The discussion began a few years ago, when facts about concussions began to emerge: Do coaches, parents and even some doctors go too far in pushing teen athletes to be all that they can be?
After much reflection, the answer has turned out to be: “Sometimes, yes.”
But now the problem is even worse than allowing (or encouraging) some child athletes to keep playing when they have a concussion. Some of those people who are supposed to be watching over them are pushing them so hard, they are turning them into heroin addicts.
The problem is so pervasive, sticking one’s head in the sand is not only futile, but can also be deadly. Stories of young adults with heroin addictions increasingly are getting traced back to a high school (or even a middle school) sports injury where a doctor gave a child an opioid-based painkiller.
While it has gotten to the point where the stories are a dime a dozen, it’s worth noting that Sports Illustrated became one of the first heavy hitters in the news media to blow the cover on the dirty little secret almost two years ago.
In a riveting report headlined, “Smack Epidemic: How Painkillers Are Turning Young Athletes into Heroin Addicts,” the magazine listed story after story of bright young stars who got injured, were prescribed a painkiller, and in some instances, wound up dead of a heroin overdose several years later.
This included the story of Cameron Weiss of New Mexico, who wrestled and played football. He broke both collarbones in the 10th grade, one while wrestling and another while playing football. After surgery, he was prescribed Percocet and hydrocodone.
Before long, “He confessed to his mother that he was addicted to heroin,” SI reported. “Because of a federal law that prevents doctors from prescribing buprenorphine, a component of Suboxone, to more than 100 patients at a time, Jennifer Weiss-Burke had to call 80 physicians before she could get her son an appointment for a Suboxone prescription.”1
When he was on Suboxone, a medicine that curbs opiate withdrawals and cravings but allows a person in recovery to function normally, Weiss-Burke said her son was fine. But sobriety didn’t last long. At 18, Cameron died of an overdose.
Anecdotal Evidence of Heroin Use ‘Abundant and Alarming’
“While hard data for heroin use among young athletes are difficult to come by, the anecdotal evidence is abundant and alarming,” SI reported. “A seven-month SI investigation found overdose victims in baseball, basketball, football, golf, gymnastics, hockey, lacrosse, soccer, softball, swimming, tennis, volleyball and wrestling – from coast to coast.”
But the blame can’t rest simply with doctors who wanted to keep young athletes out of pain. The athletes themselves wanted to stay in the game, and enjoy all the perks that come with being an athlete, from the attention of their peers to college scholarships. It doesn’t take long for an athlete given an opioid after an injury to learn that if you have the opioids, you can work out even when you’re in pain. And, you can work out harder with opioids once the pain from the original injury subsides.
“Us athletes – we’ll do anything in order to keep playing,” Patrick Taylor, a lacrosse goalie at a New Jersey high school, told SI. After a teammate shattered Patrick’s thumb during a “fluke shot,” per SI, a doctor gave him Roxicodone. Young athletes call it “Roxy.” Within three years, Patrick was on heroin.
The good news is that per the National Institute on Drug Abuse, opioid use is declining among teens, even as it is rising among adults. However, the statistics compiled from NIDA’s “Monitoring the Future” survey do not specifically break numbers down between athletes and non-athletes.
“Despite the continued rise in opioid misuse and overdose deaths among adults, past-year misuse of prescription opioids has continued to decline among high school seniors,” NIDA reports on its website.2 “Over the past five years, misuse has dropped 45 percent, from 8.7 to 4.8 percent. Heroin use remains very low.”
Overzealous Sports Parents May Increase Risk
With young adults already putting pressure on themselves to excel in sports, whether it be for popularity among their peers or to have their college paid for, the last thing they need is for their overzealous parents to push them further.
Unfortunately, that’s a problem, too.
A Los Angeles Times piece written in March tells the story of a remorseful father and his permanently disabled son.
Mark Cullen remembers when his son Aidan, then 8, had a tooth knocked out while playing in a basketball game. Little Aidan picked up the tooth, threw it to the sidelines and kept on playing.
