Painfully Obvious: A Longitudinal Examination of Medical Use and Misuse of Opioid Medication Among Adolescent Sports Participants

Abstract

Purpose The objective of this longitudinal study was to assess the prevalence of medical use, medical misuse, and nonmedical use of opioid medication among adolescents who participate in organized sports. Methods Data for this study were taken from the Secondary Student Life Survey (SSLS). A total of 1,540 adolescents participated in three waves of data collection occurring between the 2009–10 and 2011–12 school years, with 82% of the baseline sample completing all three waves. Results Using Generalized Estimating Equation (GEE) models to analyze the longitudinal data, it was found that male adolescents who participated in organized sports during each wave of the SSLS had higher odds of being prescribed an opioid medication (i.e., medical use) during the past year (AOR = 1.86, 95% CI = 1.23, 2.82), higher odds of past-year medical misuse of opioid medication due to taking too much (AOR = 10.5, 95% CI = 2.42, 45.5), and higher odds of past-year medical misuse of opioid medication in order to get high (AOR = 4.01, 95% CI = 1.13, 14.2) when compared to males who did not participate in organized sports during the study period. Among females, no association was found between participation in organized sports and medical use, medical misuse, and nonmedical use of opioid medication. Conclusions The results of this study indicate that adolescent males who participate in sports may have greater access to opioid medication, putting them at greater risk to misuse these controlled substances.

Exercise as a Prevention for Substance Use Disorder: a Review of Sex Differences and Neurobiological Mechanisms

“…Participation in sports during high-school, even if non-contact, also predicts increased binge alcohol use during adulthood, and participation in contact-sports (e.g., football, wrestling, ice hockey) during high-school predicts not only increased binge drinking, but also, increased marijuana use, and prescription opioid misuse during adulthood (27–28). Although these findings have been observed in samples that include both males and females, the enhanced opioid use/misuse reported is likely associated with male athletes given that the sports identified are expected to be comprised predominantly of males (also see 13). While these findings suggest that socio-cultural factors associated with team sport participation can offset the protective effects of exercise, it is also possible that biological factors induced by exercise contribute to the enhanced vulnerability.…”

“…For example, while exercise is negatively associated with alcohol, cigarette, and marijuana and other illicit drug use (16), sports participation is positively associated with smokeless tobacco and alcohol use (16,23–24; for review see 25). Associations between team sports participation and drug and alcohol use also differs between males and females and type of sport (e.g., 12–13). Perhaps most alarming are results showing that middle- and high-school athletes participating in sports associated with a high risk of injury (e.g., football and wrestling) have an increased risk of prescription opioid misuse (12;26).…”

“…The few recent studies that have examined sex differences have focused on middle- and high-school students, with conflicting results that vary between populations (4,6–7). Recent findings also suggest that risk of drug use from participating in certain sports differs between males and females, with evidence for reduced risk in females (13). It is possible that exercise protects against alcohol and drug use in both males and females, but that sociocultural factors associated with sports team participation interact with exercise to modify vulnerability.…”

“…For example, involvement in certain sports is associated with higher levels of drug and alcohol use, with findings that vary between males and females and between different sports (12–13). While such findings are likely attributable, at least in part, to socio-cultural factors (14–16), findings in animals have also revealed that certain exercise conditions enhance vulnerability to drug use and the development of features of addiction (9) suggesting that biological factors also contribute.…”

CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016

“…The available evidence concerning the benefits and harms of long-term opioid therapy in children and adolescents is limited, and few opioid medications provide information on the label regarding safety and effectiveness in pediatric patients. However, observational research shows significant increases in opioid prescriptions for pediatric populations from 2001 to 2010 (36), and a large proportion of adolescents are commonly prescribed opioid pain medications for conditions such as headache and sports injuries (e.g., in one study, 50% of adolescents presenting with headache received a prescription for an opioid pain medication [37,38]). Adolescents who misuse opioid pain medication often misuse medications from their own previous prescriptions (39), with an estimated 20% of adolescents with currently prescribed opioid medications reporting using them intentionally to get high or increase the effects of alcohol or other drugs (40).…”