Running head: OPIOIDS IN SPORTS 1

Opioids in Sports: The Opioid Crisis in America and How it Affects Athletes

Ethan H. Firoved

Legal Studies Academy

First Colonial High School

OPIOIDS IN SPORTS 2

Abstract

This research paper outlines the use of opioids in professional, college, and youth sports while

providing possible solutions to the problem. The author will also provide other sources of

addiction such as overprescription. This paper will detail the health effects opioid addiction has

on athletes and on general patients and the rehabilitation options athletes and patients have.

Finally, the paper will delve into the laws surrounding opioids and how doctors, patients, and

pharmacies can work together to decrease the opioid crisis in the United States.
OPIOIDS IN SPORTS 3

Opioids in Sports: Opioids in Sports and the Effects on Athletes

Opioids have become a rather large problem recently in what is known as the opioid

crisis. It is something that wins over humans day in and day out. Throughout 2016 and 2017,

more than 130 people died every single day due to opioid overdoses (CNN, 2019). This is just

over 45,000 overdose deaths a year, and the overdose percentage rose by nearly 113% (CNN,

2019). The goal throughout this paper is to provide different ways to decrease and even stop

opioid usage in sports.

Opioids in Football

Throughout my research, football has easily been the sport that involves the most opioid

use and abuse. This is due to the common occurrence of the very unpleasant injuries to the

athletes. These athletes have to undergo surgeries that can often times call for recovery times of

six months to a year, if not more. Concussions also have a very large effect on what these

athletes consume to help their bodies function to their highest ability.

Retired Player Statistics

According to Washington University School of Medicine, in 2011, regular citizens use

opioids at a quarter of the rate of retired NFL players. Often times, players will have several very

rough injuries throughout their career. In a study out of 644 players who had retired between

1979 and 2006, a little more than 50% of them said they had taken opioids at certain points in

their careers. Out of that percentage who had claimed they used opioids during their playing

days, a little more than 70% would say they fell under the misuse group. Obviously, there is a

chance that those players who popped pills throughout their career are still doing them today, and

7% of them stated that they were still doing them in 2011 (Washington School of Medicine,
OPIOIDS IN SPORTS 4

2011). Those players who abused opioids during and after their career, were, and are more likely

to abuse alcohol. As it know, one of the biggest problems in football is concussions, and many

players suffered from not only one but many throughout their playing days. Players who got

concussions, whether diagnosed or not, were more likely to abuse substances such as opioids or

alcohol than those players who didn’t have current injuries. Just under 50% of the players state

they have had diagnosed concussions in their careers and of that percentage, just above 80% of

them believe to have had an undiagnosed concussion at a point it their career. Out of this survey,

only 13 percent of the men claimed to be in good health at the end of their career (Washington

School of Medicine, 2011).

Testing for Opioids in Football

In football opioids are considered a banned product. Although there is a fishy side as

players, due to injury, may be prescribed opioids by team doctors. In order for a player to fail a

test in the NFL or raise heads, they must have more than 300ng/ml in their system. This is 0.3

grams of the substance opium and the players have to exceed this amount in order to be

punished. This would mean a larger player would have to take roughly seven 5 milligrams pills

or tablets to qualify for suspension. This ranges down for those players who are smaller and

weigh less. Players in the NFL who take opioids are considered to not be first time users.

Fentanyl, among the most lethal drugs is not tested for in the NFL.

Mike Webster

Mike Webster was a National Football League Hall of Famer for the Pittsburgh Steelers

and the Kansas City Chiefs. He played throughout 1974 to 1990 and won four Super Bowls. He

was known as “Iron Mike” and is considered to be potentially one of the greatest centers to ever
OPIOIDS IN SPORTS 5

play the game of football. Mike was the first known football player to have what we know today

as chronic traumatic encephalopathy or CTE. His post football life was a lot worse than his life

throughout his career. After football, he had been diagnosed with many unfortunate illnesses

such as amnesia, dementia, and depression. He ended up dying at the age of 50 due to a heart

attack (Wikipedia, 2019). Roughly nine years after his career had ended, Webster was caught

forging 19 prescriptions of Ritalin. This is a stimulant often times given to adolescents who have

Attention Deficit Hyperactivity Disorder or ADHD. His goal in taking Ritalin was to cure his

brain damage which made his actions very unpredictable (Litsky, 2002).

