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Study Finds Pattern Of Painkiller Misuse Among Former NFL Players

Yesterday, details Esquire divulged from a report on NFL injuries put the NFL’s concussion problem squarely into focus. And today, a recent study of painkiller use among former NFL players, covered by ESPN’s Outside the Lines, shows the injury problem doesn’t stop at the injuries themselves, and may have repercussions even decades later.

That other problem: players’ use (and all too often, misuse) of painkillers, studied by a team at Washington University in St. Louis led by Dr. Linda Cottler. Interestingly, ESPN itself commissioned the study, while the National Institute on Drug Abuse (NIDA) also partly funded the project. The results were published in the academic journal Drug and Alcohol Dependence, and they certainly don’t make the NFL’s injury issues appear any less serious.

Of 644 players (whose careers all finished between 1979 and 2006) interviewed by Cottler’s team, 52 percent said they used painkillers during their playing days. Of those who used painkillers, 71 percent say they misused them – “defined as someone using more painkillers than prescribed, using them without a prescription or obtaining painkillers from a non-medical source.” Of those who misused during their playing days, 68 percent reported no painkiller use in the past 30 days, but 15 percent reported misuse – three times the rate of misuse among those who took painkillers as prescribed during their playing careers.

Cottler called the relative rates of misuse “pretty amazing,” though it seems to us that another logical explanation (besides “misuse during playing career determines misuse in later years”) would be that perhaps those who misused both then and now were always more likely to misuse. Also, we’d guess the amount of misuse was highly correlated with degree of pain experienced, and this snippet from OTL’s report on the study seems to bear that out:

Of those players who reported no use of prescription painkillers within the past 30 days, 68 percent said they lived with moderate to severe pain. Of the players who misused the drugs, 96 percent reported experiencing moderate to severe pain.

Even so, it’s highly unlikely the NFL’s position on all this will generate any sympathy for the league:

Dr. Lawrence S. Brown, the NFL’s medical adviser for substances of abuse, cast doubt on the research: “It is scientifically flawed to compare the general population with athletes, active or retired.”

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“In the NFL and all sports, part of employment includes relief of pain because of the prevalence of injury,” Brown said. “If you don’t have the exposure, you’re less likely to misuse.”

We see what Brown’s seeing, but we also see what Dr. Wilson Compton of the NIDA is saying in his response to Brown’s criticism:

“There’s almost nothing that’s exactly like a professional athlete so I’m not sure what the proper comparison is. I don’t think it’s scientifically flawed. … We need to put it in some context.”

One aspect of the study it’s tough to argue is alarming: the correlation between painkiller misuse and alcohol consumption.

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.”

8 percent to 27 percent seems way too large a jump to be a coincidence. And again, the jump in alcohol consumption probably has something to do with the level of pain experience…but that doesn’t make the combination of excessive painkiller intake with significant alcohol intake any less dangerous.

And unfortunately, we’re not sure how to make a problem like this go away. Education on the dangers of painkiller misuse might help some, but the demand for painkillers among football players isn’t going away. the sport isn’t getting any less dangerous – and tying back in with with the injury study, the game may well only get more dangerous if the regular season indeed extends to 18 games. The findings of this study are eye-opening and suggest some kind of action is needed, but as long as football keeps on being wildly popular football, enacting real change in players’ behavior won’t be easy.

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