ElmwoodParkMemorialHighSchool

AthleticSupplementalPacketThispacketincludes:

• AthleticInjuryProcedures• SchoolInsuranceInformation• PurchasingExtraAccidentalInjuryInsurance• EyeGlassesandSportsFactSheet• ConcussionPolicy• BaselineConcussionTestingPermissionForm• SuddenCardiacDeathBrochureandSignaturePage

Bysigningbelow,youareacknowledgingthatyouhavereceivedandreviewedtheattachedinformation.Pleasedetachandreturnthisform,thecardiacform,andthebaselinetestingpermissionform.Keepthereminderofthepacketforyourreference.

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PLEASE INITIAL THE STATEMENT BELOW: ____ I DECLINE THE OFFER TO PURCHASE EXTRA ACCIDENTAL INJURY INSURANCE FOR MY CHILD AND UNDERSTAND THAT THE SCHOOL INSURANCE WILL NOT COVER ALL MEDICAL BILLS AND THAT ALL INJURIES MUST BE SUBMITTED THROUGH MY PRIMARY INSURANCE FIRST.

ElmwoodParkMemorialHighSchoolAthleticTrainingProcedures

PHYSICALS:

• Allathletesmusthaveacurrent(withinthelast365days)physicalonfilebeforeparticipatinginanyactivity.

• Physicalsmustbecompletedontheschoolissuedforms.UniversalformsareNOTACCEPTABLE.

• Ifyourson/daughterhasasthmaorusesaninhaler,thetreatingphysicianmustcompleteanASTHMATREATMENTPLAN.

• INJURYPROCEDURES:

• AllinjuriesMUSTbereportedtotheCertifiedAthleticTrainerimmediately.Thisistoensurethatpropercareisgiventotheathleteandinstructionsforathomecareisprovided.

• TheCertifiedAthleticTrainerwillcompleteanAccidentReportForm.• Iftheathletictrainerrecommendsfurthermedicalevaluation,anorthopedicphysician

shouldbeconsulted.Theathletewillnotbepermittedtoparticipateuntilthistakesplace.• Whenaphysicianseesanathlete,amedicalnotefromthetreatingphysicianisneeded

statingthediagnosisandadatewhentheathletecanreturntosports.SCHOOLINSURANCEFORMS:

• Theschoolcarriesasecondaryinsurancepolicyforuseforathleticinjuries.• Thereisa$500deductibleforeachinjurythatoccursandonlypaysupto80%.• Anaccidentreportmustbecompletedandfiledwiththeschoolbeforeaformisissued.• InjuriesnotreportedtotheAthleticTrainerwillnotbeissuedaninsuranceform.

CONCUSSIONS:

• Allathletesarerequiredtotakeabaselineconcussionassessmentpriortothestartoftheseason.

• Anyathletewhosustainsaconcussion,regardlessofhowminor,willbeexcludedfromparticipationuntilaphysicianwhospecializesinconcussionsevaluatestheathlete.

• Oncethephysicianclearstheathlete,theathletewillbegina5-dayprogressionbacktosports.TheathleteWILLNOTbepermittedtoparticipateimmediately.

RETURNTOPLAYFROMINJURIES(OTHERTHANCONCUSSIONS):

• Adoctor’snotemustbesubmittedtotheAthleticTrainerwhentheathleteisreadytoreturntoactivity.Wewillnotacceptanynotesfromtheemergencyroom.

• Allathleteswillberequiredtoparticipatein,atminimum,onefullpracticepriortocompetinginanygames.

SUDDEN CARDIACDEATHINYOUNG ATHLETESThe Basic Facts onSudden Cardiac Deathin Young Athletes

SUDDEN CARDIAC DEATH IN YOUNG ATHLETES

Sudden death in young athletesbetween the ages of 10and 19 is very rare.

What, if anything, can bedone to prevent this kind oftragedy?

What is sudden cardiac deathin the young athlete?

Sudden cardiac death is theresult of an unexpected failure of properheart function, usually (about 60% of thetime) during or immediately after exercisewithout trauma. Since the heart stopspumping adequately, the athlete quicklycollapses, loses consciousness, andultimately dies unless normal heart rhythmis restored using an automated externaldefibrillator (AED).

How common is sudden death in youngathletes?