Ritalin is the common name for methylphenidate, classified by the Drug

Enforcement Administration as a Schedule II narcotic-the same classification

as cocaine, morphine, and amphetamines. It is abused by teens for its

stimulant effects. Even when ritalin is used as a prescription drug, it may have

severe effects including nervousness, insomnia, anorexia, loss of appetite,

pulse changes, heart problems, and weight loss. The manufacturer says it is a

drug of dependency (Foundation for a Drug Free World, n.d.).

This could potentially mean that the effects of this drug had a large role in Mike Webster’s death.

Baseball

Due to all of the arm injuries and other spaced out injuries across baseball, it is the

second most opioid using sport. Dealing with blown elbows and shoulders, often times causes

players to have to get Tommy John and labrum surgery, procedures to repair the arm and

shoulder respectively. Tommy John is when a player blows a ligament in their elbow. Tommy

John surgery is defined as, “a surgical procedure in which a healthy tendon extracted from an
OPIOIDS IN SPORTS 6

arm or potentially a leg is used to replace an arm’s torn ligament. The healthy tendon is threaded

through holes drilled into the bone above and below the elbow.” These surgeries cause a great

amount of pain and opioids are often times prescribed to manage it. The chances of recovering

back to your normal self post surgery are pretty high at a rate of 85 to 90 percent (GNU

Documentation, 2019). The recovery process for pitchers is a grind as the average time it takes to

get back to normal is a year to a year and 3 months (GNU Documentation, 2019). However,

position players have it easy as their recovery takes up to about a half year (GNU

Documentation, 2019). In 2014, right around spring time, approximately one out of every three

Major League Baseball pitchers had gone through the Tommy John process (GNU

Documentation, 2019). Labrum surgery depends on several different factors, but it takes three

months on average to be back to healthy, two months if everything goes really well (Johns

Hopkins Medicine, 2019). The two things it depends on is where the tear in the shoulder is and

how good of a surgery it is performed, meaning how well your shoulder reattaches itself (Johns

Hopkins Medicine, 2019). Often times when someone tears their labrum, a shoulder dislocation

occurs (John Hopkins Medicine, 2019).

Testing for Opioids in Baseball

In professional baseball right now, the Minor Leagues test their players for opioids. If a

player fails, then they are sent to a drug treatment program. If a player fails twice, then they are

punished with a suspension. In the Minor Leagues, over the past five years, roughly 75,000

players have been tested and just 10 were positive (Demio, 2019) Marijuana suspensions in the

Minor League drug program will be dropped. On December 12, 2019, the Major League

Baseball Association edited their drug testing policy due to the death of Los Angeles Angels
OPIOIDS IN SPORTS 7

pitcher Tyler Skaggs. They will now be testing for cocaine along with opioids while marijuana

was taken off the drug abuse list. Players however, will only be disciplined if they fail a drug test

and do not follow up on and take part in their treatment program. Marijuana will be treated the

same as alcohol which sometimes results in suspension; while other times it may result in

something as simple and easy as a fine. They may also be assessed and mentioned for voluntary

treatment. “Players and team staff will have to attend mandatory educational programs in 2020

and 2021 on the dangers of opioid pain medications and practical approaches to marijuana”

(Olney, 2019).

Tyler Skaggs

The Major League Baseball Association used to suspend players if they had been caught

usin​g or possessing synthetic tetrahydrocannabinol (THC) or marijuana through random drug

tests, and they would be fined up to 35,000 dollars. They would do relatively the same thing with

alcohol but now marijuana has been taken off the drugs of abuse list and put into a category with

alcohol. Now, Major League Baseball will be testing for drugs such as opioids and cocaine. This

is due to the late death of Angel’s pitcher Tyler Skaggs. Skaggs was found dead in a Hilton Hotel

in Southlake, Texas, on July 1st of 2019. An autopsy was done, and it showed that he had

opioids such as fentanyl, oxycodone, and oxymorphone in his system (Jamle Gumbrecht and

