“I used doping for 5 years, I’m sorry to the whole world!” In a surprise press conference held at Highmark Stadium (Orchard Park, New York – the Bills’ home arena), James Cook – the Buffalo Bills’ star running back – appeared with red eyes and a trembling voice, admitting to secretly using banned substances (PED-like substances, specifically opioids and pain-relieving steroids) for the past 5 years (from 2021-2026).

In a raw and emotional moment that has sent shockwaves through the NFL, Buffalo Bills running back James Cook held a surprise press conference at Highmark Stadium on January 13, 2026, confessing to the prolonged use of banned pain-relieving substances to manage chronic injuries.

The 2025 NFL rushing champion, who just weeks ago celebrated leading the league with 1,621 yards on 309 carries and 12 touchdowns, appeared tearful and unsteady as he detailed a five-year struggle that began in his rookie season.

“I… I made a huge mistake,” Cook said, his voice breaking as he addressed reporters, teammates, and fans. “I never used banned substances to cheat on the field, to rush yard, or to win a rushing title.

But for the past five years, I’ve been secretly using opioids and some banned painkillers to cope with excruciating pain.”

Cook traced the issue back to his 2021 rookie year with the Bills, when he suffered his first major ankle and toe injury. Drafted in the second round out of Georgia, the younger brother of former NFL star Dalvin Cook faced immediate pressure to prove himself in the pros.

“The pressure of being ‘Dalvin Cook’s younger brother,’ moving from Georgia to the NFL, and then the 2025 hold-in contract drama made me afraid to rest,” he explained.

That offseason hold-in, which lasted nine days before he signed a four-year, $48 million extension with $30 million guaranteed, added immense stress amid negotiations for financial security.

Recurring injuries followed: ankle sprains, hamstring issues, and toe problems that plagued him through multiple seasons. The demanding NFL schedule, fear of losing his starting role to backups, and the responsibilities of fatherhood—with young children at home—compounded the physical toll.

“I used banned substances to relieve pain, to keep running, to not let down Bills Mafia, my brother, and the fans,” Cook continued. “I know it was wrong, but the pain… it was too much.

I apologize to my family, Coach Sean McDermott, teammates like Josh Allen, Bills fans, and everyone in the community.”

The 10-minute press conference ended abruptly as Cook, overcome with emotion, left the podium in tears. Quarterback Josh Allen and several teammates embraced him in a show of support, while head coach Sean McDermott stood nearby with a grim expression. “We will cooperate fully with the investigation,” McDermott stated flatly.

“This is the worst day of my coaching career.”

The confession comes at a pivotal time for the Bills, fresh off a Wild Card playoff win over the Jacksonville Jaguars and preparing for deeper postseason runs. Cook’s emergence as a dominant force—culminating in the franchise’s first rushing title since O.J.

Simpson in 1976—had positioned him as a cornerstone of Buffalo’s offense alongside Josh Allen. His production helped Buffalo secure a playoff spot despite challenges, including the emotional farewell to Highmark Stadium in Week 18.

The NFL and NFL Players Association (NFLPA) swiftly responded. The league’s Policy and Program on Substances of Abuse classifies opioids and certain pain-relieving steroids as prohibited under performance-enhancing substances (PES) or substances of abuse frameworks when used without proper medical exemption.

While the NFL has a prescription drug monitoring program and emphasizes alternatives to opioids for pain management, unauthorized use can lead to suspensions. First-time violations for PES often result in four-to-six game bans, escalating for repeated offenses.

Sources indicate the NFL has launched an immediate investigation, potentially involving testing records, medical documentation, and interviews. The NFLPA will represent Cook in proceedings.

Penalties could sideline him for multiple games—or worse—if deemed intentional misuse, though his voluntary disclosure and emphasis on pain management (rather than performance gain) may mitigate severity. Cook stated he is “prepared to accept any punishment from the NFL and the NFLPA.”

Reactions poured in across the league. Bills Mafia fans expressed a mix of heartbreak and support on social media, with many praising Cook’s courage in coming forward. “He’s human. The game chews you up—thank you for being honest,” one fan posted. Others voiced disappointment over integrity concerns.

Teammates rallied publicly: Josh Allen called it a “tough but brave moment,” while analysts drew parallels to broader NFL issues around injury management and mental health pressures.

This admission highlights ongoing debates in professional football: the physical demands leading to chronic pain, the fear of lost playing time, and the fine line between legitimate medical treatment and banned use. The NFL has pushed for non-opioid alternatives and stricter monitoring, yet stories like Cook’s underscore persistent challenges.

For now, the focus shifts to the investigation’s outcome and Cook’s path forward. At 27, with a new contract and a rushing title under his belt, redemption could come through accountability and recovery.

Whether forgiveness follows remains uncertain, but Cook’s tearful apology has humanized a star amid one of the league’s toughest confessions.

As the Bills eye Super Bowl contention, this saga tests team unity and league standards. One thing is clear: James Cook’s battle with pain has become a defining chapter in his career—and a stark reminder of the hidden costs behind NFL glory.