On the heels of the recent announcement by 3 Cleveland-area Catholic schools implementing mandatory drug testing next year, I want to stress it’s really a wellness initiative. There’s no punitive objective. It’s meant to help teens struggling with addiction.
Yesterday, I had the chance to visit in studio WAKR morning show host Ray Horner to discuss this topic. We also talked about kids’ abuse of both prescription and over-the-counter drugs as performance enhancers and their negative long-term effects.
Below is an audio file and transcript of our discussion. Originally aired on 1590 WAKR-AM on May 7, 2014.
DR. CONGENI: Well, we started last week [to talk] a little about drug testing. It was the day before it had been announced (that 3 Cleveland Catholic schools will perform mandatory drug testing), and a lot more has come out. There have been people discussing the pros and cons of it. It really is a wellness initiative and it’s not really a sports-related issue at all.
So, there’s not going to be any checking for performance-enhancement drugs. Really, the drugs we’re looking at are recreational drugs and the drugs of abuse, particularly the ones that we’re seeing such a problem with in teenagers: the narcotics, the heroin, Codeine, Morphine, Oxycodone, those types of things, [as well as] the recreational drugs like ecstasy. Those are the things that are gonna be tested.
There’s no punitive part to it, like you don’t get kicked out if you test positive. If you get tested as positive, it’s confidential to everybody except the parents and a counselor.
It’s really meant to help people. [To] say, “Hey, you have this problem with drugs. It can be a real issue. There are people in the community that you can see for the next step.”
That’s the way it’s supposed to play out.
HORNER: Okay, so that’s straightening out what we talked briefly about last week.
DR. CONGENI: It straightens it out a little bit. The cost is being picked up by the school.
The reason for the hair samples is they’re the most accurate for a longer period of time — they stay positive for about 3 months. We talked about that. Rather than some of the saliva tests, blood or urine tests, that might stay positive only for 2 or 3 days. So, it’s a lot more accurate, and really the expense part is not too bad.
Although, you know there was a little bump in the road there as it was released. The owner of the company who was doing the testing is actually the brother of the president of St. Edward school.
So, that was a little bit controversial and some of the negative people are [asking], is this a money-making attempt? Some of the other negative [comments] are that this may push a lot more kids into alcohol because alcohol is not being tested for.
This gives kids 3 or 4 months between now and the beginning of next school year to get off drugs. They say that it would allow people the opportunity to say no during the summer to using any of these drugs because they know they’re going to be tested. It gives kids an out to be able to do that.
In preparation, I talked to some adolescent specialists at our hospital and some judges — my sister’s a judge — about this. It’s just really heart-wrenching how many kids we’re losing, particularly with heroin overdose deaths, in the state of Ohio. That’s really what’s being targeted the most here. And most people that I’ve talked to think it would be a positive step.
HORNER: Dr. Joe Congeni with us in studio from the Sports Medicine Center at Akron Children’s Hospital. What else do you have with you this morning?
DR. CONGENI: Well, one of the things that does trickle down into the sports medicine arena is … there are some kids that use pain killers on a pretty regular basis. I know I’ve run into this in my career. I don’t know what the numbers are, but there are some kids that just act differently.
During an entire season, perhaps an entire football season or hockey season, they get the opportunity of getting narcotics and using them all season long.
It’s very different the way they respond to injuries. We worry a lot about concussive injuries because they’re masking some of the effects that would normally be telling us something’s wrong.
A real serious concern of mine is that there still are, and it may be a small number — 3 to 5 percent — of some people that get their hands on some of these narcotics and use them on a regular basis.
The Ohio State Medical Association [is trying to] reduce the amount of those pill mills, where people can get their hands on those narcotics.
One big area, Ray, used to be people would go into acute care clinics or emergency rooms with a fracture or a bad injury and be given, you know, 60 or 80 or 90 of those pain-killing narcotics.
There’s no reason for that. Two or 3 days and then [they should] follow up with their doc.
And so there are a lot of new guidelines that came out in 2014 about good use in the medical community of narcotics so they don’t get in the wrong hands.
HORNER: And, Joe — just for parents and grandparents listening — one is the addiction factor. The other is what staying on these pain killers does physically to your body.
DR. CONGENI: It’s really 3-pronged, like you said. The addiction factor and the deaths are heart wrenching when you see young kids dying from these things. The fact that it’s masking other problems, that’s an issue. And, No. 3, there’s no doubt there are long-term side effects when you’re using these over time.