Sudden cardiac death in young athletes isvery rare. About 100 such deaths arereported in the United States per year.The chance of sudden death occurringto any individual high school athlete isabout one in 200,000 per year.

Sudden cardiac death is morecommon: in males than in females;in football and basketball than inother sports; and in African-Americans thanin other races and ethnic groups.

What are the most common causes?

Research suggests that the main cause is aloss of proper heart rhythm, causing theheart to quiver instead of pumpingblood to the brain and body. This is calledventricular fibrillation (ven- TRICK-you-lar fib-roo-LAY-shun). The problem is usually causedby one of several cardiovascular abnormalitiesand electrical diseases of the heart that gounnoticed in healthy-appearing athletes.

The most common cause of sudden death inan athlete is hypertrophic cardiomyopathy(hi-per-TRO-fic CAR- dee-oh-my-OP-a-thee)also called HCM. HCM is a disease of the heart,with abnormal thickening of the heartmuscle, which can cause serious heart rhythmproblems and blockages to blood flow. Thisgenetic disease runs in families and usuallydevelops gradually over many years.

The second most likely cause is congenital(con-JEN-it-al) (i.e., present from birth)

abnormalities of the coronaryarteries. This means that theseblood vessels are connected to

the main blood vessel of theheart in an abnormal way. This

differs from blockages that mayoccur when people get older

(commonly called “coronary arterydisease,” which may lead to a heart

attack).

l Sudden Death in Athleteswww.cardiachealth.org/sudden-death-in-athletes

l Hypertrophic Cardiomyopathy Associationwww.4hcm.org

l American Heart Association www.heart.org

Collaborating Agencies:American Academy of Pediatrics New Jersey Chapter3836 Quakerbridge Road, Suite 108Hamilton, NJ 08619(p) 609-842-0014(f ) 609-842-0015www.aapnj.org

American Heart Association1 Union Street, Suite 301Robbinsville, NJ, 08691(p) 609-208-0020www.heart.org

New Jersey Department of EducationPO Box 500Trenton, NJ 08625-0500(p) 609-292-5935www.state.nj.us/education/

New Jersey Department of HealthP. O. Box 360Trenton, NJ 08625-0360(p) 609-292-7837www.state.nj.us/health

Lead Author: American Academy of Pediatrics, New Jersey ChapterWritten by: Initial draft by Sushma Raman Hebbar,MD & Stephen G. Rice, MD PhD

Additional Reviewers: NJ Department of Education,NJ Department of Health and Senior Services,American Heart Association/New Jersey Chapter, NJAcademy of Family Practice, Pediatric Cardiologists,New Jersey State School Nurses

Revised 2014: Christene DeWitt-Parker, MSN, CSN, RN;Lakota Kruse, MD, MPH; Susan Martz, EdM;Stephen G. Rice, MD; Jeffrey Rosenberg, MD, Louis Teichholz, MD; Perry Weinstock, MD

Website Resources

STATE OF NEW JERSEYDEPARTMENT OF EDUCATION

Other diseases of the heart that can lead tosudden death in young people include:

l Myocarditis (my-oh-car-DIE-tis), an acuteinflammation of the heart muscle (usuallydue to a virus).

l Dilated cardiomyopathy, an enlargementof the heart for unknown reasons.

l Long QT syndrome and other electricalabnormalities of the heart which causeabnormal fast heart rhythms that can alsorun in families.

l Marfan syndrome, an inherited disorderthat affects heart valves, walls of majorarteries, eyes and the skeleton. It isgenerally seen in unusually tall athletes,especially if being tall is not common inother family members.

Are there warning signs to watch for?

In more than a third of these sudden cardiacdeaths, there were warning signs that werenot reported or taken seriously. Warningsigns are:

l Fainting, a seizure or convulsions duringphysical activity;

l Fainting or a seizure from emotionalexcitement, emotional distress or beingstartled;

l Dizziness or lightheadedness, especiallyduring exertion;

l Chest pains, at rest or during exertion;

l Palpitations - awareness of the heartbeating unusually (skipping, irregular orextra beats) during athletics or during cooldown periods after athletic participation;

l Fatigue or tiring more quickly than peers;or

l Being unable to keep up with friends dueto shortness of breath.

