As a rising high school senior trying out for the University of Delaware football team in 2009, Donovan Allieri ripped two ligaments in his right thumb during a defensive end drill.

Known as skier’s thumb, the injury sent the 6-foot-6-inch, 350-pound Allieri immediately to the operating room.

It did not derail the 17-year-old's senior season. He played its entirety with his lower arm and hand in a cast. The Mountain Lakes High School Laker went on to sign a national letter of intent to play for the Villanova Wildcats with the promise of a full scholarship.

But instead of heading to the field, Allieri entered the world of drug addiction.

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He faced charges of burglary, theft and animal cruelty — following accusations he killed his girlfriend's dog. He landed in jail several times, never having been in trouble before, and almost lost his life to heroin overdoses; one near-death experience left him paralyzed, forcing him to relearn how to walk. He made more than two dozen trips to drug rehabs.

"I was lying in a hospital bed in intensive care for two weeks, no feeling," Allieri said. "After losing everything — football, everything — my purpose was gone."

It all started with a prescription for painkillers.

Allieri's fall — he says the catalyst was painkillers freely prescribed after his injury — has become an all-too familiar story in New Jersey's unchecked painkiller epidemic. That scourge has long been closely linked with another epidemic: the state's rising death toll from heroin overdoses. In 2015, heroin killed more than 900 New Jersey residents.

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State lawmakers are finally poised to respond. The are considering legislation in the coming week that would narrow what law enforcement and medical researchers regard as a key "gateway" to the devastation, placing sharp new limits on the prescription of opioids —  like the drugs that nearly cost Allieri his life.

Lawmakers want to reduce the maximum-allowed initial prescription for acute pain from a 30-day supply to a five-day supply, drastically limiting the number of pills patients receive and, therefore, are available for abuse — by either the patient or those with access to their medicine cabinet.

If the bill becomes law, New Jersey would forge the toughest restrictions on opioid prescriptions in the country. Other states, including Massachusetts, New York, Connecticut and Maine, have opted for seven-day limitations.

The Senate is scheduled to vote on the bill S3 Monday and the Assembly Thursday. It includes other measures, such as mandating addiction coverage by insurers with plans regulated by the state.

Gov. Chris Christie called for opioid limitations in his State of the State address in January and Attorney General Porrino has been working on issuing emergency rules to put the restrictions into effect as the legislative push gained traction. Patients with chronic pain, cancer or a need for end-of-life care would not face the limitations.

"A blanket 30-day opiate prescription window is excessive," Christie said at the State of the State address Jan. 10. "And the ability of prescribers to order a month’s worth of powerful, opiate-based pain medications is contributing to the drug crisis in a significant way."

Pushback from doctors

Some New Jersey doctors are resisting the restrictions, contending that the limit on pills could hurt patients suffering from intense pain. After exhausting their five-day supply of pills, those patients would have to make a speedy return to the doctor's office to get a refill; such refills cannot be obtained with a simple phone call by a doctor.

That concern is raised along with the medical community’s traditional resistance to government wedging itself between the patient and doctor.

The Medical Society of New Jersey has offered a compromise: set the limit at seven days, excepting trauma and surgery patients, since they would be likelier to need more pills, the society contends.

Faced with ever grimmer statistics for opioid-related deaths, the Centers for Disease Control and Prevention last year recommended even tougher restrictions than those later proposed by New Jersey: three-day supplies, seven-day supplies at most.

"We know of no other medication routinely used for a nonfatal condition that kills patients so frequently," said CDC Director Thomas Frieden said last year. "We hope to see fewer deaths from opiates. That's the bottom line. These are really dangerous medications that carry the risk of addiction and death."

Opioid addiction has been a potent killer.

From 1999 to 2015, more than 183,000 people died from overdoses related to opioid painkillers in the United States, according to the CDC.

The rise in opioid addictions has in turn led to a staggering death toll from heroin. About 80 percent of heroin users started with opioid painkillers. Since 2010, overdose deaths linked to heroin have more than quadrupled.

Nearly 13,000 people died of heroin overdoses in the U.S. in 2015, a 20 percent increase over the year before, according to the CDC.

Since the late 1990s, after the painkiller OxyContin was released with an aggressive marketing push from its maker Purdue Pharma, opioid prescriptions have more than quadrupled.

One study estimated that the percentage of the U.S. population filling an opioid pain reliever prescription in 2011 was 15 percent, the same percentage of people who smoked cigarettes in 2015.

“The origins of our opioid epidemic is the increase in prescribing,” said Dr. Andrew Kolodny, co-founder of Physicians for Responsible Opioid Prescribing and co-director, Opioid Policy Research Institute for Behavioral Health at Brandeis University.

The CDC has also linked the stunning rise in overdose deaths to the explosive growth of opioid prescriptions.

Behind all of those statistics, of course, are human tragedies.

A dangerous slide

A doctor prescribed 30 mg oxycodone pills to treat Allieri's thumb injury and he kept taking them — 240 a month, two every six hours. He spent the entire 2009 football season on the drugs.

His doctor eventually ended his prescription with no effort to wean him from the opioids, Allieri said.

“From that point when the doctor cut me off, I got very sick,” Allieri said. “I started buying them off the streets. I had no trouble finding them.”

He was addicted.

Allieri eventually pleaded guilty to several charges, including animal cruelty, a crime he nonetheless maintains he did not commit. He has avoided any jail or prison sentence.

