Sports Medicine Research: In the Lab & In the Field: NCAA Division 1 Football Players' Misuse of Nonprescription Medication (Sports Med Res)
Tuesday, February 22, 2011

NCAA Division 1 Football Players' Misuse of Nonprescription Medication

National Collegiate Athletic Association Division 1 Athletes’ Use of Nonprescription Medication
Wolf DA, Miller TW, Pescatello LS, Barnes C. Sports Health 2011; 3(1):25-8.

There is a growing concern about how patients take medication and their level of understanding about the medication. For example, in a recent post we discussed misuse of prescription analgesics among retired-NFL players. Last May, Kahanov et al. reported the adherence to drug-dispensation and drug administration laws and guidelines in collegiate athletic training rooms. Kahanov reported that athletic trainers’ compliance with federal and state laws has improved since 2001 but that overall athletic trainers in most collegiate athletic training rooms complied poorly with federal laws regulating the administration of medication (full text is available online). What is less clear is how college and high school athletes use medication. This study attempted to fill this void by surveying 144 NCAA Division 1-A football athletes (from 8 schools) about nonprescription analgesic use.  

73% reported nonprescription-analgesic use last season for football-related pain
35-37% of users took more than the recommended dose
36% of over users thought that this would alleviate their symptoms faster
89% of over users thought they needed a larger dose because they were larger than the typical person
Athletes commonly confused acetaminophen and ibuprofen products
64% of athletes decided to take nonprescription analgesics on their own
24% of athletes decided to take nonprescription analgesics when an athletic trainer thought it appropriate
29% of athletes received the medicine from an athletic trainer
41% of athletes took the medicine in anticipation of pain
31% of athletes used the medicine to avoid missing practice
63% said they sought advice about nonprescription analgesics from athletic trainers
28% said they sought advice about nonprescription analgesics from team physician

In conclusion, the authors state that athletes misuse nonprescription analgesics when there is poor communication with the athlete, when the athlete has limited knowledge about the medication, and when the athletes wants to avoid pain or missing practices/games. This was a small study among a very select group of college athletes but it raises a similar issue that keeps emerging: we need to be educating our patients better about their treatments and treatment options. I’m sure we will be seeing more research over the next few years about medication use (prescription and over-the-counter) in the general population as well as the athletic population. As a community it is time to start discussing how we can improve patient safety with medications. What are you doing to educate your patients? What information do you need to help educate your patients?

Written by: Jeffrey Driban
Reviewed by:  Stephen Thomas

4 comments:

John Goetschius said...

One of the issues I have noticed with poor adherence to OTC dosage guidelines are habits that are formed by athletes prior to their collegiate athletic careers. Through the advice of their coaches, parents, or physicians, the majority of these athletes have been using OTC medications for years prior to college. The problem is that during this time in their lives OTC ‘administration’ typically involves parents purchasing a bottle of OTCs and handing them over to the athlete to manage. This article has shown that collegiate level athletes are mismanaging the use of these medications, and now imagine that same mind-set in a younger, more naive, and less educated individual. By the time they get to the college level these athletes have been self-administering their own medications at a dosage they believe they need to be effective. As a clinician, I have had multiple occasions where collegiate athletes tell me that the amount of medication I administer is nothing compared to the 2-4x as much that they would take on a consistent basis in high school. I would be interested to see a similar study in high school athletes and see how they compare to collegiate level.

Jeffrey B. Driban, PhD, ATC, CSCS said...

John, that is great point and very interesting. I would also like to see this type of data among high school athletes. Has anyone else had this experience with HS athletes?

James F. Malseed, M.Ed., ATC said...

As a high school ATC, the biggest problem is that by law in my state, I cannot give OTC's to my athletes, but parents will just give them. I have had situations were parent will run to meet player going into locker room at half time with OTC so they can feel good for 2nd half. Upon questioning the athlete found out they took the OTC about an hour prior to the game. Have even had parents tell me they give their child OTC, even if they are not injured, just in case.

Jeffrey B. Driban, PhD, ATC, CSCS said...

James and John: After the parents give the kids the OTC medications do you think the kids then share it with their teammates?

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