What are the current recommendationsfor screening young athletes?

New Jersey requires all school athletes to beexamined by their primary care physician(“medical home”) or school physician at leastonce per year. The New Jersey Departmentof Education requires use of the specificAnnual Athletic Pre-Participation PhysicalExamination Form.

This process begins with the parents andstudent-athletes answering questions aboutsymptoms during exercise (such as chestpain, dizziness, fainting, palpitations orshortness of breath); and questions aboutfamily health history.

The primary healthcare provider needs toknow if any family member died suddenlyduring physical activity or during a seizure.They also need to know if anyone in thefamily under the age of 50 had anunexplained sudden death such asdrowning or car accidents. This informationmust be provided annually for each exambecause it is so essential to identify those atrisk for sudden cardiac death.

The required physical exam includesmeasurement of blood pressure and acareful listening examination of the heart,especially for murmurs and rhythmabnormalities. If there are no warning signsreported on the health history and noabnormalities discovered on exam, nofurther evaluation or testing isrecommended.

When should a student athlete see aheart specialist?

If the primary healthcare provider or schoolphysician has concerns, a referral to a childheart specialist, a pediatric cardiologist, isrecommended. This specialist will performa more thorough evaluation, including anelectrocardiogram (ECG), which is a graph ofthe electrical activity of the heart. Anechocardiogram, which is an ultrasound testto allow for direct visualization of the heartstructure, will likely also be done. Thespecialist may also order a treadmill exercisetest and a monitor to enable a longerrecording of the heart rhythm. None of thetesting is invasive or uncomfortable.

Can sudden cardiac death be preventedjust through proper screening?

A proper evaluation should find most, butnot all, conditions that would cause suddendeath in the athlete. This is because somediseases are difficult to uncover and mayonly develop later in life. Others candevelop following a normal screeningevaluation, such as an infection of the heartmuscle from a virus.

This is why screening evaluations and areview of the family health history need tobe performed on a yearly basis by theathlete’s primary healthcare provider. Withproper screening and evaluation, mostcases can be identified and prevented.

Why have an AED on site during sportingevents?

The only effective treatment for ventricularfibrillation is immediate use of anautomated external defibrillator (AED). AnAED can restore the heart back into anormal rhythm. An AED is also life-saving forventricular fibrillation caused by a blow tothe chest over the heart (commotio cordis).

Effective September 1, 2014, the New JerseyDepartment of Education requires that allpublic and nonpublic schools grades Kthrough 12 shall:

l Have an AED available at every sportsevent (three minutes total time to reachand return with the AED);

l Have adequate personnel who are trainedin AED use present at practices andgames;

l Have coaches and athletic trainers trainedin basic life support techniques (CPR); and

l Call 911 immediately while someone isretrieving the AED.

SUDDEN CARDIAC DEATH IN YOUNG ATHLETES

Athlete/Parent/Guardian Sudden Cardiac Arrest Symptoms and Warning Signs Information Sheet and

Acknowledgement of Receipt and Review Form What is sudden cardiac arrest? Sudden cardiac arrest (SCA) is when the heart stops beating, suddenly and unexpectedly. When this happens, blood stops flowing to the brain and other vital organs. SCA doesn’t just happen to adults; it takes the lives of students, too. However, the causes of sudden cardiac arrest in students and adults can be different. A student’s SCA will likely result from an inherited condition, while an adult’s SCA may be caused by either inherited or lifestyle issues. SCA is NOT a heart attack. A heart attack may cause SCA, but they are not the same. A heart attack is caused by a blockage that stops the flow of blood to the heart. SCA is a malfunction in the heart’s electrical system, causing the heart to suddenly stop beating. How common is sudden cardiac arrest in the United States? SCA is the #1 cause of death for adults in this country. There are about 300,000 cardiac arrests outside hospitals each year. About 2,000 students die of SCA each year. It is the #1 cause of death for student athletes. Are there warning signs? Although SCA happens unexpectedly, some people may have signs or symptoms, such as:

fainting or seizures during exercise;

unexplained shortness of breath; dizziness;

extreme fatigue; chest pains; or

racing heart. These symptoms can be unclear in athletes, since people often confuse these warning signs with physical exhaustion. SCA can be prevented if the underlying causes can be diagnosed and treated. The Commissioner of Education in New Jersey, in consultation with the Commissioner of Health in New Jersey, the American Heart Association, and the American Academy of Pediatrics, have developed a pamphlet that provides information about Sudden Cardiac Death to student-athletes and the parent/guardian of student-athletes. By signing below, we acknowledge that we have received and reviewed the attached pamphlet on Sudden Cardiac Death in Young Athletes.

