Upcoming football season offers risks, rewards for Arizona athletes

With football season less than two months away, excitement is building across the Valley for America’s favorite sport

Arizona high school teams have spent the summer beating the heat and training at camp, as The Arizona Republic recently captured in a photo album.

Since January, the Arizona Wildcats have had a new head coach — Kevin Sumlin, formerly at Houston and Texas A&M — to guide them through training. And Wildcats football ads have been spotted near Sun Devil Stadium and on the light rail.

Arizona State has a new head coach too: Herm Edwards, an eight-season NFL coach at the New York Jets and the Kansas City Chiefs. Edwards has spent the summer toughening up the Sun Devils and floating cuts if performance is lacking.

At the pro level, the Arizona Cardinals have Sam Bradford as their new quarterback. For them, the big question is whether Bradford can stay healthy enough to be successful in the 2018 NFL season, as he played only two games for the Minnesota Vikings last season because of lingering problems in his left knee.

With new changes come new opportunities. There have been changes for Arizona football teams this preseason, and this season there will be equally many opportunities for Arizona football players — at the high school, college and pro level — to excel on the field.

But as always, there will be many risks at play this season.

One of the main risks we are becoming increasingly aware of in the NFL, besides concussions, is drug abuse.

Last year, 1,800 former NFL players filed a lawsuit against the league, alleging that NFL teams routinely violated federal laws governing prescription drugs, disregarded guidelines from the Drug Enforcement Administration on controlled substances and plied their players with pain medications, The Washington Post reported in March 2017.

While the bulk of the charges were dismissed by a judge in May last year, the lawsuit exposed several dangerous practices that have taken place within the NFL.

Unlawful handling of medications is one such abuse.

In a deposition, Anthony Yates, the Pittsburgh Steelers’ team doctor and former president of the NFL Physicians Society, testified that “a majority of clubs as of 2010 had trainers controlling and handling prescription medications and controlled substances when they should not have.” Federal law prohibits unlicensed team personnel, including athletic trainers, from dispensing medication.

Turning a blind eye to off-label drug use is another abuse.

The lawsuit highlighted Toradol as a particularly common offender for off-label use. Toradol is a nonsteroidal anti-inflammatory drug (NSAID) available only with a prescription. While it is not addictive, it is powerful enough that many countries only administer it to patients after surgery.

The players’ court filing cited a 2014 survey that included responses from 27 NFL teams. On average, 26.7 players took at least one dose of Toradol on game day.

Yates also testified in his deposition that “even last season, he witnessed players lining up for the ‘T Train’ — Toradol injections before a game.”

But the greatest abuse of all that has taken place in the NFL is of opioids.

A 2011 study led by Dr. Linda Cottler of the University of Florida surveyed 644 retired NFL players, making it the most comprehensive study on painkiller use in the NFL to date.

It reported that more than half of respondents said they used opioids during their NFL careers and that 71 percent said they misused the drugs. It also found that 7 percent of respondents were still using opioids during retirement — three times the rate of opioid use in the general population at the time.

Football players at all levels should not be discouraged or stopped from pursuing their dreams on the field because of these abuses in the NFL. But they should be aware of the risks associated with football, especially in regard to drug abuse and the team cultures that foster it. If they see these cultures develop in the locker room, they must speak out against them.

If possible, doctors should promote alternative pain treatments for football players. There are many nonpharmacologic, minimally invasive treatments available to quickly reduce pain and get players back on the field, including platelet-rich plasma injections and ketamine infusions.

When a team doctor must prescribe opioids, they should be at the lowest possible effective dose for the shortest possible amount of time, as recent guidelines from the Centers for Disease Control and Prevention recommend.

And the NFL must do a better job at ensuring teams’ compliance with federal laws and DEA recommendations so as to prevent abuse.

As a pain specialist, I feel it is my responsibility to speak out on this important issue when football season is approaching. Concussions and injuries are only one part of a larger problem faced by the NFL and football leagues generally. While they have rightly received much media attention over the past few years, they have overshadowed the two dangers they can spawn — drugs and drug abuses.

For a consultation, please contact Integrated Pain Consultants at (480) 626-2552 or visit www.azipc.com.

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