Jacquellne Howard, 2019). He also had alcohol in his system and it is believed that he had

choked on his own throw-up. He had passed out due to a mixture of alcohol and drugs and he

started throwing up while he was on his back causing his death. This death has officially changed

the way the MLB is going about testing the athletes as they will be looking for the more
OPIOIDS IN SPORTS 8

addictive pain-killing drugs such as cocaine and opioids such as those found in Tyler Skaggs

autopsy (Jamle Gumbrecht and Jacquellne Howard, 2019).

Overprescription

Most addicts begin getting high on prescription drugs and then use other drugs such as

heroin because its cheaper. Patients often go home with thirty to ninety pills, but in reality the

patient doesn’t need all of the pills they are prescribed. Some patients put their unused pills in a

medicine cabinet, while others continue to take them. By continuing to unnecessarily take the

leftover pills, a patient can become addicted. Accidental opioid overdoses occur more than one

may think. Every eighteen minutes a person dies from an overdose; that’s more than seventy-five

people per day (“Overprescribing Opioids,” 2016). Washington University Anesthesiologist

Evan Kharasch has proposed a number of solutions including prescribing fewer pills to patients

and returning unused prescription pills to a pharmacy (“Overprescribing Opioids,” 2016).

Sending patients home with fewer pills will ensure the patient has none left over and the

prescription can be refilled as needed. This will shield the patient from overusing the medicine

while still addressing the patient’s pain. The second proposal involves “turn-in programs for

unused opioids” (“Overprescribing Opioids,” 2016). Certain pharmacies will take unused opioids

back to remove unused drugs from a household and prevent misuse. According to Kharasch,

“That avenue is under-utilized and under-appreciated” (“Overprescribing Opioids,” 2016).

Dr. Joel Smithers opened his own practice in Martinsville, Virginia, in 2015. Since he

opened his practice, he prescribed drugs to every patient that he saw. Patients from bordering

states such as West Virginia, Kentucky, Ohio, and Tennessee would visit Dr. Smithers’ office to

receive oxymorphone, oxycodone, hydromorphone and fentanyl (Hassen, 2019). Dr. Smithers’
OPIOIDS IN SPORTS 9

office was sometimes open later than midnight and Dr. Smithers only accepted payment by cash

or credit card. When agents investigated his practice, they found over “$700,000 in cash and

credit card payments” (Hassen, 2019). Martinsville has one of the highest rates of opioids

prescribed in Virginia and in the country. Dr. Smithers “hid behind his white doctor’s coat as a

large-scale drug dealer” (Hassen, 2019) and continued to negatively influence the nation’s opioid

crisis. Over the course of four years, Dr. Smithers prescribed over 500,000 opioids to his patients

and was convicted of over eight hundred counts of illegally prescribing opioids (Hassen, 2019).

Health Effects

Opioids not only get people to fall into a long lasting addiction, but they also have health effects

that could harm people. Opioids do not go well with people who are trying to get in shape. Heart,

bone, and lung functions may be affected by opioid use and abuse, especially, will cause

individuals to be less energetic and not participate in as many activities. It is likely that it will

affect those who abuse opioids more severely. For those who take regular doses, everyone is

different so it may affect others more severe than others. A scary affect opioids may have on

some individuals is that it lowers the heart rate. This means that for those who work out, it will

be harder to be consistently active. For people with allergies and similar illnesses, congestion

will be a problem while working out. This due to the inability to properly cough and get liquid

up from your lungs and throat. Opioids affect peoples’ stamina for working out as well. The

drugs slow down breathing and heartbeat therefore not allowing the necessary amount of oxygen

to flow to the muscles. This may not allow individuals to get the workout they would like. These

drugs cause the bone structure of humans to become weaker which leads to easier bone breaks

and fractures while completing rigorous physical activities. People are prone to falling over more
OPIOIDS IN SPORTS 10

often as these drugs are being taken as it causes poor balance. These pills also may cause health

effects like, “constipation, nausea, and mood swings.” While all of these things may happen

while trying to stay in shape while taking opioids, there are also ways to allow your body to stay

healthy. Some of these ways are to, “substitute activities that require less exertion, choose

activities that involve less impact, use exercise machines, and reduce workout time.” This is for

those who are prescribed opioids through doctors.