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ConcussionBaselineTestingProcedure

FOOTBALL,BOYS/GIRLSSOCCER:YouwillbetakingSWAYduringyourpracticetime.SeetheAthleticTrainertotakethetest.ALLOTHERSPORTS:1.Gotothefollowinglink:https://CogstateCCAT.cogstate.com/test/test.cfm?ElmwoodPark 2.EnteryourStudentID3.Nextto“Session”,click“Baseline”4.Completetheremaininginformation(gender,yearofbirth,andthehandyouwritewith).5.Makesurethevolumeisuponyourcomputersoyoucanhearthedirections.6.Clickon“StartTest”tobegin.7.Completethetest.Thereisnoneedtoprintanything.PLEASESIGNBELOWFORPERMISSIONTOTAKETHETESTANDTOSTATETHATYOU,ANDNOONEELSE,HASCOMPLETEDTHETEST.__________________________________________ _________________________

StudentSignature Date___________________________________________ _________________________

Parent/GuardianSignature Date

Concussion Information for Parents and Student/Athletes Contact: Danielle LaBianco, ATC/L

What is a concussion? A concussion is a traumatic brain injury (TBI), caused by a direct blow or motion to the head that disrupts the normal function of the brain. This can cause significant and sustained neuropsychological impairments including, but not limited to, problem solving, planning, memory, and/or behavioral problems. Quick Facts:

• Most concussions do not involve a loss of consciousness. • One can sustain a concussion without hitting his/her head. A

blow to the body can transmit an impulsive force to the brain causing a concussion.

• A clear CT/CAT scan or MRI does not rule out a concussion. SS

Return to play protocol following a concussion: Step # 1 – Completion of a full day of normal cognitive activities (attendance at school, studying for tests, watching practice, interacting with peers, using technology) without the re-emergence of symptoms. Step # 2 – Light aerobic exercise, which includes the use of a stationary bike. Step #3 – Sports specific exercises. This includes running. No head impact activities. The objective of this step is to add movement and to increase heart rate. Step #4 – Non-contacting drills such as passing drills, agility drills, throwing, catching, etc. Step # 5 - Following medical clearance (consultation between health care personnel and student/athlete’s physician), participation in sports specific activities. Step # 6 – Return to full contact practice and/or game activity.

What should a Student/Athlete do if they suspect they have a concussion?

1. Report it – to your athletic trainer, coach, school nurse, or parent.

2. Rest – Cognitive rest is

just as important as physical rest to recover from a concussion. Reading, texting, or playing video games can slow your recovery.

3. Recover – Take time to

recover. If you have a concussion your brain needs time to heal.

The risks of playing with a concussion: Regardless of the severity, a concussion is an injury that must be taken seriously. The risk of returning when signs or symptoms are still present may result in:

1. Post Concussion Syndrome – A neurological disorder, in which the signs and symptoms of a concussion, such as headaches, dizziness, or difficulty concentrating persist over an extended period of time.

2. Second Impact Syndrome- A life-threatening, neurological disorder, which can lead to severe impairment and even death. This condition can result if an athlete sustains another blow or jolt to the head while the athlete is still experiencing symptoms from a previous concussion.

Signs Observed by Others Appears dazed, stunned, and disoriented Forgets play, confused, short-term memory difficulty Exhibits poor balance or coordination Answers questions slowly or inaccurately Loses consciousness Shows behavior or personality change

Symptoms Reported by Athlete Headache Nausea/vomiting Balance problems or dizziness Double vision or changes in vision Sensitivity to light, sound, or noise Feeling sluggish, foggy, or groggy Difficulty concentrating, with short-memory, and/or confusion Sleep disturbances Irritability

STUDENT/ATHLETIC ACCIDENT INSURANCE The Board of Education has purchased insurance coverage to protect all students against accidental injury during school sponsored and supervised activities. This coverage is provided by Axis Insurance Company. The insurance plan is excess overage, which means that you must submit bills to your own insurance carrier first. The school policy will pick up the unpaid balances, up to the limits of the policy. Although this coverage is very broad, there are restrictions, limitations, and exclusions to this policy. In some situations, medical bills may not be covered in full. Parent(s)/Guardians(s) should understand that medical expenses are their own responsibility, not that of the School District. Some of the important benefits and limitations of the plan are:

• The plan has a $500 corridor deductible; the $500 deductible applies to each covered accident and does not include Covered Expenses paid under any other Health Plan.

