On December 5, the Today Show documented three teen athletes who had suffered injuries and were prescribed opioids for pain. In one instance, a 15-year-old was prescribed three refills of Vicodin. It only takes a week for the body to become physically dependent on opioids.
In every case with these three athletes, by the time they finished their prescriptions, they were hooked. They all said that their doctors didn’t warn them about the highly addictive nature of the drugs. According to federal statistics, four out of five cases of heroin addiction start with prescription medications.
Teen athletes hooked on opioids often graduate to heroin because they are molecularly very similar. A dealer might charge you up to $30 for one pill, but heroin is only $5 for a bag and it gives a stronger high. It’s not a hard leap.
Teen sports have become increasingly violent and stressful. Young athletes feel great pressure to play through pain and injuries, and many are chronically injured. The purpose of pain is to signal that the body needs to rest and heal; the natural instinct is to protect the injured area. On opioids, an athlete is fooled into playing, continually abusing the injured area, causing greater damage. The area is not allowed to heal properly, and the result is chronic pain as an adult.
Teen athletes are accustomed to taking great risks with their bodies on the field, so they may take a risk with drugs if it means they can keep playing. All they can think of is getting back on the field. As a result, there are an increasingly large number of teen athletes in all sports becoming addicted to heroin. Many die of overdose.
Teens who are prescribed opiates are at a strong disadvantage, because the developing teen brain, which is reward-driven with low impulse-control, is more easily addicted to drugs. Opioids give a high along with lessening pain, dopamine is released, and the developing brain becomes seduced.
The human brain is not fully developed until age 25. The brain enters a massive growth spurt from age 11-19, and development comes in leaps. There are an overabundance of neuronal connections, and the adolescent’s experiences shape the brain’s growth. It’s a use-it-or-lose-it scenario.
Teen brains use more of the limbic system (emotional) to make decisions, while adults brains use the prefrontal cortex (rational). Drug abuse does irreparable damage to brain cells during this sensitive time, disrupting normal brain growth and resulting in abnormal: brain volume, quality of white matter, cognitive function and brain activation.
This translates into problems with memory, high emotions, inability to set aside current pleasure for future gain, and inability to plan for the future at all. Additionally, the major long-term problem is that the brain freezes at this primitive growth stage of being emotion- and fear-driven. As these teens grow into adults, they are immature, defensive, irritable and illogical.
Last year, the FDA approved OxyContin for children as young as 11 years old. The younger a child is when they take opioids, the faster they become addicted. Unless it is an end-of-life or unusual extreme-case scenario, prescribing opioids for a child is inappropriate. There are alternatives for handling pain, both chronic and acute. Tracy Harrison, a pediatric anesthesiologist at the Mayo Clinic in Minnesota, discussed on livescience.com that Oxycontin can be debilitating; keeping teens knocked out in bed rather than going to school and socializing.
Chronic pain is complex, particularly for children, with a psycho-social component as well as the physical aspect, which is why many doctors believe that pain meds are not the best way to handle chronic pain. Many factors play a part in pain: quality of sleep, activity levels, anxiety and stress.
In fact, the CDC released guidelines in March that recommended primary care providers avoid prescribing opioid painkillers for patients with chronic pain, according to USA Today. The CDC says that the risks greatly outweigh the benefits. CDC Director Tom Friedman, MD, MPH, says that more than 40 Americans die every day from prescription opioid overdoses, and opioids are as addictive as heroin. He believes opioids poorly control chronic pain, and other therapies should be sought out prior to resorting to opioids.
Andrew Colony, executive director for Physicians for Responsible Opioid Prescribing, said the new guidelines are a “game changer” and “for the first time, the federal government is communicating clearly that the widespread practice of treating common pain conditions with long-term opioids is inappropriate.”
One parent who lost a son to heroin was quoted in Sports Illustrated as saying, “You know what really breaks my heart? My son knew he was meant to be an athlete. Sports was his first addiction. He just ran into another addiction that was so much more powerful.”
Editor’s Note: Dr. Marc Bonacci is a sports-focused chiropractic physician certified in physical medicine modalities and therapeutic procedures. He frequently helps patients reduce their intake of opioids by determining alternative courses of integrative treatment. For 18 years, his compassionate and creative approach to solving chronic pain issues has led him to develop a system in which he manually aligns nerves, muscles, connective tissue and joints to re-train the posture and allow healing.