Youth in Sports

In a report from the National Health Statistics by the Centers for Disease Control and

Prevention, a study was looked over and showed that between 2010-2016, 2.7 million sports or

recreational Emergency Room visits occurred. The most common sports that promoted these

injuries was football, basketball, bike-riding, soccer, and skating whether it being skateboarding

or roller-skating. All in all, analgesics which are drugs, some opioids some non-opioids were

given to right above 60% of these youth athletes. This study was broken down into four year

groups starting with the age group of five to nine year olds. The average, of ages five through

twenty-four is one out of four of those injured youths is prescribed opioids in an attempt to

manage pain. One out of every eight of youth athletes ages five to nine were prescribed opioids.

Children ten through fourteen years of age were given opioids one out of every five times. Ages

fifteen through nineteen were prescribed opioids one out of every four times. Patients ages

twenty through twenty-four were prescribed painkillers almost one out of every two times they

visited the Emergency Room (Demio, 2019).

OPIOIDS IN SPORTS 11

Rehabilitation

The problem with opioid abuse is one of the biggest problems across the nation. Many

people are not only using them but they are abusing them as well. There are ways to stop and or

slow down this epidemic and I believe the most healthy, effective way, if done right is rehab.

There are all kinds of programs across the nation in which people can join that can help them

stop what they are doing. When a person enters into a rehabilitation center, there are two main

categories they are associated with. One being dependency, which is when the addict goes

through pain and withdrawals when they aren’t on opioids. The goal is to train that person’s

brain not to need the drugs to be or feel normal. The other category is the addiction side, which

relates to the behavioral problems of opioid abuse. There are three ways to go about and treat the

people who are looking for help. It is based off of the person and which way best fits a person.

One way is detoxification which is when the goal is to make the person become independent

from the drug. One of the hardest things throughout detox is getting over the withdrawal stage. A

person may take medications to allow help in getting off the drug with which they were on.

These medications are not for long term use as it may be understood as to why. For some people,

others pushing you in a motivational manner may help therefore along with these programs may

be small therapy groups to keep an addict positive throughout sobriety. Another route for those

who are trying to receive help is medical maintenance treatment. The strategy behind this

treatment is to soften the withdrawal symptoms and cravings so that the focal point can be

narrowed down to treatment through therapeutic ways. While on this treatment method, the

patient or addict is put on either methadone or buprenorphine for around three to four weeks

could be more based on the individual. This is considered as, “Opioid Replacement Therapy”.
OPIOIDS IN SPORTS 12

While on this, the individual will go through different sections of treatment such as small groups

and other social support systems. The third form of treatment is called medically supervised

withdrawal. Whether you were taking methadone or buprenorphine during detox or medically

maintained medications, in the end the addict will change over to medical supervised

withdrawal. The end goal is to get the individual to stop using both the medications and the

opioids though this process could potentially take years of therapy and discipline.

General Opioid Laws

There are numerous regulations and laws pertaining to substance abuse and misuse. The

National Institute on Drug Abuse reports that more than 2 million Americans abuse opioids

(“Opioid Abuse,” n.d.).

Comprehensive Addiction and Recovery Act (CARA) of 2016

The Comprehensive Addiction and Recovery Act allocates over 181 million dollars per year to

opioid prevention programs and opioid treatment programs. CARA created numerous treatment

and intervention programs for opioid and heroin treatment as well as built programs to monitor

prescription drugs. These programs carefully watch the distribution of prescription drugs and

monitor the patients that are prescribed. This allows the programs to provide services to patients

that need them (“Laws and Regulations,” n.d.). CARA also provides teens and parents with

educational programs to prevent drug abuse and to promote treatment. Not only does CARA help

teens, parents, and addicts, it also provides resources to those in prison by “collaborating with

criminal justice stakeholders and by providing evidence-based treatment” (“Laws and

Regulations,” n.d.).

