Nonprescription pain medication use in collegiate athletes: A comparison of samples
Stache S., Close J.D., Mehallo C., Fayock K. Clinical Focus: Pain Management, Orthopedics, and Sports Injuries. 2014;42(2):19-26.
Take Home Message: Division II and III athletes use and misuse nonprescription pain medication for sports-related pain less often compared with Division 1-A football athletes.
Athletes tend to consume more nonsteroidal anti-inflammatory drugs (NSAIDs) than the general public; however, much of the research has been performed among high level American football athletes (NCAA Division 1-A teams). This is concerning because the risk of adverse effects from using NSAIDs is highly related to dose and duration of use. There is sparse research examining if nonprescription pain medication is being abused among collegiate athletes in other sports as well as other college divisions. Therefore, the purpose of this research was to survey athletes from non-Division 1-A sports about their nonprescription pain medication use. One hundred and ninety eight athletes (141 men; 57 women) who competed in a NCAA-sanctioned sport during the 2011-2012 academic year at 1 Division II and 1 Division III school anonymously completed a modified Over-the-Counter Drug Screen for Athletes questionnaire (38% response rate).
62% reported using nonprescription medication for sports-related pain,
12% reported taking more than the recommended dose,
1.5% reported taking pain medication for more than 10 consecutive days,
47% reported that they purchased their own nonprescription pain medication,
59% reported directing their own use, and
38% reported that they read the label when they took a new nonprescription pain medication.
The authors compared this study’s data with a study by Wolf et al. (144 NCAA Division 1-A football athlete’s survey responses). Results revealed that Division 1-A football athletes were more likely to take nonprescription pain medication for sports-related pain (73% vs. 62%), take more than the recommended dose (37% vs. 12%), take nonprescription pain medication for more than 10 consecutive days (7% vs. 1.5%) compared to Division II and III athletes, respectively. Division II and III (38%) were more likely to read the label prior to first use of new nonprescription pain medication compared to Division 1-A football athletes (25%). Similar results were found when the authors compared Division 1-A and non-Division 1-A American football athletes.
This study is important because it is the first to explore nonprescription pain medication habits among Division II and III athletes. The authors found that NCAA Division 1-A football athletes’ are more likely to use and misuse nonprescription pain medication compared with Division II and III athletes, even when focusing just on football athletes. This contradicts the conclusions by Wolf et al that Division 1-A football athletes do not misuse nonprescription pain medication. There may be an increase in NSAID use due to the physical nature of Division 1-A football. Overall, athletes may self-treat with nonprescription pain medication so that they do not have to miss a practice or a contest in fear of loosing their position or scholarship. However, we need to keep in mind that this study focused on one Division II and III school while Wolf and colleagues assessed 8 randomly selected schools. It will be interesting to see if these findings hold up when more schools are included. None-the-less, we need to be proactive about reducing the risk of adverse events related to the misuse of NSAIDs, particularly among athletes in Division 1-A football. Medical professionals need to educate athletes about the risks and long-term effects due to the misuse of nonprescription pain medication as well as introduce what are the safe practices for handling their nonprescription pain medication usage.
Questions for Discussion: How do you control nonprescription pain medication at your facility? Do you educate athletes on their nonprescription pain medication use?
Written by: Jane McDevitt, PhD
Reviewed by: Jeffrey Driban
Wolf D, Miller T, Pescatello L, Barnes C. National Collegiate Athletic Association Division I athletes’ use of nonprescription medication. Sports Health. 2011;3(1):25–28.