“Game On: Inside the Surprising Opioid Use Among NFL Players for Pain Relief”

Given the contact-heavy nature of their profession, elite athletes in the National Football League (NFL) frequently endure pain. Nonetheless, an examination of data from the National Football League Prescription Drug Monitoring Program for 2021 and 2022 reveals that players during those two years were even less prone than both the general U.S. population and similarly aged males residing in the U.S. to hold a prescription for opioid pain relief.

The research indicated that under 3 percent of pain relief medications prescribed to the players participating in one or both seasons were opioids. Just over 86 percent of the medications were nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen, naproxen, diclofenac, or celecoxib – which are currently recommended as first-line treatments for pain management.

NFL athletes face substantial physical contact and are at risk of developing pain during or following games due to injuries. There has consistently been concern regarding what methods they employ to alleviate their pain from a safety and health standpoint.”

Kurt Kroenke, M.D., researcher-clinician at Regenstrief Institute and Indiana University School of Medicine, co-author of the study and national authority in the field of medical symptoms

“The positive aspect is that of all medications given to league athletes for pain, opioids comprise only 3 percent. Additionally, merely 10 percent of NFL players obtained even a single prescription for an opioid within a year. I believe there’s been significantly more focus on addressing injuries and pain in the training rooms for NFL athletes without relying on medications.”

Dr. Kroenke serves as a consultant for the National Football League-National Football League Players Association (NFLPA) Joint Pain Management Committee, with members appointed by the NFL and NFLPA. The committee’s objectives revolve around tackling the difficulties of pain management for current NFL players while promoting research to enhance understanding and improve potential alternative therapies.

A total of 3,142 players were under contract with at least one NFL team during the 2021 season. 14,903 pain medication prescriptions for 2,207 of these individuals, provided by a team physician or external medical practitioners, were logged into the monitoring program database.

In the 2022 season, there were 14,880 prescription pain medications issued, slightly lower than the previous year, for 2,189 players (from a marginally larger population of 3,152 with contracts) entered into the monitoring program database.

In 2021 and 2022, a total of 576 players were prescribed opioid medications, signifying that the majority of players (over 90 percent) did not receive any opioid prescriptions.

Opioid prescriptions for NFL players in 2021 and 2022 starkly contrast with findings from a 2011 survey of retired NFL players, which indicated that 52 percent had utilized prescription opioids during their careers, and among those who did use opioids, 71 percent reported misuse.

Since that time, the prescribing guidelines for opioids from the Centers for Disease Control and Prevention (CDC) have undergone significant revisions to mitigate risks associated with opioid use disorder, overdose, and fatalities.

In 2019, the NFL and the NFLPA initiated the prescription drug monitoring program to oversee the prescribing of controlled substances and other prescription drugs. The years 2021 and 2022 marked the first two years of standardized and substantial data within this centralized electronic medical record system.

“The NFL-NFLPA Pain Management Committee continuously seeks to enhance the health and safety of the players, and the Prescription Drug Monitoring Program is designed to accomplish this by educating medical teams on their prescribing patterns. We are encouraged by these preliminary findings but aim to further reduce opioid prescriptions in the future,” stated paper co-author Kevin Hill, M.D., MHS, director of the Division of Addiction Psychiatry at Beth Israel Deaconess Medical Center, associate professor of psychiatry at Harvard Medical School, and co-chair of the NFL-NFLPA Joint Pain Management Committee.

“Professional football is an extremely physical endeavor. However, anyone who observes professional hockey, NBA basketball, or major league soccer, as well as college and high school sports, recognizes that these athletes too are vulnerable to injuries and pain,” remarked Dr. Kroenke. “I believe the approach we take to manage pain safely, with very infrequent use of opioid pain medications, is applicable across all sports.”