Support Act of 2018

OPIOIDS IN SPORTS 13

The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for

Patients and Communities Act of 2018, also known as the Support Act, addresses the United

States’ opioid epidemic. Among other things, the Support Act creates jobs to educate the public

about opioid misuse and increases access to recovery care (“Laws and Regulations,” n.d.). Each

year, the Support Act continues the First Responder Training program which teaches first

responders how to handle opioid overdoses and just started to include training on handling

fentanyl misuse. The Support Act also provides grants to create opioid recovery centers that

provide “holistic care [which includes] counseling, recovery housing, and job training” (“Laws

and Regulations,” n.d.).

Doctor Shopping Laws

Doctor shopping is defined as “the use of deception and manipulation to encourage a

doctor to prescribe drugs for illicit use or sale” (“Doctor Shopping Laws,” n.d.). Patients use

many strategies to deceive their doctor, such as fake symptoms, lie about important information,

and ask for earlier refills because they “lost” their other refill. Because doctors cannot tell if the

patient’s pain is real or fake, no one knows how large the problem of doctor shopping actually is.

Federal. ​The federal law on doctor shopping is vague and unclear; however, 21 U.S.C. §

844 states that it is illegal to obtain a prescription unless the prescription was written directly for

the patient (21 U.S.C. § 844 ). If the prescription as not written for the patient, the prescription

becomes invalid and results in punishment. The code also states that attempting to obtain a

prescription without direct written permission is a criminal offense (“Doctor Shopping Laws,”

n.d.). Most punishments include a fine of up to $5,000 and not more than 3 years in prison ().
OPIOIDS IN SPORTS 14

State. ​Most doctor shopping laws are prosecuted at the state level, leaving some room for

difference in laws and penalties. In addition to doctor shopping laws, most states have laws that

prevent patients from lying to their doctor about important information when they are being

prescribed medicine (“Doctor Shopping Laws,” n.d.). The Uniform Narcotic Drug Act states,

“​No person shall obtain or attempt to obtain a narcotic drug, or procure or attempt to procure the

administration of a narcotic drug ... by fraud, deceit, misrepresentation, or subterfuge or ... by the

concealment of a material fact” (​“Doctor Shopping Laws,” n.d.​). The state doctor shopping laws

vary in each state. In Arizona, withholding information from a doctor isn’t “protected as

privileged communication” (​“Doctor Shopping Laws,” n.d.​). In Kansas, lying to a doctor in order

to receive medicine is illegal. Montana prevents patients from receiving the same or similar drug

from two different sources within a month. Louisiana prevents doctor shopping by requiring

patients to tell the doctor of any medicines and the details of the medicines that have been

prescribed (​“Doctor Shopping Laws,” n.d.​).

Solutions

Most opioid addiction in athletes stems from the injuries they suffer. The opioid crisis in

professional sports, youth, and in general has solutions, but the implementation of the solutions

is weak. The National Football League’s (NFL) opioid problem has always been a topic

addressed in the news and on television. An injured player makes headlines on sports channels

and magazines, but the reporters never report what goes on behind the scenes. Football players

are often bruised up, sore, or injured and look for ways to relieve their pain. The NFL has begun

to look into alternative methods for pain relief, finding one specific, yet controversial option:

CBD. Former football player Ryan McNeil “personally [thinks ​Cannabinoids (​CBD)] is a safer
OPIOIDS IN SPORTS 15

and better alternative to the addictive opiates” (​Chiangpradit, 2019​). Prescription drugs have

been used in the NFL since the NFL was founded in 1920. Regardless of pain, soreness, or

exhaustion, players are required by coaches and owners and expected by viewers to perform their

best in every game. In order to be at their best, many players look to opioids. NFL players are

exposed to opioids all of the time; a recent study showed around fifty percent of NFL players

reported being exposed to opioids while seventy-one percent reported misuse of the pills they

were prescribed. Director of sports medicine at the Mayo Clinic Phoenix and doctor at Arizona

State University said, “Studies on CBD products and pain control are promising as an alternative

to habit forming opioids. There is no consensus yet on CBD efficacy on certain conditions”