You have to kinda weigh those 3 things. When you’ve been through, like a lot of the judges and the people in the legal system, a steady dose of these young kids that are totally addicted and have trouble getting off these, they’re looking for any place that there may be help. And this may be something, you know, in a non-threatening way that helps them keep kids off of these dangerous drugs.
HORNER: You know, speaking of drugs, one drug that works positively when used correctly for these young athletes — and I’ve seen it first-hand — is Adderall.
I know we’ve talked briefly about this with some professional athletes who are trying to use Adderall who don’t have the prescriptions for it, but when you get a prescription for it for these youngsters, age 12 to 18, whether it be for focus or other things, we’ve seen it really pay off for these young athletes.
DR. CONGENI: No question about it. My colleagues at Children’s use this and help a lot of kids in the neurology world and behavioral medicine world. I saw again a number that’s upwards in the teens of kids who need things for concentration issues, and Adderall has become the best of those. But, you know that fine line of how it crosses over into sports.
DR. CONGENI: There’s no question about it. You know the Joe Haden (cornerback for the Cleveland Browns) thing and other athletes that use it for the benefits on the field.
And one other area, a lot of college students say that they think that upwards of 10, 15, 20 percent use it for testing. They feel if there’s going to be drug testing (this is what a lot of college students told me in the last week.), they should be testing at times of the MCATs, LSATs, DATs or tests that college students have to take.
They’d like to see testing for drugs that get in the wrong hands like Aderall. People are using them for trying to gain an advantage on the standardized tests, too. So, it’s a tricky world. It’s a slippery slope.
HORNER It really is. Do you have other stuff with you this morning?
DR. CONGENI: Uh, you know, the only other thing is we have a really good research project going on: non-steroidals. It’s another drug, so we’re staying in the drug vein. It was really an eye-opener to me.
We looked at your sport — baseball. We just did a survey of 261 kids, high-school baseball players in the Greater Akron area. This just crossed my desk yesterday. My Fellow is going to write this up and I’ll give you more details.
But, I was really shocked, 72 percent, I think he said, of baseball players through their high-school season use non-steroidal, anti-inflammatory drugs over the counter, like Aleve and Advil, on a regular basis without talking to their parents in many cases, without talking to medical people.
So, this over-the-counter use of, again, a good drug that can be beneficial for something that is in flammatory condition is getting over used and abused. And, again, over a long period of time, there are side effects.
Luckily, what you don’t get into are some of the neurologic effects. The non-steroidals don’t cross the blood-brain barrier, so we don’t worry about the addictive effects of narcotics and other things. But, clearly, there are some liver issues and kidney issues.
HORNER: Stomach and brain bleed-out, I was reading about that.
DR. CONGENI: You’re right. And, so, is the message to these young kids the way to deal with these injuries is to use non-steroidal anti-inflammatories?
He’s got some really interesting things that he broke out, like once kids have had one elbow or shoulder injury then they are a lot more likely to, rather than seek help or rest during a season, grab the anti-inflammatories.
The No. 1 position wasn’t pitcher. The No. 1 position was catcher. Catchers use more non-steroidals than anybody else.
So some interesting things coming from a study that we’ll be talking about coming out of Children’s later this month.
HORNER: It’s interesting as far as being thrown into the official “Little League rules” this year. On our league, if you catch a certain amount of innings, you’re not allowed to pitch. That kinda goes with what you just said with arm problems, trying to take care of that.
If you catch so many innings, you’re not allowed to pitch because pitchers and catchers are basically throwing each and every, you know, pitch.
DR. CONGENI: For sure. We’re working on it. You know, we call ’em maximum effort throws. You know this as a manager and a coach, [how many] maximum effort throws in a baseball game [certain positions] might have to make.
It’s interesting how quickly a pitcher will fatigue — a youth pitcher, a junior high, high school pitcher — when they’re throwing 70, 80, 90 pitches.
Those muscles around the shoulder that support the shoulder and the elbow, they fatigue very easily in 50, 60, 70 pitches and then what happens is there’s no support for the shoulder, no support for the elbow late in the game and that’s when injuries occur.
Catchers make maximum effort throws all the time, too, so I’m really, really happy to hear that those rules are being implemented and we gotta do a better job to protect these kids.
HORNER: Alright, Joe, good seeing you. Thanks for coming in to the studio, great information this morning.
DR. CONGENI: Thanks for having me, Ray.
HORNER: There you go. Dr. Joe Congeni, Sports Medicine Center at Akron Children’s Hospital, joining us live this morning.