Updated: Feb 23, 2021
Serious injuries often lead athletes into opioid addiction with the risk of becoming over reliant on pain medication. An anterior cruciate ligament tear is one of the most severe injuries an athlete can experience. East Tennessee State University women’s soccer player Maegan Sours has sustained an ACL injury in each of her knees.
This injury is associated with acute pain that requires management with pain medication, particularly after surgery. Sours tore her right ACL in her sophomore year of high school and then her left ACL during her first college season.
“I became quite dependent on my opioid medication during both of my ACL recoveries, but more so the second time around,” said Sours. “I took painkillers more often than I should have because I was struggling to cope. Looking back, I should have reached out for help from my doctor because I became resistant to the pain meds, and they stopped doing their job.”
Opioid addiction has been an epidemic in the Appalachian region for decades, and in 2014 the area accounted for more than a fifth of nationwide opioid-related deaths, according to the Center for Disease Control and Prevention. ETSU head football trainer, Nathan Barger, said athletes who are recovering from surgery are most vulnerable to the risk of opioid addiction.
“The biggest thing for us is that the epidemic has changed our whole dynamic with dispensing pain medication,” said Barger. “We now control exactly how many pills are taken by athletes post-surgery and we start to wean them off their pain medication as rehab and recovery progresses.”
Dr. Benjamin England is an exercise and sports medicine specialist at Appalachian Orthopedics. He works as a team doctor alongside Dr. Ralph Mills at ETSU. England said an opioid addiction during recovery doubles the problem for athletes as they have two rehab and recovery processes to undergo instead of one.
Orthopedics is an area where opioid addiction is very common as many become addicted through injuries and after surgery.
“If a condition is chronic then sometimes the medication is used chronically as well,” said England. “I’m very hesitant to use opioids with athletes because of the risk of addiction that comes with them.”
The trainers and physicians within the department have under-gone training in identifying drug seeking behaviors as part of new patient evaluations. Barger said that stigma has affected his athletes as, with football, there has always been a “push through the pain” and “play at all costs” attitude. However, Barger stated that this attitude has changed in recent years because of the damaging effects it has had on the players.
Psychiatrists and neurology-trained physicians in addiction are best able to manage a person addicted to opioids’ rehabilitation, according to England. Treatment includes behavioral and cognitive therapy combined with a weaning schedule to get the patient off the opioid medication. Behavioral therapy provides strategies or skills to modify behavior and cognitive therapy focuses on identifying and changing the distorted thinking that maintains the addiction.
ETSU’s counseling center has a Campus Alcohol and Drug Program that offers students professional help and support with substance abuse. The counseling center operates a stepped care model, which provides all students with different choices to address individual needs.
Drop-in counseling sessions are provided specifically for athletes in the athletic training room on Wednesdays from 2 p.m. to 4 p.m. This free, informal program is called “Let’s Talk” and offers athletes a chance to briefly share what’s on their mind, find support and get recommendations on their next steps.