(​Chiangpradit, 2019​). Similar to opioids, cannabinoids can be used for pain relief; however,

unlike opioids, cannabinoids are not addictive. It has been reported that several NFL players

have said if CBD was allowed in the NFL, their careers would’ve lasted longer (​Chiangpradit,

2019)​. As of right now, the NFL doesn’t allow cannabinoids to be used by athletes and if athletes

are caught using cannabinoids the athlete would be punished. Because CBD is prohibited, the

NFL would have to change their rules, as would most professional sport leagues. ​Former Ravens

player Eugene Monroe said, ​“It’s time for the NFL to better protect its players. For too long, I’ve

watched my teammates and good friends battle with opioid addiction and leave the game with a

long road still ahead” (​Chiangpradit, 2019). ​ The National Hockey League (NHL) allows its

players to use cannabinoids to relieve pain and soreness. The NHL does not allow players to use

marijuana or CBD oil, but the players are not punished for using it. The NFL could follow in the

National Hockey Leagues footsteps by not punishing players for their use of CBD to relieve pain

(​Chiangpradit, 2019​).
OPIOIDS IN SPORTS 16

Conclusion

All in all, the opioid crisis is a terrible obstacle that not only our country but the whole

world needs to solve. The section focused on throughout this paper was opioids in sports.

Athletes across the nation face injuries which put them through surgeries and pain. As a result,

they are prescribed opioids. The problem here is the gray area which goes unseen by the majority

of our population. Specifically, the abuse of these drugs which throw people into a cycle of

addiction that is very hard to get out of even with the help of professionals in this field. A way to

stop this starts not during the cycle of addiction but at the beginning of the process. While the

drugs are being prescribed, the doses should be given out in small amounts so that there isn’t an

excessive amount of pills left over. When there is excess drugs, teenagers and even adults start

taking and selling them illegally. This is the start to addiction which then transfers over to the

cheaper, deeper hole of heroin. Through experience of family members, this is one of the most

addictive drugs that is nearly impossible to get off of.

OPIOIDS IN SPORTS 17

References

[Special issue]. (n.d.). ​Retired NFL players using painkillers.​ Retrieved from Washington

University School of Medicine in St. Louis database.

Boykin, N. (n.d.). Virginia Beach dentist sentenced to over 8 years for opioid fraud scheme.

Retrieved from

https://wtkr.com/2019/10/03/virginia-beach-dentist-sentenced-to-over-8-years-for-opioid-

fraud-scheme/

Chiangpradit, L. (2019, April 3). CBD may be the solution for the NFL's opioid use. Retrieved

December 14, 2019, from Globalsport Matter website:

https://globalsportmatters.com/health/2019/04/03/cbd-solution-nfls-opioid-use/

DeMio, T. (n.d.). 1 in 4 US youths hurt in sports get opioids. ​CDC​. https://doi.org/2019

Diamond, J. (n.d.). Baseball weighs drug policy changes after pitchers autopsy. ​Wall Street

Journal​. Retrieved from

OPIOIDS IN SPORTS 18

https://www.wsj.com/articles/baseball-weighs-drug-policy-changes-after-pitchers-autops

y-11567811364

Doctor shopping laws. (n.d.). Retrieved December 14, 2019, from FindLaw website:

https://healthcare.findlaw.com/patient-rights/doctor-shopping-laws.html

A doctor who prescribed 500,000 doses of opioids is sent to prison for 40 years. (n.d.). ​The New

York Times​. Retrieved from

https://www.nytimes.com/2019/10/02/us/opioids-doctor-sentenced-joel-smithers.html

Elkins, C. (2018, October 26). Opioid addiction treatment. Retrieved 2019, from Drugrehab.com

website: https://www.drugrehab.com/treatment/opioid-rehab/

Foundation for a Drug Free World. (n.d.). What is ritalin? Retrieved december 14, 2019, from

Drug free world website: https://www.drugfreeworld.org/drugfacts/ritalin.html

GNU Free Documentation. (2019, April 25). Tommy John Surgery . Retrieved November 21,

2019, from Baseball Reference website:

https://www.baseball-reference.com/bullpen/Tommy_John_surgery

Gumbrecht, J. (2019, August 30). Angels pitcher Tyler Skaggs died from accidental drug

overdose. ​Angels Pitcher Tyler Skaggs died from accidental drug overdose​. Retrieved

from

https://www.cnn.com/2019/08/30/health/tyler-skaggs-autopsy-opioids-death/index.html

Hodges, G. (2019, November 27). [Personal interview].

