Now that the Super Bowl is over, and everyone can look back and reflect on an exciting football season, it might be time to mention one of the lesser-known sides of professional football. Professional football players are some of the fastest and strongest athletes in the world, and it’s important to remember that with these athletes competing in a violent collision sport, injuries are not only common, but they are likely. Some studies have even suggested that up to two thirds of NFL players may be injured in any given year.

A study in the December 2010 edition of the journal Drug and Alcohol Dependence performed by Linda B. Cottler et al. studies the use of opioid drugs among former NFL players. The authors performed a telephone survey of 644 retired NFL players registered with the 2009 Retired Players Association Directory. They were able to complete the surveys with approximately 53% of the players they attempted to contact. Their results shed a lot of light on the major injuries, pain, and prescription and illicit use of opioids both during the careers of the players and after their careers are over.

Of the players surveyed, 52% said they used opioid drugs (painkillers) at some point during their careers. Of these, 37% got the drugs from a doctor, 12% got them from sources other than physicians, and just over half got them from a combination of doctors and nonmedical people.

One interesting finding in this study is how much the players’ health status deteriorates after they stop playing. 88% of the players reported that they had excellent health when they signed the first NFL contract, but only 13% of the players reported currently having excellent health. 93% of the responders to this survey reported pain with current activities and 81% reported their pain to be moderate or severe. This is approximately three times the rate of moderate-to-severe pain in the general population.

The study also reveals some of the risk factors that lead to the misuse of opioids during the players’ careers. The study demonstrated that 71% of these players misused opioid medicines while they were playing. The strongest risk factors for using these drugs were undiagnosed concussions, having suffered three or more injuries, and being an offensive lineman. The authors speculate that offensive linemen often have the poorest overall health, which could lead to pain and other medical problems due to their size and weight. The authors also speculate that players who had undiagnosed concussions might be those players who fail to reveal their pain to the team doctors for fear that they would be pulled out of practice or a game. Therefore, they may be the players managing their pain on their own.

By no means in writing this post am I suggesting there is an inherent problem with the NFL or football as a sport. I am huge football fan, and I understand injuries are part of the sport. I just want to discuss this study as a way to point out the nature of the injuries in this sport and the potential long-term consequences of these injuries. I think it’s important for players to be honest with the team doctors and reveal their injuries so that they can be treated and rehabilitated appropriately. Hopefully proper treatment and rehabilitation and an honest discussion of medication use could prevent misuse of narcotic drugs at that time and after the players retire. It might also shed light on the need for further research into the long-term effects of the injuries. It might also stimulate discussion of ideas that could be incorporated in the players’ contracts, such as health insurance and retirement benefits after their careers are over.