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Opioid abuse is a widespread and grave problem. According to the U.S. National Institute on Drug Abuse opioid abuse and addiction have become a national crisis5. The opioid crisis affects public health along with social and economic welfare. Illicit drugs are not the only problem. Prescription opioids like fentanyl also contribute to the opioid crisis.
This increase in opioid prescriptions in the United States includes an increase in use among high school and college athletes. This is because opioid painkillers are often prescribed for sports injuries.
Such prescriptions may be totally legitimate in the immediate aftermath of a serious injury or surgery. However, continued opioid use can easily slide into misuse and addiction. Addiction is a destructive habit that can follow young athletes into their adulthood.
The American Medical Association estimates that somewhere between 3% and 19% percent of people who take pain medications develop an addiction1. And young athletes are not exempt from this trend.
One of the many dangers of drug addiction is an overdose, which can be fatal. And according to the CDC, a full 75% of the nearly 92,000 drug overdose deaths in 2020 involved an opioid2. In other words, in three out of every four deaths resulting from a drug overdose, the ingested substance was an opioid.
Athletes & Injuries
Injuries are common among young athletes. This includes everything from bruises, shin splints, and muscle strains; to sprained or torn ligaments and broken bones. In fact, one in every three of these young athletes will miss practice time or games due to an injury.
The total number of injuries sustained by high school and college athletes every year is substantial. Approximately 1.4 million injuries occur annually at high school level sports8. And approximately 209,000 sports-related injuries occur at the collegiate level.
All youth sports injuries will involve some degree of physical pain. Many may require medical attention, and some will require surgery.
Most athletes who get injured are highly motivated to return to the sport. Receiving a prescription for an opioid pain-relieving medication may be part of the process of recovering from the injury. or temporarily dulling its effects—and being able to return to competition.
And this is how some young athletes can fall into the trap of opioid addiction. Their enthusiasm for participating in their chosen sport leads to the unwise and irresponsible use of opioid medications.
Opioids In Sports
Opioids can be effective for pain management after a serious injury or orthopedic surgery. Especially when they are taken short-term and as prescribed. But opioids are also highly addictive and are not intended for long-term use.
They’re not intended to allow athletes to return to competition before their injury has fully healed. They’re not intended as a post-competition remedy for the aches and pains accrued during the match, game, or race. They are not intended as a feel-good emotional boost or psychological balm for athletes.
Using opioids in these ways can set the stage for addiction. A study published in Sports Health found opioid use to be widespread among athletes3. For professional athletes, opioid use ranged from 4.4% to 4.7%. Meanwhile, high school athletes had opioid use rates of 28%-46% over their lifetime.
This study also found that opioid use during a high school, college, or professional athlete’s playing career predicts postretirement use. Athletes who use opioids while playing youth sports are likely to continue using opioids even when they’re no longer competing.
Athletes & Substance Abuse
Young athletes are often exposed to opioids for the first time through legitimate prescriptions following a dental or surgical procedure. Or for pain management purposes in the treatment of a sports injury.
Why Some Athletes Abuse Opioids
Because of the increased availability of opioids nationwide, youth athletes have relatively easy access to these medications. All it takes is just one or two players who have current prescriptions who then share their opioids with injured teammates. Instead of reporting the sports injury to their coach or parents, these players readily accept the locker-room “gift”.
Reasons, why an athlete may choose to abuse pain-relief medications such as opioids, include::
Narcotic Painkillers & Heroin Addiction
Narcotic painkillers are highly addictive and easy to get hooked on. When the addict can’t obtain enough opioid medication through legitimate prescriptions, they may turn to illegal channels and may start to purchase street drugs such as heroin. In fact, 80% of all heroin users made the switch to heroin after abusing prescription opioids7.
Not All Athletes Succumb to Opioid Addiction
It’s important to remember that participation in youth sports can be highly beneficial—and doesn’t necessarily lead to opioid addiction. In fact, playing sports may protect again substance abuse. One study showed that participation in sports, at the high school level, reduced the risk of overall illicit drug use4.
It is vital that people educate themselves to become fully aware of the risks of prescription opioids. Such awareness can help prevent opioid misuse and addiction, and the devastating consequences these can have.
What are Opioids?
