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Substance availability and career era
Participants in this study played professional ice hockey during a 36-year span from 1978–2014. It became evident that the patterns of substance use for players who played in the 70’s and 80’s were not the same as for players in the late 90’s or post-2000 (please refer to Fig. 1). This pattern of divergence was observed for alcohol use as well as prescription, non-prescription, and illicit substances. The mid-1990s seemed to be when the transition in the patterns of substance use occurred.
Alcohol use
Embedded within the culture
Six participants described how alcohol was present in their culture. Comments such as ‘I don’t have a problem with alcohol though I can consume a lot of it at times … like every other Canadian’ (P5) were relatively common. Two participants described alcoholism in their immediate families. P4 shared ‘I come from a long line of drinkers. …my grandfather died of sclerosis of the liver. My Dad died of sclerosis of the liver.’ (P4). Another participant stated:
‘My mom’s an alcoholic. My dad probably was an alcoholic at a certain time …when we were younger he’s the one that did all the drinking and my mom kind of took over the bottle and she’s the alcoholic still. …my grandparents on her side are both alcoholics.’ (P9)
Embedded within the sport
Six participants commented on how drinking alcohol was a part of their experience as ice hockey players. Having access to beer in the dressing room or while traveling after a game was described by several players. For example, P7 stated “If we had a big win, then the coach would walk by and hand you cans and it was fun.’ The use of alcohol for most started with their experiences in junior hockey:
‘booze is certainly engrained in the culture of hockey, at a young age, I mean you move away from home and, they’re hardly legal to drive half these guys and they’re boozing and you know what I mean. They’re legal to drink? They’re certainly not, half of them, um, it’s a problem…’ (P6).
At some point during the 1990s, the environment regarding alcohol availability in dressing rooms began to change. Three participants commented on how alcohol use in the dressing rooms was eventually phased out. P10 stated:
‘…when I came in with NHL city, the game was over, there was a bucket of beer. You had a couple beers, you spent 30 minutes maybe 45 talking to your teammates… now they come in, they shower and do their interviews and they (expletive) off with their girlfriend or wife, you know?’
P9 described the transition from beer to the availability of blended non-alcoholic drinks to aid in post-game recovery:
‘And by the end it was blenders, you know what I mean? …you know NHL player and I would be sitting there in, NHL city… and we talked about how before you hear a (beer opening sound) like the, like the crack of a bottle… Now you hear the blender’ (P9).
Excessive Alcohol Use
Four participants described patterns of excessive alcohol use that occurred during their professional careers. P4 shared ‘Sometimes I didn’t know when to say when… I never drank hard alcohol… I was always just pretty much strict beer drinker’ Another commented ‘…uh did I drink? Ya, I drank a lot. I’ll be honest with you.’ (P8). One participant described his pattern of regular alcohol consumption this way:
‘After practice you went for lunch and had 10 beer. Then you’d go home and have dinner. …and if you didn’t play for three to four days, guess what? Your lunch turned into an all-night affair … I learned to be a good drinker through the NHL’ (P9).
Two participants described substantial alcohol use but in combination with other substances. For one participant, the alcohol became part of a life of excess that coincided with other changes in the sport at that time. P6 described that his alcohol use was:
‘not every day, but when I partied, I partied hard, like but it was still a big part of the party in my life (emphasis) …you know it didn’t matter how hung-over I was the next day, I was fighting, fighting the biggest guys, I played hard you know what I mean? So I think that between the fighting and managing (clears throat) you know the fight and the anxiety of the fight a lot of the times with alcohol… it became probably a little bit too extreme’.
Near the end of his career, P9 described the combined challenges of injury, end of career transition, and substance use:
‘…I was a runaway in NHL city because, you get injured – what (do) guys do, you get hurt… and you pull yourself away from the team so you don’t feel a part of it. And it’s a hard pill to swallow when you show up at the rink and everybody’s getting ready for the game and you’re just a (expletive), you’re sitting, you’re not a part of it. So, where do you feel a part of it? Well you go drink with your friends there, right? And the girls and …the clubs whatever …in NHL city I went to a whole nother level of drinking.’
