Background: Some ex-professional ice hockey enforcers have experienced negative outcomes following their careers. The purpose of this study was to determine whether athletes who had this role were negatively impacted by substance use and misuse during and/or following their careers. It was hypothesised that given their role in the sport, significant exposure to concussive injury occurred leading to a substantial number of challenges including high levels of post-career substance use. Methods: This study also utilises a mixed methods quantitative and qualitative approach with one-on-one semi-structured interviews with questions related to substance use/abuse. Results: This hypothesis for this study was not supported. Participants in this study reported low levels of substance use post-career. Patterns of substance use during career varied by era with a change in use from alcohol and over-the-counter stimulants to opioids, sleep aids, and AAS estimated to occur near the mid to late 1990s. Alcohol misuse was reported by four participants at some point during their careers. Stimulant use was prevalent in the sport pre-mid 1990s. The use of prescription opioid pain medication and sleep aids was reportedly rare before the mid to late 1990s but eventually became easily attainable via team medical staff and prescription sharing. Two participants from the later era also reported the use of AAS.Discussion: It has been revealed that this sample of ex-professional hockey enforcers experienced a significant number of concussions, continue to have challenges with chronic pain, and were exposed to several unique stressors during their careers, the effects of which may have varied based upon how the role was viewed. The combination of these factors may have led to increased substance use in some of these athletes during their careers.