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Shari' Welton/MEDILL

Misuse of opiod medications, such as Vicodin, is a common problem among active and retired NFL players, Washington University researchers are reporting.

Opioid use plagues NFL players on, off field

by Shari' N. Welton
Feb 25, 2011


Data provided by Washington University School of Medicine

Washington University researchers surveyed 667 retired NFL players about their opioid use, injuries and chronic pain during their careers and after retirement.

During their careers, countless NFL players are recognized for their athletic ability, brute strength and hard hits.

Now retired, several NFL athletes are being acknowledged for tackling a tougher opponent off the field-opioid abuse.

Former NFL players are using opioid drugs at a rate four times that of the general population, according to a new study conducted by researchers at Washington University School of Medicine in St. Louis, Mo.

Opioids are used primarily for their “pain-relieving properties,” and engage opioid receptors in the brain, spinal cord and gastrointestinal tract. When opioids connect with specific opioid receptors “they can block the perception of pain,” according to a report by the National Institute on Drug Abuse.

Commonly used medications in the opioid class include: Vicodin, codeine, morphine and oxycodone.

After asking 667 retired NFL players about their injury and concussion history, level of pain and use of prescription pain medication, Washington University researchers concluded that 7 percent of former NFL athletes were using opioids after retiring.

“This research is telling us we better be careful,” said Linda Cottler, lead researcher and professor of Epidemiology at Washington University School of Medicine.

The study, published in the Dec. 27 issue of the Drug and Alcohol Dependence Journal, was performed after ESPN reporters contacted Cottler and her team about the misuse of opioids among NFL players. “We were asked to design and conduct a survey because reporters only had anecdotal information,” Cottler said.

The survey included questions about what medications players used during their careers and if they had taken the prescribed drugs in other ways aside from doctors’ instructions. Players who participated in the survey retired between 1979 and 2006.

Cottler, director of the Epidemiology and Prevention Research Group at Washington University, found that more than half of the players surveyed used opioids during their NFL careers, and 71 percent misused the drugs, taking them for reasons other than what they were prescribed for.

Fifteen percent of the players who misused the drugs during their careers were still misusing them in retirement, according to the study. Researchers also concluded that only 5 percent of former players who took the drugs as recommended misused them.

Misuse of prescription medication can often lead to dependency.

“Dependence is kind of the biggest concern with opioids, said Andy Rock, a pharmacist with the Neuroscience Center for Medco Health Solutions, Inc., a pharmacy benefits manager based in Columbus, Ohio.

He said immediate effects of low-level opioid misuse can include: sleepiness, cognitive ability, alterations of mood, depression and euphoria.

Rock added that high use can result in dependency because a person wants to have a euphoric experience after using an opioid. In trying to achieve this “high,” the user can develop a tolerance to the medication and consume it in large amounts at one time.

“It’s like Lays, one chip is not enough,” Rock said.

When opioids are misused at high levels, seizures, tremors, blurred vision, decreased heart rate and respiratory depression can occur.

Rock said the Washington University study sheds light on boundaries between prescription drug use and misuse. “Generally, I think it states the fact that there’s a difficult divide between pain treatment and abuse,” he said. “Abuse itself is a pretty complex disease that we are still understanding.”

Whether retired NFL athletes used or misused opioids, Cottler and her research team concluded that pain was the primary reason for initial use. Seventy-five percent of NFL players surveyed said they “had severe pain,” and nearly 70 percent said they experienced “moderate-to-severe physical impairment.”

Along with pain, researchers discovered that reported and unreported concussions also led to use and misuse. On average, NFL players who were surveyed suffered nine concussions while playing. Forty-nine percent were diagnosed with a concussion, while 81 percent said they believed they suffered concussions that went undiagnosed.

The way prescription medications, such as opioids, are obtained can also lead to misuse.

Researchers found 37 percent of the NFL players surveyed said they received opioids solely from their doctor, while 67 percent admitted to getting the medication from someone who was not a physician.

Cottler said monitoring NFL players during and post-career could help with pain prevention and maintenance. She added that the research reflects how the needs of many NFL athletes are not being met.

“I think it shows that players are not being taken care of and they are being left on their own,” Cottler said.

Besides consistently monitoring players, she suggested making efforts to find alternatives to prescription drug use.

“We should try to find other ways besides medications to help players to cope with their pain,” Cottler said.