• Benefits are paid at 80% U&C. • Treatment must commence within 90 days of the date of the injury, or

there is no coverage. • Benefits are payable for up to 2 years from the date of injury.

All injuries should be immediately reported to the School Nurse, Athletic Trainer, Coach, or Faculty Advisor. Each claim will be processed through WebTPA. For Additional Coverage: In addition to the school district excess coverage, parents/guardians have the opportunity to purchase Student Accident Plans through Monarch Management Corporation (MMC). For more details go to www.mmc-ms.com or see the attached form. For questions about the plan options, please call Monarch Management Corporation at 1(800)-662-2778.

Approximately 90% of sports-related eye injuries can be prevented with simpleprecautions, such as using protective eyewear.2 Each sport has a certain type ofrecommended protective eyewear, as determined by the American Society forTesting and Materials (ASTM). Protective eyewear should sit comfortably on theface. Poorly fitted equipment may be uncomfortable, and may not offer the besteye protection. Protective eyewear for sports includes, among other things, safetygoggles and eye guards, and it should be made of polycarbonate lenses, a strong,shatterproof plastic. Polycarbonate lenses are much stronger than regular lenses.3

Health care providers (HCP), including family physicians, ophthalmologists, optometrists,and others, play a critical role in advising students, parents and guardians about the proper use

of protective eyewear. To find out what kind of eye protection is recommended, and permitted for your child’ssport, visit the National Eye Institute at http://www.nei.nih.gov/sports/findingprotection.asp. Prevent BlindnessAmerica also offers tips for choosing and buying protective eyewear at http://www.preventblindness.org/tips-buying-sports-eye-protectors,and http://www.preventblindness.org/ recommended-sports-eye-protectors.It is recommended that all children participating in school sports or recreational sports wear protectiveeyewear. Parents and coaches need to make sure young athletes protect their eyes, and properly gear up forthe game. Protective eyewear should be part of any uniform to help reduce the occurrence of sports-relatedeye injuries. Since many youth teams do not require eye protection, parents may need to ensure that theirchildren wear safety glasses or goggles whenever they play sports. Parents can set a good example by wearingprotective eyewear when they play sports.

Participating in sports and recreational activities is an important part of a healthy, physically active lifestyle forchildren. Unfortunately, injuries can, and do, occur. Children are at particular risk for sustaining a sports-relatedeye injury and most of these injuries can be prevented. Every year, more than 30,000 children sustain serioussports-related eye injuries. Every 13 minutes, an emergency room in the United States treats a sports-relatedeye injury.1 According to the National Eye Institute, the sports with the highest rate of eye injuries are:baseball/softball, ice hockey, racquet sports, and basketball, followed by fencing, lacrosse, paintball and boxing.

Thankfully, there are steps that parents can take to ensure their children’s safety on the field, the court, or whereverthey play or participate in sports and recreational activities.

Prevention ofSports-RelatedEye Injuries

1 National Eye Institute, National Eye Health Education Program, Sports-Related Eye Injuries: What You Need to Know and Tips for Prevention,www.nei.nih.gov/sports/pdf/sportsrelatedeyeInjuries.pdf, December 26, 2013.

2 Rodriguez, Jorge O., D.O., and Lavina, Adrian M., M.D., Prevention and Treatment of Common Eye Injuries in Sports,http://www.aafp.org/afp/2003/0401/p1481.html, September 4, 2014; National Eye Health Education Program, Sports-Related Eye Injuries: What You Needto Know and Tips for Prevention, www.nei.nih.gov/sports/pdf/sportsrelatedeyeInjuries.pdf, December 26, 2013.

