title: Injury, pain, and prescription opioid use among former National Football League (NFL) players.
abstract: BACKGROUND
  Athletes with injury-related pain, especially National Football League (NFL) players, are at increased risk for opioid use and misuse which may result in medical, psychiatric and social problems. This is the first study to evaluate the intersection of sports pain and opioid use and misuse among former NFL players.
  
  
  METHODS
  A telephone survey of 644 retired NFL players from the 2009 Retired Players Association Directory was conducted (53.4% completion rate) from March to August 2010.
  
  
  RESULTS
  Over half (52%) used opioids during their NFL career with 71% reporting misuse. Additionally, 15% of NFL misusers currently misused vs. 5% among players who used just as prescribed during their NFL career. Prevalence of current opioid use was 7%-3 times the rate of the general population. Multivariate analyses indicated that significant NFL pain increased the adjusted odds (AOR) of any current opioid use vs. non-use (AOR 6.76, 95%CI 2.88-15.87), as did moderate to severe mental impairment (AOR 1.88, 95%CI 1.19-2.98) and heavy drinking in the past week (AOR 2.15, 95%CI 1.17-3.98). Undiagnosed concussions singly predicted current misuse vs. use just as prescribed (AOR 4.25, 95%CI 1.12-16.22). Three variables predicted current misuse vs. non-use: significant pain (AOR 8.33, 95%CI 1.98-35.04), undiagnosed concussions (AOR 3.51, 95%CI 1.98-35.04) and heavy drinking (AOR 3.48, 95%CI 1.63-7.41).
  
  
  CONCLUSIONS
  Players who misused during their NFL career were most likely to misuse currently compared to others. Current misuse was associated with more NFL pain, undiagnosed concussions and heavy drinking. Longitudinal studies are needed to determine the long term effects of opioid misuse among athletes.
authors.affiliation: Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63108, USA. cottler@epi.wustl.edu
authors.forename: Linda B
authors.initials: LB
authors.lastname: Cottler
authors.forename: Arbi
authors.initials: A
authors.lastname: Ben Abdallah
authors.forename: Simone M
authors.initials: SM
authors.lastname: Cummings
authors.forename: John
authors.initials: J
authors.lastname: Barr
authors.forename: Rayna
authors.initials: R
authors.lastname: Banks
authors.forename: Ronnie
authors.initials: R
authors.lastname: Forchheimer
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000378:metabolism; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use; D056352:Athletes / Q000706:statistics & numerical data*; D001265:Athletic Injuries / Q000188:drug therapy / Q000453:epidemiology*; D001924:Brain Concussion / Q000175:diagnosis; D003625:Data Collection; D005538:Football / Q000293:injuries / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000378:metabolism; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000453:epidemiology*; D010146:Pain / Q000188:drug therapy / Q000453:epidemiology*; D013997:Time Factors
chemical_list: D000701:Analgesics, Opioid