderall's case, a large portion of the metabolites are then excreted via urine.

Adderall also happens to be an example of a drug that can be found unchanged in the urine, meaning Adderall and other amphetamine drug tests can also look for the actual drug itself.

In Sherman's case, he contended that collectors used a second, unsealed urine specimen cup to collect urine leaking from the original specimen cup, and the sample is therefore invalid.

He has a point.

Chemical tests for drugs and their metabolites can be finicky, and there is reason for the existence of such an excruciatingly detailed protocol of sealed cups, chain of custody and timing.

False positives frequently occur, and as many additional outside variables as possible must be eliminated from the testing procedure.

No test, be it a urine test for drugs or a blood test for a disease, is 100 percent accurate, even under the best of circumstances.

Add in the fact that Sherman's sample may have been altered by a leaky first cup or a contaminated second cup, and there is no way that the NFL could have justifiably upheld his suspension.

Of course, the successful appeal does not make clear what really happened.

Yet it does tell us that the appeals process works. Richard Sherman is innocent until proven guilty, just as anyone else.

Did he abuse Adderall?

Maybe. Maybe not.

Thanks to a leaky cup, we will never know for sure.

Dave Siebert is a medical/injury Featured Columnist for Bleacher Report who will graduate from medical school in June 2013.  He plans to specialize in both Family Medicine and Primary Care (non-operative) Sports Medicine, and he also has past experience working in multiple basic science and chemistry laboratories.  Adderall and medical information discussed above is based on his own knowledge and was supplemented by both WebMD's and's webpages on Adderall.


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