INDIANAPOLIS – Due to the physical contact nature of their occupation, the elite athletes of the National Football League (NFL) often experience pain. However, an analysis of 2021 and 2022 data from the National Football League Prescription Drug Monitoring Program shows that team members in those two years were even less likely than both the general U.S. population and males of similar age living in the U.S., to have a prescription for an opioid pain medication.
The study found that less than 3 percent of pain medications prescribed to the athletes who played in one or both of the two seasons were for opioids. Slightly more than 86 percent of the pain medications were nonsteroidal anti-inflammatory agents (NSAIDs) such as ibuprofen, naproxen, diclofenac or celecoxib – which are currently the preferred first-line pain medication recommended for pain.
“NFL athletes are exposed to very physical contact and to the development of pain during or after games due to injuries. There’s always been a concern from a safety and health perspective about what are they using to treat their pain,” said Regenstrief Institute and Indiana University School of Medicine researcher-clinician Kurt Kroenke, M.D., a study co-author and national leader in the field of medical symptoms.
“The good news is of all medicines prescribed to league players for pain, opioids account for only 3 percent. Moreover, only 10 percent of NFL athletes received even a single prescription for an opiate during a one-year period. I think there’s been much greater attention to what can be done in the training room for NFL athletes for their injuries and pain that doesn’t rely on medicines.”
Dr. Kroenke is a consultant to the National Football League-National Football League Players Association (NFLPA) Joint Pain Management Committee, whose members are appointed by the NFL and the NFLPA. The committee’s goals are to address the challenges of pain management for current NFL players and to facilitate research to better understand and improve potential alternative treatments.
A total of 3,142 players had a signed contract with at least one NFL team during the 2021 season. 14,903 prescriptions for pain medications issued to 2,207 of these men by either a team doctor or external medical providers were entered into the monitoring program database.
During the 2022 season, there were 14,880 prescription pain medications, slightly fewer than the prior year, issued to 2,189 players (out of a slightly larger population of 3,152 with signed contracts) entered into the monitoring program database.
In 2021 and 2022 a total of 576 players were prescribed opioid medications, indicating that most players (more than 90 percent) did not receive any opioid prescriptions.
The opioid use by NFL players in 2021 and 2022 contrasts significantly with the findings of a survey of retired NFL players, reported in 2011, which showed that 52 percent had used prescription opioids during their career and of those who had used opioids, 71 percent reported misuse.
Since that time, Centers for Disease Control and Prevention (CDC) guidelines for prescribing opiates have changed significantly to reduce risks of opioid use disorder, overdose and death.
In 2019 the NFL and the NFLPA established the prescription drug monitoring program to track prescriptions of scheduled substances and other prescription medications. 2021 and 2022 were the first two years of standardized and robust data in this centralized electronic medical record system.
“The NFL-NFLPA Pain Management Committee is always looking to improve the health and safety of the players, and the Prescription Drug Monitoring Program aims to do that by educating medical staffs about their prescribing habits. We are encouraged by these early results but we hope to limit opioid prescriptions even further in the future,” said paper co-author Kevin Hill, M.D., MHS, director of the Division of Addiction Psychiatry at Beth Israel Deaconess Medical Center, an associate professor of psychiatry at Harvard Medical School and co-chair of the NFL-NFLPA Joint Pain Management Committee.
“Professional football is a very physical sport. But anyone who watches professional hockey or NBA basketball or big league soccer and even college and high school sports, realizes how these players also are prone to injuries and pain,” said Dr. Kroenke. “I think how we treat pain safely, using opioid pain medications very infrequently, applies across all sports.”
“Pain Medication Data from the 2021 and 2022 National Football League Prescription Drug Monitoring Program” is published in Current Sports Medicine Reports, a publication of the American College of Sports Medicine.
Authors and affiliations as listed in the paper:
Hill, Kevin P. MD, MHS1,2; Kroenke, Kurt MD, MACP3; Wasserman, Erin B. PhD4; Mack, Christina PhD, MSPH4; Ling, Geoffrey S.F. MD, PhD5,6; Mayer, Thom MD6; Solomon, Gary S. PhD7,8; Sills, Allen MD, FACS7,8
1Division of Addiction Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA
2Department of Psychiatry, Harvard Medical School, Boston, MA
3Indiana University School of Medicine and Regenstrief Institute, Indianapolis, IN
4IQVIA, Research Triangle Park, NC
5National Football League Players Association, Washington, DC
6Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD
7National Football League, New York, NY
8Department of Neurological Surgery, Vanderbilt University School of Medicine, Nashville, TN
Kurt Kroenke, M.D., MACP
In addition to his role as a research scientist with the William M. Tierney Center for Health Services Research at Regenstrief Institute, Dr. Kroenke is an Indiana University Indianapolis Chancellor’s Professor and a professor of medicine at the Indiana University School of Medicine.
