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Young athletes susceptible to opioid addiction

Josh VanDyke • Aug 26, 2017 at 10:00 AM

Imagine being involved in a car accident.

Even if it’s just a fender-bender, you’ll likely feel the effects such as: head, neck and back injuries due to whiplash; soft tissue injuries from ligaments being stretched or pulled in abnormal ways; or even a concussion or other trauma due to your head making physical contact with another object.

Now imagine being involved in 25-30 car crashes in a single night — let’s say Friday night, under the lights at a local high school football stadium.

It might sound hyperbolic, but the nature of many competitive sports is that these types of collisions happen on a game-by-game basis, often involving one human body crashing into another multiple times a game.

I’m not writing this article to condemn competitive sports — that would be foolhardy and unfruitful. The benefits of playing competitive sports far outweigh the risks involved, in my opinion.

The problem lies in how we are treating injuries in young athletes, especially teenagers.

The University of Michigan did a research study in 2013 on the use of narcotic pain relievers and found that 11 percent of high school athletes in the United States have used opioid painkillers such as Oxycontin or Vicodin in non-medical situations. In essence, that means in a classroom full of only nine student-athletes, one of them has used a prescription-strength drug to get high.

This same study found that the percentage rose from 6.4 percent in 1994 to 11.2 percent in 2007.

The problem isn’t the nature of competitive sports — it’s how we are treating the injuries associated with them.

Most opioid pain medications are used strictly for post-surgical procedures or short-term pain relief in severe conditions. The Centers for Disease Control and Prevention recommends that primary care doctors prescribe opioid painkillers for no more than seven days, yet that same institution has helped field research that has proven that, far too often, that’s not what happens.

Whether it’s being caused by overcorrecting past treatments, lack of medical insurance coverage on other options or even not being able to spot the symptoms of addiction in time, opioid addition has become an epidemic across the country.

The CDC has recently added stricter guidelines to narcotic painkiller use, recommending that patients try physical therapy, exercise and over-the-counter medicine before diving directly into high-strength opiates such as Oxycontin and Vicodin to treat chronic pain. The institution now only recommends narcotic drug use for end-of-life care in long-term usage or short-term pain relief for a maximum of three days, using the lowest effective dosage and close monitoring of such patients.

Ask the doctor

To get a better understanding of what local professionals in the medical field are doing to help treat their patients’ pain, while also avoiding the conflicts that come with opioid drug addiction, I asked Dr. Ryan Klanseck of the North Ottawa Community Health System his views on the issue.

Klanseck earned his medical degree from the Michigan State University College of Osteopathic Medicine and now works within the NOCHS family practice.

“I think the intention of painkilling opiates is for short-term duration, such as post-surgical,” he said. “I truly believe that they are not intended for long-term treatment. Long-term treatment leads to tolerance issues (requiring more of the medication to get the same effect), dependence issues (going without the medication leads to withdrawal symptoms), addiction and abuse.

“Long-term use actually causes hyperanalgesia, where your pain threshold is decreased to the point that things that actually hurt your body cause little to no pain,” the doctor continued. “The United States is only 5 percent of the world’s population, but comprises of 85 to 90 percent of the narcotic usage. I have seen these medications destroy so many lives and dictate how that person feels on a day-to-day basis.”

Klanseck only prescribes opiates in severe conditions in which he feels the short-term pain relief is the only option for the patient.

“I very rarely prescribe opiates for my patients,” he said. “I might prescribe a small dosage for things such as fractures or other serious injuries, but I tend to see orthopedics prescribe them more often, typically during post-surgical situations.”

The tell-tale signs of addiction can be easy to spot if you know what you are looking for. According to Klanseck, these are some signs that anyone should be able to spot if they know someone who might be struggling with painkiller addiction.

“The symptoms often include an increased use or need for the drug, change in general behavior, inconsistent stories, or constantly looking for a new doctor or health care provider,” he said. “The patient might also have trouble sleeping, have sudden mood changes and, for student-athletes, a change in academic or athletic performance.”

There are many safer alternatives to opiates that can be far less addictive.

“I believe non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin or Advil) and naproxen (Aleve or Naprosyn) can help the majority of short-term pain,” Klanseck said. “They work better in gel cap form versus a tablet form. Physical therapy can improve injuries dramatically and get athletes returned to the sport at a much quicker rate. Massage therapy and acupuncture are other alternatives, as well. I perform a lot of osteopathic manipulative medicine or treatment since I am a doctor of osteopathy.

“Adjusting the individual with several techniques such as muscle energy, myofascial release and high-velocity, low amplitude can lead to quick pain relief,” he continued. “Correcting mechanical flaws in posture or walking can lead to improved muscle balance. More homeopathic methods for pain control include glucosamine with chondroitin sulfate and MSM, vitamin D (if levels are low), omega 3, lemon or lime juice, apple cider vinegar, and turmeric are just a few that I strongly encourage to my patients. Eating healthy foods can also go a long way in the prevention of or healing of pain process.”

The monitoring and prevention of young athletes from painkillers is difficult for everyone involved. According to Klanseck, in some cases, it’s nearly impossible to avoid if the particular patient is persistent.

“Coaches and staff should always be monitoring behavior and performance,” the doctor said. “Medical providers can avoid prescribing patients such drugs — but, unfortunately, they are so prevalent on the streets that people can buy it without the ability to track them.”

Peer pressure, along with the pressure to earn a college scholarship or simply prove one’s value on an athletic stage, can sometimes lead athletes to overuse painkillers in order to subdue injuries and get back to the sport.

“I think it’s a larger risk for the more talented or skilled athletes,” Klanseck said. “The more demand on performance and winning, instead of playing for fun, can cause athletes to do things under pressure that they might not typically do in normal, everyday circumstances.”

While the epidemic is a national issue, Klanseck said he has seen plenty of firsthand accounts in West Michigan to know that the Lakeshore does indeed have the same problem.

“Unfortunately, I’ve seen too many cases to count,” he said. “This area is definitely not immune to this particular issue.”

If you or someone you know is struggling with drug addiction of any kind, call 877-894-2346 to talk to a treatment advisor about the next step to recovery.

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