Horizons, R. (2019, July 17). Rural health voices. Retrieved December 5, 2019, from NRHA

website:
OPIOIDS IN SPORTS 19

https://www.ruralhealthweb.org/blogs/ruralhealthvoices/july-2019/searching-for-solution

s-to-the-rural-opioid-crisis

Johns Hopkins Medicine. (2019). Shoulder labrum tear. Retrieved November 22, 2019, from

Health website:

https://www.hopkinsmedicine.org/health/conditions-and-diseases/shoulder-labrum-tear

Kounang, N. (2017, March 13). Lawsuit alleges that NFL teams gave painkillers recklessly.

Retrieved December 5, 2019, from CNN website:

https://www.cnn.com/2017/03/12/health/nfl-painkiller-lawsuit/index.html

Laws and regulations. (2019, May 7). Retrieved December 14, 2019, from SAMHSA website:

https://www.samhsa.gov/about-us/who-we-are/laws-regulations

Litsky, F. (2002, September 25). Mike Webster, 50, dies; Troubled football hall of famer.

Retrieved December 14, 2019, from The New York Times website:

https://www.nytimes.com/2002/09/25/sports/mike-webster-50-dies-troubled-football-hall

-of-famer.html

Mayo. (2018, February 13). Exercise and opioids-what to know before you go. Retrieved

December 5, 2019, from Mayo Clinic: Consumer Health website:

https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/opioids-and-exer

cise/art-20396866

The NIDA Blog Team. (2015). Pro athletes, marijuana, and opioids. Retrieved December 5,

2019, from National Institute on Drug Abuse for Teens website:

https://teens.drugabuse.gov/blog/post/pro-athletes-marijuana-and-opioids
OPIOIDS IN SPORTS 20

NIDA Team. (2019, November 12). Mind matters: The body's response to opioids. Retrieved

December 5, 2019, from NIDA for Teens website:

https://teens.drugabuse.gov/teachers/mind-matters/opioids

Olney, B. (2019, December 12). MLB, union agree to opioid testing; Marijuana removed as 'drug

of abuse'. Retrieved December 12, 2019, from ESPN website:

https://www.espn.com/mlb/story/_/id/28283499/mlb-union-agree-opioid-testing-marijuan

a-removed-drug-abuse

Opioid crisis fast facts. (n.d.). ​CNN​. Retrieved from CNN database.

Overprescribing opioids. (n.d.). ​Washington University School of Medicine.​ Retrieved from

https://medicine.wustl.edu/news/podcast/overprescribing-opioids/

A place for pot in sports?​ (n.d.). Retrieved from

https://go-gale-com.eztcc.vccs.edu:2443/ps/i.do?&id=GALE|A486309963&v=2.1&u=viv

a2_vccs&it=r&p=SCIC&sw=w

R., B. (2008, March 11). Opioid complications and side effects. Retrieved December 5, 2019,

from PubMed.gov website: https://www.ncbi.nlm.nih.gov/pubmed/18443635

Raymond, N. (2019, May 29). U.S. football players overdose death spotlighted in j&j Oklahoma

opioid trial. Retrieved from Physician's Weekly database.

21 U.S.C. § 844 - U.S. Code - Unannotated Title 21. Food and Drugs § 844. Penalties for simple

possession. (n.d.). Retrieved December 14, 2019, from FindLaw website:

https://codes.findlaw.com/us/title-21-food-and-drugs/21-usc-sect-844.html

Wikipedia. (2019, October 25). Mike webster. Retrieved December 13, 2019, from The free

encyclopedia website: https://en.wikipedia.org/wiki/Mike_Webster