Purpose Involvement in sports increases the risk of injury and the risk for prescription opioid use and misuse. This was an exploratory retrospective study to examine if previous involvement in interscholastic sports was associated with a greater lifetime prevalence of medical prescription opioid use, lifetime risk of diverting prescribed opioids, and lifetime risk of nonmedical prescription opioid use. Method A web-based survey was self-administered to a sample of 4187 full-time undergraduate students at a large public university located in the Midwest. Student demographics, involvement in interscholastic sports during high school, lifetime medical prescription opioid use, lifetime risk of diverting prescribed opioids, and lifetime risk of nonmedical prescription opioid use were measured and analyzed for this study. Results When compared to their peers who did not participate in interscholastic sports during high school, multiple logistic regression analyses indicated that those who participated in at least one interscholastic sport during high school had greater odds of lifetime medical prescription opioid use on multiple occasions and greater odds of being approached to divert their prescribed opioid medications on multiple occasions. Conclusions The findings indicate some association between previous involvement in interscholastic sports and prescription opioid use and misuse. These findings further suggest that greater awareness should be instilled in parents and coaches regarding this form of substance misuse.

Objectives We identified peak annual incidence rates for medical and nonmedical use of prescription opioid analgesics, stimulants, sedatives and anxiolytics (controlled medication), and explored cohort effects on age of initiation. Methods Data were gathered retrospectively between 2009–2012 from Detroit area students (n=5185). Modal age at last assessment was 17 years. A meta-analytic approach produced age-, year-, and cohort-specific risk estimates of first-time use of controlled medication. Cox regression models examined cohort patterns in age of initiation for medical and nonmedical use with any of four classes of controlled medication (opioid analgesics, stimulants, sedatives or anxiolytics). Results Peak annual incidence rates were observed at age 16, when 11.3% started medical use, and 3.4% started using another person’s prescription for a controlled medication (i.e., engaged in nonmedical use). In the more recent birth cohort group (1996–2000), 82% of medical users and 76% of nonmedical users reported initiating such use by age 12. In contrast, in the less recent birth cohort group (1991–1995), 42% of medical users and 35% of nonmedical users initiated such use by age 12. Time to initiation was 2.6 times less in the more recent birth cohort group (medical use: adjusted hazard ratio [aHR]=2.57 [95% confidence interval (CI)= 2.32, 2.85]; nonmedical use: aHR=2.57 [95% CI=2.17, 3.03]). Conclusions Peak annual incidence rates were observed at age 16 for medical and nonmedical use. More recent cohorts reported initiating both types of use at younger ages. Earlier interventions may be needed to prevent adolescent nonmedical use of controlled medication.