“I should have said, ‘Stop, are you OK?” Mark Cullen recalled in the Times interview. “But I heard other parents saying, ‘Whoa, that’s such a tough kid.’ So, I did nothing.”3
And the high Mark would feel when other parents would marvel at his son’s athletic prowess became addictive in and of itself. In middle school, Aidan passed out on a soccer field from exhaustion and dehydration.
“I thought he had died, but then I was glad he kept playing,” Mark Cullen recalled. “Everybody cheered him so much, I felt like they were cheering for me. I loved it. I loved the power of it.”
Today, Aidan Cullen lives with a neurological disorder called Central Pain Syndrome. His central nervous system is so damaged from injuries he is in constant pain. Per the Times story, doctors have said one of the reasons he developed the disease is because he continued to play sports while injured.
“He quit sports for several months and began dealing with the disease with a combination of medicine and physical therapy,” the Times reported. “He eventually felt better, and his love of baseball led him to rejoin the Windward team this winter for his senior season. But the nagging injuries have returned, and his contributions will probably be limited.”
Aidan has a new interest – photography—and recently was accepted into the Tisch School of the Arts at New York University. His dad already has asked about the baseball team. Aidan’s flat response: “I don’t know if I’m going to play.”
The elder Cullen, who reached out to the reporter who wrote the story himself and encouraged him to write it, told the Times he shared his story for one reason. “I want parents to realize we’re pushing our kids way too hard. Don’t do travel leagues. Don’t play year-round. Kids will find their way.”
Remember, ‘It’s Only a Game’
In many ways, the concussion discussion that began several years ago revolves around the same issues that the opioid crisis does now. “It’s only a game,” as they say, and yet parents, athletes and even doctors sometimes forget that.
The National Athletic Trainers Association has done a lot to advance the discussion about concussion awareness in recent years. In the past, they even have referred to a “culture of resistance” among parents, coaches and players who did not want to take concussions seriously.
NATA did not return a telephone call from Foundations Recovery Network, but they do mention opiates in a blog post on their website. In fact, they quote Weiss-Burke, who also serves as executive director of Healing Addictions in Our Community and Serenity Mesa Youth Recovery Center in Albuquerque, New Mexico.
The blog post mentions that during a presentation called “Opiate Abuse Among Teenage Athletes: What You Need to Know,” Weiss-Burke explained that after taking opiates for 10 days, “the brain begins to change and addiction begins,” adding, “Heroin and prescription pain killers are closely tied together. The line between use, misuse, abuse and addiction is incredibly thin.”
In Massachusetts, one of the nation’s opioid epidemic hot spots, state law requires opioid education among student athletes in addition to concussion education, which began sweeping the nation in 2010.
“If a student athlete is injured, whenever possible, treat the injury first with rest, ice, compression, elevation and anti-inflammatory medication – but do seek medical care if necessary,” the state instructs coaches on its website.4 “Opioids for pain should be considered only by a physician and only when other approaches have not provided relief.”
The state also reminds coaches that injured athletes need rest. “Too often, athletes do not allow sufficient time to recovery from their injuries and turn to pain medication to enable their continued participation in their sport. Care must be taken to avoid the common cycle of injury, pain and re-injury.”
Sources1. Wertheim, L. et al. (2015, June 18). How painkillers are turning young athletes into heroin addicts. Sports Illustrated. Retrieved March 14, 2017, from http://www.si.com/more-sports/2015/06/18/special-report-painkillers-young-athletes-heroin-addicts2. National Institute on Drug Abuse. (2016, December). Monitoring the Future Survey: High school and youth trends. Retrieved March 14, 2017, from http://www.latimes.com/sports/la-sp-sports-dad-plaschke-20170308-story.html3. Plaschke, Bill. (2017, March 8). A cautionary tale of what can happen when a parent pushes too hard. Los Angeles Times. Retrieved March 14, 2017, from http://www.latimes.com/sports/la-sp-sports-dad-plaschke-20170308-story.html4. MassTAPP technical assistance, Partnership for Prevention. (2016, Aug.) Preventing prescription opioid misuse among athletes. Retrieved March 14, 2017, from http://www.mayoclinic.org/diseases-conditions/concussion/symptoms-causes/dxc-20273155Written by David Heitz