Pain isn’t Gain: The Attitudes and Effects of Acetaminophen Use and Abuse in Sub-Elite Athletics

By: Riley Cleverdon

In a modern competitive world of athletics, athletes are currently pushing themselves to the max; to be the toughest, strongest, fastest in their discipline. Our heroes are the athletes who push through the blood, sweat and tears and may take to unwise decisions in their quest to be at the top of their game [1]. As a student athlete, this means substantial pressure to perform at peak performance in competition as well as pressure to perform well academically [1]. As a collegiate athlete training constantly, it is inevitable sport-related injury will occur [1, 2]. Physical pain can be perceived as the body’s way of telling the brain that it needs to rest [2]. By taking drugs, we can increase the body’s pain tolerance and therefore keep practicing at a similar level while performing injured [2]. It is found that higher levels of acetaminophen intake occur in athletes than the general population, likely due to higher levels of soft tissue injury [2]. Injury is often an added pressure, as it is quite likely that their position on their team is dependent on their performance in their sport [1]. This pressure to perform while still injured can push athletes to use and sometimes abuse different painkilling drugs, including acetaminophen [1]. The effects of abusing painkillers like acetaminophen however, can have dangerous consequences.

Acetaminophen is considered to be safe drug when it is taken within a certain range, however if it is abused, or taken in higher than recommended doses than issues can occur [3]. The largest recognized issue of ingesting too much acetaminophen is hepatotoxicity or in other words, a chemical driven liver damage which can lead to acute liver failure [3]. In an overdose of acetaminophen, the metabolized form of acetaminophen combines with glutathione stored in our liver [4, 5]. By acetaminophen and glutathione binding together, the liver’s glutathione stores are depleted and the liver cannot protect itself against the toxic metabolized form of acetaminophen and damage occurs [4, 5]. After a lethal dose, liver failure can occur roughly three to five days after acute ingestion and can occur sooner depending on the severity of overdose [4, 5].

An athletic mindset that is determined to do anything to win is one at risk for the possibility of abusing substances like painkillers [1, 2]. In one study on football athletes found that 37% of athletes used more than the dose of acetaminophen recommended [4]. Another study, which was conducted through survey found that one third of athletes interviewed were not aware of the addictive properties that painkillers possess [1]. Approximately 25% of these athletes also were not aware of the dangerous side effects that acetaminophen abuse can create [1]. With statistics like these it is clear that there is potential for athletes to over-use and possibly abuse painkilling drugs like acetaminophen.

From a combination of internal and external pressures for peak athletic performance as a university level athlete, there is increased risk of athletes using and abusing painkillers like acetaminophen [1].

[1] Tricker, R. (2000). Painkilling drugs in collegiate athletics: knowledge, attitudes, and use of student athletes. Journal of drug education, 30(3), 313-324. 90gh-tthu

[2] Garcin, M., Mille-Hamard, L., Billat, V., Imbenotte, M., & al, e. (2005). Use of acetaminophen in young subelite athletes. Journal of Sports Medicine and Physical Fitness, 45(4), 604-7. Retrieved from []

[3] Ghanem, C. I., Pérez, M. J., Manautou, J. E., & Mottino, A. D. (2016). Review: Acetaminophen from liver to brain: New insights into drug pharmacological action and toxicity. Pharmacological Research, 109(Country in focus: Pharmacology in Argentina), 119-131. doi:10.1016/j.phrs.2016.02.020

[4] Bateman, D. N., & Vale, A. (2016). Specific substances: Paracetamol (acetaminophen). Medicine, 44(Poisoning (Part 2 of 2), 190-192. doi:10.1016/j.mpmed.2015.12.014

[5] Anker, A, L., Smilkstein, M, J. (1994). Concepts and Controversies. Emergency medicine clinics of North America, 12(2), 335. Retrieved from []

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