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High school athletes surprising risk group for opioid misuse

  • Caleb Holmes in his football jersey. “It was the joy of his life, it really was,” said his mother, Sheryl Holmes of Belchertown. Submitted photo

  • After Caleb’s shoulder surgery, he couldn’t complete his wrestling season. “He lost his identity because he couldn’t play anymore,” said his mother. “If you have a predisposition to addiction, it quickly feeds you into that flow of addiction.” Submitted photo

  • youth football player tackled james boulette—Getty Images/iStockphoto

  • As a group, athletes tend to push themselves hard, have high expectations of themselves — and are even bigger risk-takers than the average teen. Getty Images/iStockphoto

  • Oxycodone is the generic name for a range of opoid pain killing tablets. Prescription bottle for Oxycodone tablets and pills on wooden table with USA flag in background Steve Heap—Getty Images/iStockphoto



For the Gazette
Wednesday, September 26, 2018

High school athletes are at higher risk than other teens to fall prey to opioid misuse and addiction. As the country’s opioid crisis wears on, prevention specialists, those who work with high school athletes and, increasingly, parents, are paying attention to this elevated risk.

The reasons behind this trend are many: As a group, athletes tend to push themselves hard, have high expectations of themselves — and are even bigger risk-takers than the average teen.

Dr. Jonathan Fallon, a physician with Cooley Dickinson Orthopedics and Sports Medicine, believes another factor is a culture of bravado within team sports in which there may be a reluctance to reach out for help when it is needed.

In addition, based on the startling statistic that 90 percent of high school athletes will be injured at some point in their athletic careers, they are more likely than other teens to be prescribed opiates. When you add to the mix the fact that sports can bring a strong sense of identity for high school athletes — which might make some inclined to play through the pain — well, you pretty much have a perfect storm for misuse or addiction.

Sheryl Holmes of Belchertown knows all about this. She believes her own family tragedy is related to this phenomenon. Her son Caleb Holmes was a passionate athlete throughout high school — playing football, track and field and wrestling.

“It was the joy of his life, it really was,” she said.

He was prescribed opiates for pain relief in his senior year as he recovered from shoulder surgery to repair a sports injury. His mother doesn’t believe that injury caused his addiction, but she contends it exacerbated a problem and set him on a tragic course.

“From there, I believe, was the beginning of a downward spiral into depression,” she said. After the surgery, he couldn’t complete his wrestling season, which only added to his emotional downfall because sports had been a primary motivator in his life.

“He lost his identity because he couldn’t play anymore,” she said. “If you have a predisposition to addiction, it quickly feeds you into that flow of addiction.”

Caleb Holmes’ struggle with addiction ultimately led to a death described on his death certificate as “accidental overdose by multi-drug intoxication” in May, at age 19. 

Fallon recommends parents consider alternatives before resorting to opiates after injuries. While narcotics may be appropriate for an acute injury, he said, they aren’t necessarily the best option for other types of pain.

And, he said, families need to be especially vigilant when there are leftover pills in a prescription — if there are a few pills remaining and the student experiences another injury, there is a tendency to simply use the pill that worked well before without seeing a medical provider.

What harm could there be? A lot, says Fallon.

“The cycle becomes seductive because they are very effective medications,” he said. “They’re just difficult to control.”

Fallon said an increasing number of parents are talking to him about their fears related to prescription opiates. He believes they are right to be wary.

“I don’t think you can understate how concerned parents should be about the potential for addiction,” he said. “The concerns about teenagers having such easy access to opioids are very real and have long-lasting ramifications.”

As the opioid epidemic has worsened, claiming more lives and devastating more families, efforts to respond to the crisis and prevent opioid deaths have increased, including initiatives to educate student athletes and their families about the increased risk factors and strategies for keeping teens safe.

Landmark opioid prevention legislation adopted in Massachusetts in 2016 requires schools to provide student athletes with educational materials about the risks of opiates in conjunction with the already-established head injury safety programs schools must provide.

The bill featured other important practices, including: It was the first law in the nation to limit an opioid prescription to a 7-day supply for first-time adult prescriptions and a 7-day limit on every opiate prescription for minors (with certain exceptions.) Other key measures include the option of partially filling opioid prescriptions in consultation with doctors and pharmacists and mandatory substance misuse screenings in public schools.

Fallon believes parents should limit the amount of opiates they bring into their homes by taking advantage of the partial-fill option and that they should always diligently dispose of medicines after the treatment concludes.

“If you look at kids who are addicted to heroin, an overwhelming percentage of them start out with prescription narcotics,” he said. “It’s usually not their prescription — that’s the scary part.”

That’s precisely why public health advocates continue to beat the drum about keeping opiates locked up at all times.

Sheryl Holmes had additional advice for parents of high school athletes, including that they not fall under the false belief that such a tragedy could never happen in their family. Fear, she said, can make parents miss important clues that their teens might be in danger.

She also encourages parents to look beyond the façade teens can adopt around team sports.

“Athletes tend to be full of pump and bravado because that’s what team sports do,” she said. “Pay attention to the softer side of your kid, the side that might be in pain or the side that is other than sports, because sports is where they’re shining.”

Laurie Loisel is director of outreach and education for the Northwestern District Attorney’s office and a member of the Hampshire HOPE opioid prevention coalition run out of the city of Northampton’s Health Department. Members of the coalition contribute to a monthly column in this space about local efforts underway to address the opioid epidemic.