3 Bedinghaus, Troy, O.D., Sports Eye Injuries, http://vision.about.com/od/emergencyeyecare/a/Sports_Injuries.htm, December 27, 2013.

The most common types of eye injuries that can result from sports injuries areblunt injuries, corneal abrasions and penetrating injuries.

� Blunt injuries:Blunt injuries occur when the eye is suddenly compressedby impact from an object. Blunt injuries, often caused by tennis balls,racquets, fists or elbows, sometimes cause a black eye or hyphema(bleeding in front of the eye). More serious blunt injuries often breakbones near the eye, and may sometimes seriously damage importanteye structures and/or lead to vision loss.

� Corneal abrasions: Corneal abrasions are painful scrapes on the outsideof the eye, or the cornea. Most corneal abrasions eventually heal on their

own, but a doctor can best assess the extent of the abrasion, and may prescribe medication to help control thepain. The most common cause of a sports-related corneal abrasion is being poked in the eye by a finger.� Penetrating injuries: Penetrating injuries are caused by a foreign object piercing the eye. Penetrating injuries

are very serious, and often result in severe damage to the eye. These injuries often occur when eyeglasses breakwhile they are being worn. Penetrating injuries must be treated quickly in order to preserve vision.4

� Pain when looking up and/or down, or difficulty seeing;

� Tenderness;� Sunken eye;� Double vision;� Severe eyelid and facial swelling;� Difficulty tracking;

If a child sustains an eye injury, it is recommended that he/she receiveimmediate treatment from a licensed HCP (e.g., eye doctor) toreduce the risk of serious damage, including blindness. It is alsorecommended that the child, along with his/her parent or guardian,seek guidance from the HCP regarding the appropriate amount oftime to wait before returning to sports competition or practice aftersustaining an eye injury. The school nurse and the child’s teachersshould also be notified when a child sustains an eye injury. A parent

or guardian should also provide the school nurse with a physician’s notedetailing the nature of the eye injury, any diagnosis, medical orders for

the return to school, as well as any prescription(s) and/or treatment(s) necessary to promotehealing, and the safe resumption of normal activities, including sports and recreational activities.

According to the American Family Physician Journal, there are several guidelines thatshould be followed when students return to play after sustaining an eye injury. For

example, students who have sustained significant ocularinjury should receive a full examination and clearanceby an ophthalmologist or optometrist. In addition,students should not return to play until the period oftime recommended by their HCP has elapsed. For more

minor eye injuries, the athletic trainer may determine thatit is safe for a student to resume play based on the nature of the injury, and how the

student feels. No matter what degree of eye injury is sustained, it is recommended thatstudents wear protective eyewear when returning to play and immediately report any concerns with their visionto their coach and/or the athletic trainer.

Additional information on eye safety can be found at http://isee.nei.nih.gov andhttp://www.nei.nih.gov/sports.

4Bedinghaus, Troy, O.D., Sports Eye Injuries, http://vision.about.com/od/emergencyeyecare/a/Sports_Injuries.htm, December 27, 2013.

Most CommonTypes of EyeInjuries

� The eye has an unusual pupil sizeor shape;

� Blood in the clear part of the eye;� Numbness of the upper cheekand gum; and/or

� Severe redness around the whitepart of the eye.

What to do if aSports-RelatedEye InjuryOccurs

Signs orSymptoms of an Eye Injury

Return to Playand Sports

School athletics can serve an integral role in students’ development. In addition to providing healthy forms of exercise, school athleticsfoster friendships and camaraderie, promote sportsmanship and fair play, and instill the value of competition. Unfortunately, sports activities may also lead to injury and, in rare cases, result in pain that is severe or long-lasting enough to require aprescription opioid painkiller.1 It is important to understand that overdoses from opioids are on the rise and are killing Americans of allages and backgrounds. Families and communities across the country are coping with the health, emotional and economic effects ofthis epidemic.2

This educational fact sheet, created by the New Jersey Department of Education as required by state law (N.J.S.A. 18A:40-41.10),provides information concerning the use and misuse of opioid drugs in the event that a health care provider prescribes a student-athlete or cheerleader an opioid for a sports-related injury. Student-athletes and cheerleaders participating in an interscholastic sportsprogram (and their parent or guardian, if the student is under age 18) must provide their school district written acknowledgment oftheir receipt of this fact sheet.

