Nonprescription pain
medication use in collegiate athletes: A comparison of samples

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.

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
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.
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.

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?

by: Jane McDevitt, PhD
by: Jeffrey Driban



Stache, S., Close, J., Mehallo, C., & Fayock, K. (2014). Nonprescription Pain Medication Use in Collegiate Athletes: A Comparison of Samples The Physician and Sportsmedicine, 42 (2), 19-26 DOI: 10.3810/psm.2014.05.2054