Opioid Abuse Series Part 1: An Athletic Trainer’s Role in Preventing Opioid Abuse
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February 19, 2018
By Katie Ostrovecky, MS, ATC
As Athletic Trainers (ATs), we witness many acute and chronic injuries that can create varying levels of pain for our patients. Helping patients learn how to manage the pain from injuries can be a tricky process. One option patients often turn to are pain medications – specifically opioids. Opioids include medications such as hydrocodone and oxycodone (also known as Vicodin and Percocet).
While pain medications are meant to aid patient’s post-injury, we are now seeing more and more individuals misuse and abuse them. Opioid analgesics are currently the second highest abused drug in the United States and, shockingly enough, nearly half of students in 7th through 12th grades have been prescribed one of these controlled substances.1,5 We understand opioid misuse and abuse is an epidemic, but what is the ATs role in preventing opioid addiction?
First and foremost, ATs need to understand that they do play an important role in preventing opioid misuse and abuse within the athletic population. This issue is seen across the board from youth sports and clinics to professional sports. Unfortunately, athletes are at greater risk for nonmedical prescription opioid use due to their injuries.3 Stressors specific to the athletic population include maintaining a high level of performance, balancing academics with sports and coping with possible career termination. These stressors may encourage athletes to misuse and abuse pain medication to cope with physical and mental issues.2
In addition, athletes are also less likely to report opioid misuse or abuse due to consequences from coaches or parents.2 Therefore, it is safe to say that the athletic population is not immune to the opioid epidemic that the United States is experiencing today. As ATs, we need to recognize our role in preventing substance abuse through education, awareness, communication and prevention.
When it comes to education and awareness, ATs should focus on 3 things: at-risk athletes, individual motives and signs and symptoms. Collegiate athletes and individuals with previous mental health problems are more likely to misuse and abuse drugs than the average athlete.2 Athletes who participate in high-contact sports have also reported higher opioid use due to increased likelihood of severe injuries.3
Using this information, ATs should monitor at-risk athletes to understand their motives for misusing and abusing opioids. Multiple studies showed that individuals misuse and abuse pain medication for different reasons – the main 2 being for pain relief (beyond their allotted dosage) and the sensation of feeling high.1 If ATs can identify higher risk athletes and their reasons for using these drugs, then they may be able to prevent further misuse, abuse or addiction.
Since ATs normally see athletes on a more regular basis, it may be easier for us to recognize when an athlete is “not themselves.” It is important for us to know the signs and symptoms of opioid misuse and abuse so we can help an athlete who may be struggling.
Common signs and symptoms include, but are not limited to: increased sensitivity to pain, nausea or vomiting, dry mouth, constipation, dizziness or sleepiness, confusion, depression or low levels of energy and strength.6 If drug abuse is suspected and any of these signs or symptoms may be present, then you should immediately address the athlete, team doctor, team psychologist or parent (depending on setting and athlete age).
Using proper knowledge and becoming educated will not only help us recognize athletes struggling with substance abuse, but can also aid in creating prevention plans. Prevention can start in schools and carry over to the medical side with pre-participation examinations. In the school setting, administrators, teachers, parents, coaches and medical staff should all be educated on signs and symptoms of opioid misuse and abuse.4 Clinicians, such as ATs, are then responsible to educate athletes and screen them if possible. Obtaining medical records and incorporating substance abuse-related surveys into PPEs may aid ATs when looking for higher risk athletes.1 This addition to the PPEs is a simple change that could make a huge difference for preventing opioid abuse.
With the proper education, awareness and prevention, ATs can make a positive impact on the fight against opioid abuse in the athletic population. Along with awareness and implementation, ATs should also be able to communicate effectively with team doctors, team psychologists, coaches and parents (in adolescent cases) to get the athlete the help they need if they do struggle with opioid abuse. Ideally, with the help of ATs and future federal and state legislations, we will see opioid misuse and abuse decrease in sports.
1. Boyd, C., Young, A., & McCabe, S. (2014). Psychological and drug abuse symptoms associated with nonmedical use of opioid analgesics among adolescents. Substance Abuse, 35, 284-289.
2. Ford, J. (2008). Nonmedical prescription drug use among college students: A comparison between athletes and nonathletes. Journal of American College Health, 57(2), 211-219.
3. Knopf, A. (2016). Participation in sports reduces teen risk of nonmedical use of prescription opioids and heroin. The Brown University Child and Adolescent Behavior Letter, 4.
4. McCabe, S., & Boyd, C. (2012). Do motives matter? Nonmedical use of prescription medications among adolescents. The Prevention Researcher, 19(1), 10-12.
5. Prince, J. (2015). Opioid analgesic use disorders among adolescents in the United States. Journal of Child & Adolescent Substance Abuse, 24, 28-36.
6. Center for Disease Control and Prevention (2018). Prescription opioids: Side effects. Retrieved from https://www.cdc.gov/drugoverdose/opioids/prescribed.html.
Opioid Abuse Series Part 2: Opioid Abuse Risks After Surgical Intervention
About the Author
Katie Ostrovecky, originally from Northern Virginia, graduated with her Bachelor of Science in Athletic Training in 2014 from Nova Southeastern University. She then went on to receive her Master of Science in Kinesiology with a concentration in Exercise and Sports Psychology from A.T. Still University. She currently works as an Athletic Trainer with the youth population in Southern California. Katie is also a recent self-published author and an advocate for suicide prevention awareness.