What Are Some Ways Opioid Use andMisuse Can Be Prevented?

Keeping Student-Athletes Safe

In some cases, student-athletes are prescribed these medications. According to research, about a third of young people studiedobtained pills from their own previous prescriptions (i.e., an unfinished prescription used outside of a physician’s supervision),and 83 percent of adolescents had unsupervised access to their prescription medications.3 It is important for parents tounderstand the possible hazard of having unsecured prescription medications in their households. Parents should alsounderstand the importance of proper storage and disposal of medications, even if they believe their child would not engage innon-medical use or diversion of prescription medications.

According to the National Council on Alcoholism and Drug Dependence, 12 percent of male athletes and 8 percent of femaleathletes had used prescription opioids in the 12-month period studied.3 In the early stages of abuse, the athlete may exhibitunprovoked nausea and/or vomiting. However, as he or she develops a tolerance to the drug, those signs will diminish.Constipation is not uncommon, but may not be reported. One of the most significant indications of a possible opioid addiction isan athlete’s decrease in academic or athletic performance, or a lack of interest in his or her sport. If these warning signs arenoticed, best practices call for the student to be referred to the appropriate professional for screening,4 such as provided throughan evidence-based practice to identify problematic use, abuse and dependence on illicit drugs (e.g., Screening, BriefIntervention, and Referral to Treatment (SBIRT)) offered through the New Jersey Department of Health.

According to the New Jersey State Interscholastic Athletic Association (NJSIAA) Sports MedicalAdvisory Committee chair, John P. Kripsak, D.O., “Studies indicate that about 80 percent of heroinusers started out by abusing narcotic painkillers.”The Sports Medical Advisory Committee, which includes representatives of NJSIAA member schools aswell as experts in the field of healthcare and medicine, recommends the following:● The pain from most sports-related injuries can be managed with non-narcotic medications such as acetaminophen, non-

steroidal anti-inflammatory medications like ibuprofen, naproxen or aspirin. Read the label carefully and always take therecommended dose, or follow your doctor’s instructions. More is not necessarily better when taking an over-the-counter(OTC) pain medication, and it can lead to dangerous side effects.4

● Ice therapy can be utilized appropriately as an anesthetic. ● Always discuss with your physician exactly what is being prescribed for pain and request to avoid narcotics.● Tramadol, a non-opioid analgesic in the serotonin uptake inhibitor category, is a good choice should the previously listed

options be insufficient to relieve pain.● In extreme cases, such as severe trauma or post-surgical pain, opioid pain medication should not be prescribed for more

than five days at a time;● Parents or guardians should always control the dispensing of pain medications and keep them in a safe, non-accessible

location; and ● Unused medications should be disposed of immediately upon cessation of use. Ask your pharmacist about drop-off locations

or home disposal kits like Deterra or Medsaway.

How Do Athletes Obtain Opioids?

According to NJSIAA Sports Medical Advisory Committee chair,

John P. Kripsak, D.O., “Studies indicate that about 80 percent of

heroin users started out by abusing narcotic painkillers.”

What Are Signs of Opioid Use?

EDUCATIONAL FACT SHEETOPIOID USE AND MISUSE

There are two kinds of sports injuries. Acute injuries happen suddenly, such asa sprained ankle or strained back. Chronic injuries may happen after someoneplays a sport or exercises over a long period of time, even when applyingoveruse-preventative techniques.5

Athletes should be encouraged to speak up about injuries, coaches should besupported in injury-prevention decisions, and parents and young athletes areencouraged to become better educated about sports safety.6

Half of all sports medicine injuries in children and teens are from overuse. An overuse injury is damage to a bone, muscle, ligament, or tendoncaused by repetitive stress without allowing time for the body to heal. Children and teens are at increased risk for overuse injuries becausegrowing bones are less resilient to stress. Also, young athletes may not know that certain symptoms are signs of overuse.

The best way to deal with sports injuries is to keep them from happening in the first place. Here are some recommendations to consider:

Resources for Parents and Students on Preventing Substance Misuse and Abuse

PREPARE Obtain the preparticipation physical evaluation prior toparticipation on a school-sponsored interscholastic or intramuralathletic team or squad.