Opioids (aka narcotics) are drugs that are derived from the poppy plant or synthesized in a laboratory. Some are used for legitimate medical purposes as prescription pain-relief medications. Other opioids are illicit “street drugs.”
Prescription opioids are used to help ease the pain of dental or surgical procedures or accident-related injuries. They can also ease the discomfort of minor bruises and tears, or traumatic sports wounds. Doctors may also prescribe opioids to help alleviate cancer pain.
All opioids depress the central nervous system and decrease the number of pain signals that the body sends to the brain. This is how they relieve pain and induce feelings of extreme relaxation and a sense of euphoria.
Common opioid medications include:
Synthetic opioids include:
The Dangers of Opioids
When used as directed by a medical professional, opioid medications can safely help to reduce acute pain. But there are risks and genuine dangers if these medications are used incorrectly.
While at lower doses opioids create drowsiness. This makes it easier to fall asleep. At higher doses, they can slow breathing and heart rate, which can result in death.
The feelings of pleasure that come from taking opioid medication can lead to a person wishing to continue experiencing those feelings. This pattern of thought may lead to addiction.
The intense withdrawal symptoms of opioid misuse include elevated blood pressure, diarrhea, and feelings of anxiety and dysphoria. These negative experiences fuel a strong desire for more opioids.
Individuals (including youth athletes) can reduce the risk of unpleasant or dangerous side effects of opioid pain relief. They must follow their doctor’s instructions and take the medications exactly as prescribed.
How do Opioids Affect the Brain?
Drugs alter the way that neurons send, receive, and process signals via neurotransmitters6. Neurotransmitters are chemical messengers that transmit signals from one neuron to another. Opioids bind to the brain’s opioid receptors. This interaction triggers chemical changes between neurons that result in both feelings of pleasure and pain relief.
The Body's Natural Opioids
The human body produces natural opioids which activate the brain’s opioid receptors. One example of a natural endogenous opioid is endorphins. These chemicals create an analgesic (pain-relieving) effect and feelings of elation and euphoria, naturally.
Activities that release endorphins include exercise, dancing, meditation, laughing, having sex, listening to music, and receiving a massage.
When opioid medications interact with the body’s opioid receptors, they can also lead to feelings of intense pleasure and pain relief. But opioid drugs work differently than naturally produced opioids like endorphins. Opioid drugs can have negative side effects that damage the brain.
Negative Effects of Opioids on the Brain
Opioids can cause negative effects cognitively, physically, and emotionally. Opioids can have negative impacts on the brain that can affect the body in the short and long term.
Opioids Halt the Brain’s Own Production of Dopamine
Dopamine is a neurotransmitter that helps relieve pain and increase pleasure. It also plays an important role in many body-mind functions, including attention, memory, learning, movement, motivation, and mood. Continued opioid use causes the brain to rely on opioid-induced dopamine as a primary source of pleasure. Rather than the brain producing dopamine on its own.
When the brain stops producing its own dopamine, an individual may experience:
Opioids May Increase the Brain’s Sensitivity to Pain
Using opioid pain-relief drugs for extended periods of time can cause a paradoxical outcome, known as opioid-induced hyperalgesia (OIH). OIH is an increased sensitivity to pain.
Opioid medications activate receptors that block pain signals from reaching the brain. When this happens, the body tries to overcome these blocked signals through the additional activation of more pain signals. And this can lead to increased pain sensitivity.
Opioids can Damage the Frontal Lobe
Chronic opioid use can damage the brain’s frontal lobe—which plays an important role in planning, attention, memory, and executive functioning.
Extended opioid use may result in:
Opioids can Interfere with Impulse Control Circuits
One of the brain’s many functions is to help regulate impulse control. Opioid abuse disrupts the neural circuitry involved in impulse control. When this happens, it becomes even more difficult to resist opioid cravings.
Decreased impulse control may also lead to interpersonal conflict and aggression that negatively affects work, school, and family relationships.
Opioid Use Disorder (OUD)
The psychiatric diagnosis used to describe opioid abuse is opioid use disorder (OUD). While opioid use disorder is similar to other substance use disorders, it has several unique features1. Opioid use can turn into physical dependence in a short period of time.
When chronic users suddenly stop using opioids, they start to experience severe symptoms. These symptoms include generalized pain, chills, cramps, diarrhea, dilated pupils, restlessness, anxiety, nausea, vomiting, insomnia, and intense cravings. These severe symptoms make it even more difficult for the person to stop using opioids. Some may continue using opioids just to avoid the withdrawal symptoms.
