Question
What are the key signs and symptoms of opioid use and withdrawal, particularly in student athletes?
Answer
Recognizing the signs and symptoms of opioid use and withdrawal is critical for early intervention, especially among vulnerable populations like student athletes. Opioid use often presents with distinct physical indicators. The most prominent sign is pinpoint pupils, where the pupils become unusually small. Other physical signs include redness and flushing of the face and neck, fatigue, red and glazed eyes, and slurred speech. Additionally, individuals may report constipation and slowed digestion, common side effects of opioid consumption.
Behaviorally, athletes using opioids may exhibit a lack of energy, drowsiness, and difficulty concentrating. Their mood may become erratic, swinging from irritability and anger to anxiety. This behavior often leads to isolation from peers and withdrawal from commitments, such as missing practices or avoiding team activities. Over time, these individuals may demonstrate a decline in academic performance and interest in personal hygiene, further signaling a potential issue.
Withdrawal symptoms, on the other hand, occur when an individual attempts to stop or reduce opioid use after developing dependency. Common withdrawal signs include frequent yawning, runny nose, dilated pupils (the opposite of pinpoint pupils), joint pain, and severe insomnia. Behavioral changes such as restlessness, increased irritability, and an inability to focus are also typical.
In educational settings, teachers, coaches, and healthcare professionals should remain vigilant for specific signs unique to student athletes. These include falling asleep in inappropriate settings, such as classrooms or team meetings, and dramatic mood swings. Physical signs, like unexpected weight loss and flushed appearance, often accompany behavioral shifts. Athletes may become secretive, sneaking into locker rooms or other private areas to access medication. Frequent scratching of the skin, slurred speech, and difficulty keeping their eyes open are also common markers of opioid misuse.
Behavioral and social changes can offer additional clues. Increased secrecy, irritability, and restlessness are frequently observed in those struggling with opioid misuse. On the other hand, there are decreases in self-esteem, motivation, and concentration. For example, a once-dedicated athlete may begin skipping practice or performing poorly in games. Declining academic performance, coupled with neglect of personal hygiene, further underscores the need for intervention.
To effectively address these issues, it’s essential for healthcare professionals and school staff to foster open communication with student athletes and their families. By identifying these signs early and providing support, healthcare teams can intervene and guide individuals toward appropriate treatment and recovery resources.
This Ask the Expert is an edited excerpt from the course, "Preventing and Recognizing Opioid Abuse in Athletes by the Healthcare Professional," presented by John Boudreaux, EdD, PT, LAT, ATC, SCS.