PLAY SMART Try a variety of sports and consider specializing inone sport before late adolescence to help avoid overuse injuries.

TRAINING Increase weekly training time, mileage or repetitions nomore than 10 percent per week. For example, if running 10 miles oneweek, increase to 11 miles the following week. Athletes should alsocross-train and perform sport-specific drills in different ways, such asrunning in a swimming pool instead of only running on the road.

ADEQUATE HYDRATION Keep the body hydrated to help the heartmore easily pump blood to muscles, which helps muscles workefficiently.

REST UP Take at least one day off per week from organized activity torecover physically and mentally. Athletes should take a combinedthree months off per year from a specific sport (may be dividedthroughout the year in one-month increments). Athletes may remainphysically active during rest periods through alternative low-stressactivities such as stretching, yoga or walking.

CONDITIONING Maintain a good fitness level during the season andoffseason. Also important are proper warm-up and cooldownexercises.

PROPER EQUIPMENT Wear appropriate and properly fitted protective equipment such as pads (neck, shoulder, elbow, chest, knee, and shin), helmets,mouthpieces, face guards, protective cups, and eyewear. Do not assume that protective gear will prevent all injuries while performing more dangerousor risky activities.

The following list provides some examples of resources:National Council on Alcoholism and Drug Dependence – NJ promotes addiction treatment and recovery.New Jersey Department of Human Services, Division of Mental Health and Addiction Services has a mission to decrease the abuse of alcohol, tobacco and other drugs bysupporting the development of a comprehensive network of prevention, intervention and treatment services in New Jersey.New Jersey Prevention Network includes a parent’s quiz on the effects of opioids.Operation Prevention Parent Toolkit is designed to help parents learn more about the opioid epidemic, recognize warning signs, and open lines of communication withtheir children and those in the community.Parent to Parent NJ is a grassroots coalition for families and children struggling with alcohol and drug addiction.Partnership for a Drug Free New Jersey is New Jersey’s anti-drug alliance created to localize and strengthen drug-prevention media efforts to prevent unlawful druguse, especially among young people. ReachNJ provides information for parents and families, including addiction and treatment stories.The Science of Addiction: The Stories of Teens shares common misconceptions about opioids through the voices of teens.Youth IMPACTing NJ is made up of youth representatives from coalitions across the state of New Jersey who have been impacting their communities and peers byspreading the word about the dangers of underage drinking, marijuana use, and other substance misuse.

References

An online version of this fact sheet developed in January 2018 is available on the New Jersey Department of Education’s Alcohol, Tobacco, and Other Drug Use webpage.

Even With Proper Training and Prevention, Sports Injuries May Occur

Number of Injuries Nationally in 2012 Among Athletes 19 and Under from 10 Popular Sports

(Based on data from U.S. Consumer Product Safety Commission's National Electronic Injury Surveillance System)

What Are Some Ways to Reduce the Risk of Injury?7

1 Massachusetts Technical Assistance Partnershipfor Prevention

2 Centers for Disease Control and Prevention3 New Jersey State Interscholastic Athletic

Association (NJSIAA) Sports Medical AdvisoryCommittee (SMAC)

4 Athletic Management, David Csillan, athletictrainer, Ewing High School, NJSIAA SMAC

5 National Institute of Arthritis and Musculoskeletaland Skin Diseases

6 USA TODAY7 American Academy of Pediatrics

StAtE of NEw JERSEydEPARtMENt of EduCAtIoN

In consultation withStAtE of NEw JERSEy

dEPARtMENt of HEAltHNJSIAA SPoRtS MEdICAl

AdvISoRy CoMMIttEE

Karan ChauhanParsippany Hills High School,

Permanent Student Representative New Jersey State Board of Education

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9,610

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2,470

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119,8

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SOURCE: USA TODAY (Janet Loehrke) Survey of Emergency Room Visits

ElmwoodParkSchoolDistrictAthleticDepartment

Opioid Use and Misuse Educational Fact Sheet By signing below, you acknowledge that you have received and reviewed the attached pamphlet, “Opioid Use and Misuse Educational Fact Sheet”.

Date: __________________________

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Student-Athlete (print name) Student-Athlete (signature)

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Parent/Guardian (print name) Parent/Guardian (signature)