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Retired NFL players misuse opioid pain medications at a rate more than four times that of the general population, and new evidence suggests that is occurring because players misused the painkillers during their NFL careers, according to a study published online in Drug and Alcohol Dependence, a peer-reviewed, scientific journal.
The study, conducted by researchers at Washington University in St. Louis School of Medicine, is the first of painkiller use and misuse by former NFL players. Directed by Linda Cottler, a professor of epidemiology in Washington University's Department of Psychiatry, the study was commissioned by ESPN, with additional funding provided by the National Institute on Drug Abuse, a division of the U.S. Department of Health and Human Services. ...
This is important because of the public health implications for players of sports all over the world," Cottler said of the research.
"Clearly, this study indicates we're not doing enough to care for our wounded and impaired athletes," said Dr. Wilson Compton, who served from 1995 to 2002 as a treating clinician in the NFL's substance abuse program and is now division director for NIDA.
Key findings:
• 52 percent of the retired players said they used prescription pain medication during their playing days. Of those, 71 percent said they misused the drugs then, and 15 percent of the misusers acknowledged misusing the medication within the past 30 days.
• Those who misused prescription painkillers while playing were three times more likely to misuse the drugs today than those who used the pills as prescribed while playing.
• 63 percent of the retired players who used prescription pain pills while playing obtained the medications from a nonmedical source: a teammate, coach, trainer, family member, dealer or the Internet. ...
From March to August 2010, Cottler's research team interviewed 644 former NFL players by telephone. The players who participated in the research retired from the NFL between 1979 and 2006, played an average of 7.6 seasons, and averaged 48 years in age. Researchers asked them a series of questions about their health, pain levels, NFL-related injuries and their use and misuse of prescription painkillers and other substances. ...
When asked about their prescription painkiller use within the past 30 days, 7 percent of the retired players surveyed said they either used more prescription pain medication than prescribed by their doctors, used the medication without a prescription at all, or both.
"That's a very large number in a population that, at that age, we wouldn't expect to see much use of these substances at all," Compton said. "Most typical 30- and 40-year olds aren't taking pain relievers, and they're not misusing them, so that's a much higher than expected rate."
The rate of current misuse of prescription pain medications within the general population age 26 and older is 1.6 percent, according to data from the National Survey on Drug Use and Health, an assessment conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA), a division of the federal Department of Health and Human Services. The rate of misuse within the past 30 days for men older than 26 is 2.5 percent, according to the latest SAMHSA drug survey.
"[The former players] are three times as likely as men their age in the general population to be misusing prescription opioids right now. I think that's a lot," Cottler said. ...
Dan Johnson, who played tight end for the Miami Dolphins in the mid-1980s, said he became addicted to painkillers after two back surgeries that were necessary because of injuries he suffered as a player."I was taking about a thousand Vicodins a month," he said. "You know, people go 'That's impossible. You're crazy.' No, that was exactly what I was taking." ...He said he acquired the drugs through acquaintances, over the Internet and from overseas shipments. He broke so many bones during his playing days that teammates called him "The King of Pain." Yet his addiction to painkillers had him contemplating suicide. "A few times," he said, struggling to control his emotions. ...
According to the Washington University researchers, three main variables predicted the current misuse of prescription pain medications by retired players versus nonuse: significant pain, undiagnosed concussions and heavy drinking.
"We were shocked to learn that [current prescription painkiller] misuse is really associated with undiagnosed concussions, and heavy drinking," Cottler said. Of those former NFL players who said they did not currently use prescription painkillers within the past 30 days, 8 percent had 20 or more drinks in that same period. Of the retired players who said they misused opioids in the past 30 days, 27 percent had 20 or more drinks in that same time period. "There's a major concern that the risk of overdose and death is markedly increased if you're drinking on top of taking painkillers," Compton said. "That would be the No. 1 concern I would have. … Some of these men are reporting very heavy levels of alcohol consumption."
"Mixing alcohol and pain pills, that's really scary," said Bob Newton, a former lead counselor at the Betty Ford Clinic in Rancho Mirage, Calif. Newton is also a former offensive lineman who played 11 years for the Chicago Bears and Seattle Seahawks. ...
According to sources cited by the Washington University researchers, 26 percent of the general population suffers from some level of pain. But of the 644 former NFL players surveyed, 93 percent suffered some level of pain, and 73 percent described their pain as moderate to severe.
