Retired NFL players misuse painkillers more than general population

Jan 28, 2011
Retired NFL players use painkillers at four times the rate of the general population. Credit: Washington University School of Medicine

Retired NFL players use painkillers at a much higher rate than the rest of us, according to new research conducted by investigators at Washington University School of Medicine in St. Louis.

The researchers say the brutal collisions and bone-jarring injuries associated with football often cause long-term pain, which contributes to continued use and abuse of painkilling medications.

The study is published online in the journal Drug and Alcohol Dependence. It involved 644 former NFL players who retired from football between 1979 and 2006. Researchers asked them about their overall health, level of pain, history of injuries, concussions and use of prescription pain pills.

The study found that 7 percent of the former players were currently using painkilling . That's more than four times the rate of opioid use in the general population. are commonly prescribed for their analgesic, or pain-relieving, properties. Medications that fall within this class of drugs include , Vicodin, codeine and .

"We asked about medications they used during their playing careers and whether they used the drugs as prescribed or whether they had ever taken them in a different way or for different reasons," says principal investigator Linda B. Cottler, PhD, professor of epidemiology in psychiatry at Washington University. "More than half used opioids during their NFL careers, and 71 percent had misused the drugs. That is, they had used the medication for a different reason or in a different way than it was prescribed, or taken painkillers that were prescribed for someone else."

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In this year's Super Bowl, many players with the Green Bay Packers and Pittsburgh Steelers may decide to "gut it out" and do whatever they can to play in the big game, in spite of pain from injuries. But a new study from researchers at Washington University School of Medicine in St. Louis has found that there's a price for such heroism, namely the use and misuse of pain-killing drugs called opioids. Jim Dryden has more. Credit: Washington University BioMed Radio

Those who misused the drugs during their playing days were more likely to continue misusing them after retiring from football. Some 15 percent of those who misused the drugs as active players still were misusing them in retirement. Only 5 percent of former players who took the drugs as prescribed misused them after they retired from the NFL.

Cottler, director of the Epidemiology and Prevention Research Group in the Department of Psychiatry, says it's not clear from the study whether retired players became dependent on the drugs. What is clear from the survey, she says, is that retired NFL players continue to live with a lot of pain.

"The rate of current, severe pain is staggering," she says. "Among the men who currently use prescription opioids — whether misused or not — 75 percent said they had severe pain, and about 70 percent reported moderate-to-severe physical impairment."

Pain was one of the main predictors of current misuse. Another was undiagnosed . Retired NFL players in the study experienced an average of nine concussions each. Some 49 percent had been diagnosed with a concussion at some point during their playing careers, but 81 percent suspected they had concussions that were not diagnosed. Some players believed they may have had up to 200 concussions during their playing days.

"Many of these players explained that they didn't want to see a physician about their concussions at the time," says Simone M. Cummings, PhD, a senior scientist in psychiatry who conducted phone interviews with the former players. "These men said they knew if they reported a concussion, they might not be allowed to play. And if you get taken out of a game too many times, you can lose your spot and get cut from the team."

She says players with suspected-but-undiagnosed concussions reported they borrowed pills from teammates, friends or relatives to treat the pain themselves, thus misusing opioids in an attempt to remain in the NFL. Although 37 percent of the retired players reported that they had received opioids only from a doctor, the other 63 percent who took the drugs during their NFL careers admitted that on occasion they got the medication from someone other than a physician.

Retired players currently misusing opioid drugs also are more likely to be heavy drinkers, according to Cottler.

"So these men are at elevated risk for potential overdose," she says. "They reported more than 14 drinks a week, and many were consuming at least 20 drinks per week, or the equivalent of about a fifth of liquor."

The ESPN sports television network commissioned the study, which also was funded by the National Institute on Drug Abuse. The ESPN program "Outside the Lines" spoke informally to many retired players about their use of painkillers. One reported taking up to 1,000 Vicodin tablets per month. Another reported ingesting 100 pills per day and spending more than $1,000 per week on painkillers.

Former St. Louis Rams offensive lineman Kyle Turley said in a statement to ESPN that he knew of many players who took drugs to help them deal with the pain inflicted by the injuries they sustained in the NFL.

"I know guys that have bought thousands of pills," Turley said. "Tons of guys would take Vicodin before a game."

The researchers say offensive linemen had particularly high rates of use and misuse of opioids.

"The offensive linemen were twice as likely as other players to use or misuse prescription pain medicines during their NFL careers," Cottler says. "In addition, this group tends to be overweight and have cardiovascular problems, so they represent a group of former players whose health probably should be monitored closely."

In fact, Cottler says it would be a good idea to continue monitoring everyone who has played in the NFL. She says this study revealed that some 47 percent of retired players reported having three or more serious injuries during their NFL careers, and 61 percent said they had knee injuries. Over half, 55 percent, reported that an injury ended their careers.

"These are elite athletes who were in great physical condition when their playing careers began," she says. "At the start of their careers, 88 percent of these men said they were in excellent health. By the time they retired, that number had fallen to 18 percent, primarily due to injuries. And after retirement, their health continued to decline. Only 13 percent reported that they currently are in excellent health. They are dealing with a lot of injuries and subsequent pain from their playing days. That's why they continue to use and misuse pain medicines."

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More information: Cottler LB (WU), Abdallah AB (WU), Cummings SM (WU), Barr J (ESPN), Banks R (ESPN), Forchheimer R (ESPN). Injury, pain and prescription opioid use among former NFL football players, Drug and Alcohol Dependence, vol. 113(3), Jan. 28, 2011.

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1 / 5 (1) Jan 28, 2011
I admire the speed, strength, the competitive nature of the men who lay this sport.
The large sums of money they earn...they risk so very much to excel and achieve.
Either we can stop the sport, END PRO FOOTBALL -OR-
Let's get more science involved: Let's find a solution to the trauma induced in this collision sport!
Space age uniforms might look like Iron Man suits-hey- that would not be so bad if it saves the sport and preserves human quality of life
I would pay more for a ticket to see this sport if, IF, more would be done to protect these players otherwise I will have to cancel my season ticket holder status in protest..now that I know the truth of it all.
geokstr
1 / 5 (1) Jan 28, 2011
Nah. Let's go the opposite direction of Iron Man suits.

Ever seen the old movie with Fred MacMurray "Son of Flubber" where they blow up the player's football uniform with a gas that makes him look the Michellin Man and he just bounces off tacklers? Give them all "fat suits" and just let them bounce around until someone scores.
Johnny_Morales
not rated yet Jan 28, 2011
Why does this matter? It doesn't.

Why is it a surprise? It shouldn't be considering the nature of football.

This is one study that was definitely NOT needed.

It seems done more out of nosiness than a problem that needed solving.

As long as they have a safe medical supply of the painkillers they DO need to deal with the endless pain their football careers left them suffering, it should be no one's business least of all people who think they have a role in creating rules and regulations for pain they do NOT suffer.

Should their use evolve into abuse, than it's a drug dependence/addiction issue, which regardless of the cause is no different in football players than non-football players.

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