Now 25, Allieri has been clean for six months, he said Friday.

After the probationary sentence he received ended, he left New Jersey for Exline, Iowa, a town of 159 just north of the Missouri state line, to find a new life with his fiancée, who is from a farming family.

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There was another reason to leave the state.

“In New Jersey, heroin is everywhere,” he said. “I could always find it."

Lessons forgotten

This isn’t the first time opiods killed droves of people in the United States.

The technological innovation of hypodermic medications, specifically morphine injections, spurred an opioid crisis that swept the country not long after the Civil War ended it, according to David Courtwright, professor of history at the University of North Florida.

The quick high morphine produced, the instantaneous relief of pain and intense economic competition among doctors fueled the epidemic. Poor medical training added to it.

“Morphine developed a reputation as being the lazy physician’s remedy,” said Courtwright, the author of “Dark Paradise: A History of Opiate Addiction in America.”

Soon, medical journals reacted against the trend. Peer pressure, even shunning, brought problem doctors and pharmacists into line.

By the mid -1890s, primary prevention halted the growth of the epidemic, Courtwright said.

Plenty of blamce

The lessons learned from that epidemic carried over through the 1970s, Kolodny said.

But in the 1980s, the stage was set for the new wave of opioid deaths, when prominent physicians with financial links to the pharmaceutical industry espoused the view that too much pain was going under-treated, Kolodny said.

Opioids were used widely to treat pain from cancer treatments.

Those influential doctors said opiods could now be used to treat other chronic pain sufferers. And those advocates used a flimsy but persuasive bit of research, now debunked: less than 1 percent of opioid users get addicted.

Authorities say that number is closer to 25 percent and may exceed it.

Along with that, few medical schools were training doctors about the risk of opioids.

A decade later, prescriptions rose dramatically after Purdue Pharma introduced OxyContin to the market, Kolodny said.

“Doctors started to prescribe it aggressively,” Kolodny said. “Soon everybody started to have it in their households.”

Medical societies  — funded by pharmaceutical companies — devoted to treating pain began to espouse the idea that there was an epidemic of untreated pain.

The message about the undertreatment of pain became institutionalized. It was adopted by state medical boards, hospitals and professional boards: More opioids was the compassionate way to treat pain.

That put more pressure on doctors to conform, Koldony and other physicians said.

“You’re letting patients suffer because of the overblown fear of addiction,” Kolodny said, recalling the pitch from opioid makers and doctors with a financial link to them. “Many were duped by the drug companies. That message was hitting the medical community from every different direction.”

In 2012, health care providers wrote 259 million prescriptions for opioid painkillers — enough for every adult in the U.S. to have a bottle of pills, according to the CDC.

Pressing for change

Last spring, the CDC released guidelines on prescribing opioids, prefacing it with statistics about the harm caused by the epidemic.

The centers’ 50-page PDF is filled almost entirely with information on treating chronic pain with opiods. For acute pain, it containd a sentence: “3 days or less will often be sufficient; more than 7 days will rarely be needed.”

Dr. Lewis Nelson, chair of the Emergency Department at Rutgers New Jersey Medical School and board certified in emergency medicine, medical toxicology and addiction medicine, said the reason for the guideline on acute pain is well established.

The greatest amount of pain, he said, is experienced when acute pain, even involving a traumatic injury, happens. That pain subsides over a few days.

“The intensity goes away by day three, even with severe trauma,” he said. “The pain moderates to the point where you don’t need opioids.”

But Dr. Joseph Costabile, the president of the Medical Society of New Jersey who practices general and vascular surgery, is asking legislators to reconsider their restrictions.

“They’re really tying the hands of physicians by telling us what we can prescribe,” he said. Costabile echoes the message the lobbying group disseminates about government interference in the patient-doctor relationship.

Legislators, he said,  don’t sit in the examining room, assessing the case-specific circumstances and nuances of a person that help doctors determine how to treat.

“I’ve been in practice for 21 years. I spent nine years as a resident and went to medical school for four years,” he said. “Now somebody is telling me how to prescribe?”

But he also stresses a practical concern.

Prescriptions for narcotics — with the exception of Tylenol with codeine — cannot be called in by a doctor to a pharmacy, he said. An original paper prescription must be picked up and handed to a pharmacist.

That means a patient undergoing surgery Tuesday could run out of painkillers by the weekend if the proposed restrictions go into effect, exposing them to tremendous pain.

An opioid-taking patient who risks driving himself to a doctor's office to get a prescription risks losing their driver's license — or much more.

Moreover, alternatives to opioids like Lidocaine are not covered by insurers, Costabile said.

Warnings too late

Allieri  is now working in a factory making tractor parts, cattle feeders and other farming equipment. His fiancee’s two young children are giving him a reason to succeed in recovery, he said.

“Once they came into my life, I just wanted to be something for them,” he said.

His mother, Sue, who raised Donovan while as a single parent, said more information about the dangers of opioids may have led to a football career instead of an addict’s life.

She recently brought her 74-year-old mother to a dentist who gave her mother a sheet that included a detailed warning about opioids.

“I’m not blaming the doctor” who started her son on opioids, Sue Allieri said. “But if I saw that when he was 17, I would have read it.”

Ken Serrano: 732-643-4029; kserrano@gannettnj.com