Just a decade ago, it seemed that the “biggest deal” in youth sports drug-abuse news was high school athletes’ use of performance-enhancing drugs, or PEDs for short. Article after article described the win-at-all-costs pressure experienced by young athletes who took PEDs because they thought they needed a leg-up on their competition. While that particular pressure hasn’t dissipated and has arguably ramped up in recent years, the level at which young athletes compete today and the amount of time they spend practicing and playing any given sport has sky-rocketed. Between too-early specialization in youth sports and playing a singular sport year-round, the injury rate among young athletes has significantly increased in step with the participation rate. The injuries sustained cause pain, and some require surgical repair.
Enter opioids into an already scary picture.
The transition from increased sports participation and specialization to injury, surgery and possible opioid addiction isn’t that big of a leap, unfortunately. I have written extensively on the epidemic of youth sports specialization, and a bevy of clinical research done by my esteemed colleagues in the field has corroborated the fact that the related injury trend is alarming. In fact, according to the Centers for Disease Control and Prevention, “more than half of the 7 million sports and recreation-related injuries that occur each year are sustained by youth between the ages of 5 and 24.” It stands to reason that an increase in athletic participation correlates with an increase in the incidence of injury. When we factor in the additional research that tells us sports specialization and increased participation in youth is also associated with overuse injuries, we then enter into the territory of how those injuries are treated by physicians and handled by children, their parents and coaches.
Kids are undergoing orthopedic surgery for youth sports injuries in record numbers today. As an example, Tommy John surgery, a reconstructive procedure done on the elbows of baseball pitchers when the ulnar collateral ligament has torn or ruptured, has steadily increased since the mid-2000s. In fact, one study of people who underwent this type of surgery indicated that more than 50 percent of the participants were between the ages of 15 and 19 years old. The statistic itself is indicative of a problem, but the next question becomes: Whether or not a child undergoes surgery for a sports-related injury, how do doctors help them manage the pain associated with it?
When it comes to moderate to severe pain after an injury or orthopedic surgery, opioids can be effective for pain management when taken as prescribed and for a short time. But one study that was recently published in the Journal of the American Academy of Pediatrics noted that up to 15 percent of children received opioid prescriptions from health care providers for acute, minor and self-limiting conditions. Of those prescribed opioids for minor issues, 1 in approximately 2,600 experienced a related adverse event — from an ER visit to death. Coupled with this disturbing information is the fact that opioids are incredibly addictive. The epidemic of their use and abuse in this country doesn’t discriminate against children. With the increase in opioid prescriptions in America over the years has come a rise in availability and access, and our young athletes are also victims of this dangerous and destructive trend.
One study published in the American Journal of Public Health indicated that non-medical use of prescription opioids among adolescent competitive athletes is up to 50 percent higher in kids who participate in high-injury sports than those who don’t participate in high-injury sports. One way to view this statistic is to think of it as a locker room trend where easy access to opioids allows kids to “share” medications that may not have been prescribed to them — with friends or teammates who have been injured and don’t want to alert their parents or coaches to the injury. This again speaks to the pressure and fear of failure that so many of today’s young athletes are faced with.
Tragic stories of opioid addiction and overdose among young, talented athletes have been splashed across sports magazine covers and websites for the last few years. These are beautiful children with such bright futures ahead of them — robbed by addictive drugs and faulty logic that the risk of taking them is worth the short- and long-term rewards. Parents and coaches, here is something to remember: The risk of orthopedic injury to young athletes when they specialize in a sport too early or train too much is far higher than the potential for collegiate scholarship that kids are told they’re working toward. And that injury risk is even more significant than the professional sports career you may be dreaming of for them. Once an injury happens, how the pain associated with it is treated matters — a lot. We know opioids are a massive problem in our country, and our kids aren’t immune to it. Health care providers and parents must band together to do better for our young athletes, because they deserve the chance to reach their true potential … in life.
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From Injury to Opioid: the Unintended Side Effect of Youth Sports Participation originally appeared on usnews.com