The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) describes opioid use disorder as problematic opioid use. This use leads to problems or distress, with at least two of the following occurring within a 12-month period.
DSM-V Criteria for Opioid Use Disorder:
Treatment for Athletes
Regardless of the specific type of opioid that an individual becomes addicted to, the negative consequences can be extensive. For this reason, it’s important that action is taken to get the young athlete admitted to a rehab facility. Rehab can provide the necessary treatment options and professional care.
Treatment options for Opioid Use Disorder (OUD) include:
Helping Young Athletes Recover from OUD
Find Help for Opioid Addiction
Opioid abuse is common among young athletes after injuries. Opioids are often prescribed for pain relief in athletes even though these medications are known to be addictive. Abuse of opioids can lead to long-term side effects, but with treatment opioid recovery is possible.
Healthy Life Recovery offers an effective professional opiate rehab program to help athletes recover from opioid addiction. Our team of treatment professionals can help set the stage for healthy and fulfilling lives.
Medically Reviewed By:
Dr. Sanjai Thankachen
Dr. Sanjai Thankachen graduated from Adichunchanagiri Institute of Medicine in 2000. He completed his residency in psychiatry in 2008 at Creedmoor Psychiatric Center in New York. Dr. Thankachen is currently working with Pacific Neuropsychiatric Specialists in an outpatient practice, as well as working at multiple in-patient psychiatric and medical units bringing his patients the most advanced healthcare treatment in psychiatry. Dr. Thankachen sees patients with an array of disorders, including depression, bipolar illness, schizophrenia, anxiety, and dementia-related problems.
Edited for Clinical Accuracy By:
Sean Leonard is a board-certified psychiatric nurse practitioner. He received his master’s degree in adult geriatric primary care nurse practitioner from Walden University and a second postmaster specialty in psychiatry mental health nurse practitioner from Rocky Mountain University. Sean has experience working in various diverse settings, including an outpatient clinic, inpatient detox and rehab, psychiatric emergency, and dual diagnosis programs. His specialty areas include substance abuse, depression, anxiety, mood disorders, PTSD, ADHD, and OCD.
- 1. APA Staff. (2018, November). Opioid use disorder. American Psychiatric Association (APA). Retrieved June 27, 2022, from https://psychiatry.org/patients-families/opioid-use-disorder
- 2. CDC Staff. (2022, June 2). Death Rate Maps & Graphs. Centers for Disease Control and Prevention. Retrieved June 27, 2022, from https://www.cdc.gov/drugoverdose/deaths/index.html
- 3. Ekhtiari, S., Yusuf, I., AlMakadma, Y., MacDonald, A., Khan, M., & Leroux, T. (2020, August 6). Opioid use in athletes: A systematic review. Sports health. Retrieved June 27, 2022, from https://pubmed.ncbi.nlm.nih.gov/32758077/
- 4. Kwan, M., Bobko, S., Faulkner, G., Donnelly, P., & Cairney, J. (2013, November 10). Sport participation and alcohol and illicit drug use in adolescents and young adults: A systematic review of longitudinal studies. Addictive behaviors. Retrieved June 27, 2022, from https://pubmed.ncbi.nlm.nih.gov/24290876/
- 5. National Institute on Drug Abuse Staff. (2022, June 3). Opioid overdose crisis. National Institutes of Health. Retrieved June 27, 2022, from https://nida.nih.gov/research-topics/opioids/opioid-overdose-crisis
- 6. NIDA Staff. (2020, July). Drugs and the brain. National Institutes of Health. Retrieved June 27, 2022, from https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drugs-brain
- 7. NIDA Staff. (2021, June). Heroin drugfacts. National Institutes of Health. Retrieved June 27, 2022, from https://nida.nih.gov/publications/drugfacts/heroin
- 8. U.S. Department of Health and Human Services. (2018, November). Informational Materials and Resources to Prevent Addiction Related to Youth Sports Injuries. U.S. Department of Health and Human Services. Retrieved June 27, 2022, from https://www.hhs.gov/opioids/sites/default/files/2018-11/informational-materials-resources-prevent-addiction-related-to-youth-sports-injuries.pdf