NJSIAA recommends protocols to combat prescription drug abuse

The New Jersey State Interscholastic Athletic Association’s Medical Advisory Committee, citing a nationwide epidemic of prescription medication abuse, announced on Monday multiple recommendations to combat an issue that the governing body says “has struck particularly hard among scholastic athletes.”

“When it comes to our nation’s young people, this is about as serious as a problem can get,” NJSIAA Executive Director Steve Timko said. “Lives are being ruined – and in many cases ended – at an unprecedented rate. As an organization dedicated to the well-being of student-athletes, the NJSIAA is taking a proactive role in addressing what amounts to an outright crisis.”

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The recommended protocols include, but are not limited to, encouraging physicians to exercise extreme caution when prescribing opioid medications to student-athletes, and encouraging doctors to seek every effort to utilize non-narcotic medications. When prescribing opioids is absolutely necessary, the Medical Advisory Committee says every effort should be made to ensure the safe administration of those medications which includes educating student-athletes and their parents/guardians about the drug’s potential for addiction through physical and psychological dependence. The protocols recommend that student-athletes’ treating physicians notify the school nurse and/or athletics trainer when opioids have been prescribed.

Longtime East Brunswick High School athletic trainer Phil Hossler, who has never administered even aspirin in his more than four decades, said supports the NJSIAA's decision in taking a proactive measure.

"I applaud the NJSIAA and anybody who pulls their head out of the sand and looks around," he said. "Their stance is really a home run in the sense that it starts with physicians and ends on the parents. I don't think it's safe to ask the adolescents to police themselves."

Hossler admitted he doesn't know the prevalence of physicians prescribing opiods, and hasn't directly seen the effects of student athletes abusing them.

"Have I seen it? No. Is it out there? I'm sure," he said. "It was eye opening for me reading (the NJSIAA's memo). They're shining the light on a larger societal issue."

“By recommending this list of specific protocols, the NJSIAA’s Medical Advisory Committee is intensifying the ongoing battle against prescription drug abuse,” state Sen. Richard Codey said. “With so many of our young people now at risk, it’s crucial that groups with the necessary connections and resources push hard to identify solutions.”

According to the National Council on Alcoholism and Drug Dependence, 12 percent of male student-athletes and 8 percent of female student-athletes have been prescribed highly-addictive opioid class narcotics in the past year. Separate studies show that 83 percent of all adolescents have unsupervised access to their own narcotics prescriptions, according to the NJSIAA, which identifies narcotic painkillers – including Vicodin, Percocet and OxyContin – as the most frequently abused prescription medications. The NJSIAA's Medical Advisory Committee said that the percentage of adolescents prescribed opiates rose from 3.5 percent in 1994 to 6 percent in 2007.

The Medical Advisory Committee, which recommends that school districts develop policies for student-athletes taking opiates, will reach out to potential coalition partners – including medical societies, pharmacy groups, education associations, law enforcement organizations, and others – to gain access to additional thought-leaders, while also broadening support for its protocols.

“Studies indicate that about 80 percent of heroin users started out by abusing narcotic painkillers,” said Dr. John Kripsak, chair of the NJSIAA’s medical advisory. “That statistic makes it frighteningly clear what the stakes are in this battle. It’s an emergency now, and there’s no doubt we need to implement new strategies in our schools to turn the tide.”

The Medical Advisory Committee, which includes representatives of NJSIAA member schools, as well as experts in the field of healthcare and medicine, recommends the following nine protocols related to scholastic athletes and opioid abuse:

• Physicians should exercise extreme caution whenever considering opioid prescriptions for student-athletes.
• In terms of prescriptions, the first option should be such non-narcotic alternatives as acetaminophen, non-steroidal anti-inflammatory medications, salicylates, and non-medication treatments like cryotherapy and transcutaneous electric nerve stimulation. 
• If opioids are prescribed, it should only be for acute injuries resulting in severe pain – and only for one week at a time, with no automatic refills.
• All opioid prescriptions should be accompanied with detailed information on use, including specific warnings about abuse and addiction risks.
• Opioid prescriptions should never be given directly to student-athletes, and should never be administered in an unsupervised manner.
• Treating physicians and/or parents/guardians should notify the school nurse and/or athletic trainer about all opioid prescriptions.
• Treating physicians should utilize a “contract” – to establish boundaries and behaviors – whenever prescribing opioids to student athletes.
• Every school district needs to develop a specific, detailed policy addressing this issue.
• School districts should implement drug monitoring programs, with an emphasis on identifying students who seem to exhibit signs of opioid abuse. 

Staff Writer Greg Tufaro: gtufaro@gannettnj.com