Teen athletes at risk for medication misuse

Nearly 7.5 million adolescents take part in sports at the high school level and 2 million high school athletic injuries occur each year.

"We should expect that adolescents who participate in competitive sports at the interscholastic level are at a greater risk to get injured and, subsequently, be more likely to be prescribed opioids to manage pain," said lead researcher Philip Veliz, Ph.D., of the Institute for Research on Women and Gender at the University of Michigan in Ann Arbor.

The study, which followed 1,540 teens, showed that male athletes were more likely to use and misuse opioids medications on at least one occasion in the past year than non-athlete males. However, said Veliz, "one surprise was that female athletes were not more likely to be prescribed these medications or misuse them."

Male athletes may be more likely to be prescribed opioid medication because they are more likely to play sports such as wrestling and football, which have the highest rate of severe injury among high school sports. But their misuse and abuse of the medications may also have something to do with the role that sports play in the lives of young men, say the researchers.

"Adolescent males depend on sports for social status, the maintenance of relationships with male peers and family members," said Veliz. "In other words, sports are a powerful site to be recognized as a man, and male adolescents will sacrifice their bodies through athletic performances to prove their masculinity. Consequently, opioid use and misuse among males could be the byproduct of a play-through-pain culture."

There is still value to prescribing opioids, says Veliz, as they are helpful in managing pain on a short-term basis. Prescribing physicians can reduce the odds of misuse by discussing the management of medications with both adolescents and their parents.

"It's important to discuss abuse with patient and parent and prescribe narcotics only when necessary, in limited amounts and for a limited duration," said Daniel Green, M.D., a pediatric orthopedic surgeon at New York's Hospital for Special Surgery. He suggests that legislation can help.

"Legislation in New York now requires doctors to review a patient's narcotic history on a pharmacy database prior to prescribing narcotics," said Dr. Green. "Physicians should only provide narcotics for a limited amount of time and use non-opioid alternatives whenever possible."

Parental involvement can decrease the likelihood of misuse or abuse. "Most adolescents have unsupervised access to these medications giving them the opportunity to misuse these drugs," said Veliz.