Dec 10, 2017 4 min read

Patrick DeMeo has been a physician for 25 years, all in Pittsburgh. It is a silver anniversary in a region dominated by black and gold.

He is inextricably linked to the athletic landscape here, a sports medicine doctor who has worked with high school and college programs and, on a more visible plain, is medical director of the Pittsburgh Pirates. DeMeo also is a professor and chairman of orthopedic surgery at Allegheny Health Network and a staffer at Allegheny General and St. Clair hospitals.

DeMeo is well-versed in health issues facing athletes, including painkillers and the possibility they could become a gateway to opioid or heroin addiction. He spoke about the perils of medications with the Observer-Reporter’s Rick Shrum.

Q. Pain is a companion of many athletes. How do prescription medicines play into that equation?

A. There is a reason why narcotic drugs exist – they’re very effective in controlling pain. But they can lead to abuse. You use them judiciously and try to wean an athlete off them as quickly as possible, usually a few days. We have to be very judicious when we prescribe pain medications to anyone.

Q. How and when do you prescribe them?

A. I would never dispense narcotics to a college or high school athlete unless there was a serious injury, usually requiring surgery or hospitalization. When we prescribe them to young athletes, we tell parents to distribute them and monitor them closely. We don’t want young athletes in charge of their own pain medication. With professional athletes, unless there is a surgical procedure or something develops, we very rarely prescribe narcotic medication.

Q. High school and college officials and professional teams educate athletes about drug use. What safeguards have they put in place?

A. The NCAA has a list of banned drugs. It also does random drug tests at all collegiate levels (during postseason national competition. The NCAA also conducts them year-round at Division I and II schools, and urges Division III schools to do them.) The Pirates do not store narcotic medications in the clubhouse, and we don’t prescribe them there.

Q. Do you know of any young athletes who have gotten around laws and regulations?

A. There was a case of a young man at a local university whose roommate had had surgery. The young man ended up with an injury, and the roommate said, ‘Here, take one of my pain pills.’ What 19-year-old wouldn’t do that? He ended up failing a drug test without having a physician’s prescription. He explained the situation to the college president and could have gotten thrown out of school, which I think is the proper thing. But he was lucky. He didn’t get thrown out.

Q. Should athletes be wary of overusing over-the-counter products as well?

A. Back in my training days, there was a very famous case involving Kenny Easley (a defensive back for Seattle). He ended up taking too much ibuprofen, and even though it’s over the counter, that shut his kidneys down and he needed a kidney transplant. The lesson I learned is you can’t treat an athlete any differently with prescription and nonprescription drugs than you would anyone else. (Editor’s note: Easley sued the Seahawks, their trainer and doctors, claiming an overdose of Advil for an ankle injury led to kidney failure. The suit eventually was settled out of court. Easley was inducted into the Pro Football Hall of Fame in August.)

Q. How prevalent is the use of pain medicine among athletes?

A. I don’t think the opioid problem among athletes is nearly as impactful as it is in the general population mainly because (most are) tested. It’s no different in professional circles. If you are caught with illicit drugs in your system, there’s a price you pay for that. From 15 to 20 years ago to now, I don’t see a big difference.

Q.There was a time, maybe 20 years ago, when so-called “miracle drugs” like oxycontin were considered nonaddictive and being prescribed for pain management. Then they, indeed, proved to be addictive. How much of an impact has that had on the current addiction issue?

A. It’s sad we have such an opioid crisis today. Part of the reason is the federal government. Doctors were once told they weren’t giving enough pain medication to patients, and 20 years later the government realizes it has a problem. With narcotics, you have to use them appropriately and judiciously.