It was untreated anxiety and depression that Colorado Avalanche defenseman Samuel Girard blamed for his alcohol abuse, a problem that reached the point where he needed to step away from hockey.

He made a decision to leave the Avalanche and enter the NHL/NHLPA player assistance program earlier this season. Girard returned to practice a month later, resumed playing and declared: “It changed my life.”

Girard was the first of five players to step away this season to receive care from the program jointly run by the league and union — the same number of players who sought help over the previous three years combined. The participation increase is credited in part to a growing belief in the venture that has been around since 1996, as well as a reflection of the general population seeking more help since the pandemic.

“I think what has happened is the players have developed a real comfort level that the counselors, the people that run the program, can be trusted because there’s a fair amount of confidentiality involved,” NHL Commissioner Gary Bettman said.

Valeri Nichushkin (Colorado), Patrik Laine (Columbus), Evgeny Kuznetsov (then Washington now Carolina) and Ethan Bear (Washington) followed Girard into the program this season. Like Girard, Nichushkin and Kuznetsov returned to play; Bear was cleared just after the Capitals were eliminated from the playoffs.

The program was in the headlines this week after Nichushkin was suspended for six months on Monday for violating terms of the program. The news caught the Avalanche by surprise, including coach Jared Bednar, who paused during a news conference to note the importance of Nichushkin getting the support he needs.

“I’ve gotten to know Val as a person and I’ve gotten to know him as one of our teammates and I want what’s best for him,” Bednar said. “I want him to be happy and I want him to be content in his life, whether that is with our team or not with our team. I want the best for him and his family. I think all of our guys are the same. We hope that he can find some peace and get help.”

THE PROGRAM

Confidentiality is guaranteed for players and their family members, at least when it comes to details. An announcement is only made when a player becomes unavailable to his team during the season.

“We don’t get much information on it,” Capitals general manager Brian MacLellan said. “The parameters of the program are confidential, how they go in are confidential and how they come out are confidential.”

Help is offered for anything from alcohol or drug abuse to mental health issues, sleeping problems or a gambling addiction. Bettman, who has been commissioner since 1993, said a goal when launching the program was to educate and counsel players and families, as well as providing treatment when necessary. It now includes access to confidential counseling, a phone number available any time and annual meetings for every team with program administrators.

“Having that support system for our players is imperative in life,” said Nashville coach Andrew Brunette, who played 16 NHL seasons. “Some of those things are bigger than a hockey puck, and that help and the job they do ... players are very fortunate to use it.”

Bettman said the venture, formerly known as the Substance Abuse and Behavioral Health Program, covers a broader spectrum of things than it used to. NHLPA executive director Marty Walsh agreed.

“You saw this big shift in the United States from addiction programs to substance use programs to mental health to kind of all-encompassing, so it’s a lot more than alcoholism or drug addiction,” Walsh said. “It’s everything that goes with it that it’s really important to get help for.”

Nashville’s Michael McCarron went into the program in late 2022 and was reinstated in early 2023.

“Everybody has different circumstances,” he said. "In my circumstance, I definitely reached out and asked for help. I know some guys, they’re told that, ‘You know, it’s probably be a good idea for you to go in.’ Other guys ask for help.”

Goaltender Connor Ingram recalls waking up in a Dallas hotel room in January 2021 and saying to himself, “I don't want to do this anymore.” An undiagnosed obsessive-compulsive disorder led him to drink to cope with anxiety — sometimes all 12 beers in his fridge when he intended to have one — and to worry incessantly during the pandemic about germs.

“You hear the things about OCD, like, I don’t know, have a clean apartment or care what ways the labels are looking — I didn’t know that OCD had other forms,” said Ingram, who was on the taxi squad for Nashville at the time and is now with the franchise in Utah. “I went to the rink quickly, I had a coach talk to me about the program and say, ’Let’s get you some help and then you can decide what you want to do.' It was a whirlwind when it happened, and it’s scary and intimidating. But once you get there, it’s just time to put your work boots on and get better.”

QUIET PARTICIPATION

The number of players who choose to voluntarily enter the program is not made public, nor are the reasons why. It is possible the five players announced publicly by the league were joined by many others.

“You don’t necessarily hear of the successes of the program because people don’t generally go out there and beat their chest, ‘I’m sober six years,’ or ‘I’m sober X amount of years,’” said Walsh, who has spoken openly about going into treatment himself in 1995. “Their life gets better, and we try to provide the tools to the player. They have to do the work, but we try to provide the tools.”

Walsh, a former Boston mayor and U.S. labor secretary, said he would not be in his current job if not for his treatment and wants to do more work to remove the stigma of seeking help. McCarron, the Nashville forward, said he felt it was important to be something of a role model to other men, inside and outside sports.

“Early on in my life, guys always tended to keep things in and not seek out help,” McCarron said. “Whether it be sports, movies in Hollywood, the more people see that it’s OK for guys and men to ask for help, it’s huge.”

For Girard, the ice has always been the place where he felt at home. Going through the program reaffirmed his passion for the game.

“Before I went into recovery, I always loved the game,” Girard said before the playoffs began. "I still love the game the same way.”

Each player in the program could help others in silent ways, too. Girard, 26, recommended it to anyone around the league who feels the need to seek help.

“I learned a lot about myself over there," Girard said. “If you’re at the point where you need help, that’s a great program."

___

AP Sports Writer Teresa M. Walker in Nashville, Tennessee, contributed.

___

AP NHL: https://apnews.com/hub/nhl

Stephen Whyno And Pat Graham, The Associated Press