Prescription and non-prescribed substances
Pre mid-1990s: Pseudoephedrine and NSAIDs
Seven participants who played professional hockey before the mid-90’s generally denied regular use of prescription pain relievers and instead relied primarily on non-steroidal anti-inflammatory (NSAID) medication to manage pain. Comments such as ‘I’m hearing stories and I can’t relate to it …I was …pretty active in fighting …and I probably did have a lot of pains or aches or pains or whatever but I never took a medication of any type’ (P3) and ‘Probably the only medication we took would have been (laughs), like I say, tape an aspirin to it’ (P8) were common. Another participant commented that:
‘the team doctor used to give it, it was an anti-inflammatory …it was like they had the tester bottles… So you could get them every day if you wanted right? …so I mean I used to live on (them) …because it was like you’d just, it would make your body feel good right?’ (P4).
At times, pain management included alcohol: ‘And of course they also hand you a six pack of beer in those days …a strip of pills and a six pack of beers and go to the back of the bus and uh wake up in Tulsa’ (P7). Two of the participants mentioned the regular use of cortisone injections by the medical staff of one NHL team. Another participant mentioned the regular use of Toradol (an injectable NSAID).
When asked about PEDs, seven participants had first-hand knowledge of pseudoephedrine use on their teams. For example:
‘…we took Sudafed right? Sudafed, especially if it was a big game and you knew you might be, you knew you had to fight NHL enforcer, or (laughing) guys like that …it was like, you had a couple of Sudies in you so that you were pumped up and ready, you were revved up.’ (P4).
P7 comments on the transition to the common use of pseudoephedrine near the end of his career:
‘what came at the tail end (of his career) was Sudafed, that was the big thing …guys were starting to realize (it) could pick you up just before the game so there would be the green mint flavour Sudafeds in the bathroom’.
Another participant stated: ‘in the room, you would have your gum, you’d have your laces, you’d have your tape, you would have a thing of Sudafed’ (P8). While some participants admitted to use of Sudafed, others reported not liking the effects or not needing it to be effective in their role. These participants had opinions such as ‘I honestly tried it a few times but, I didn’t really, didn’t really need it’ (P5) and ‘did I ever take any of that? No because I didn’t need it. A cup of coffee was fine’ (P8).
When asked about AAS, seven participants who played prior to the mid-1990s generally denied use and/or did not have first-hand knowledge about use. A typical comment was ‘they talk about steroids and stuff, I didn’t see a lot of that in our game. I didn’t see it.’ (P5). Other participants from this era mentioned rumours or suspicions of AAS use but had no definitive first-hand knowledge. Additionally, the response was similar for the use of sleep aids. Participants understood why they may be considered beneficial for management of sleep when traveling through different time zones or when in pain, but none of the seven reported first-hand knowledge of use. P3’s comments were representative of participants from this era: ‘I don’t want to try something just to say oh this will make you feel good, or here’s an upper, or, you know I can’t sleep, give me some medication. I’m just, I’ve never done that’.
Post mid-1990s: Opioids, sleeps aids, and AAS
For the three participants whose careers extended beyond the mid-1990’s, the patterns of substance use changed dramatically. Alcohol and pseudoephedrine were no longer provided by teams and/or present in dressing rooms. The most significant change was the prevalence of prescription opioids and sleep aids that were available from the team medical staff or via medication sharing. Typically, participants who used opioids also used sleep aids. For example, P1 stated:
‘I would take sleeping pills on the buses and stuff. Ambien. And then uh, there was a point… so if I had a legit injury, I would, I would take pain killers… Um, and then there’s a point in… I would say my second last year, something like that where… I was starting to get a little bit more heavy into the pain killers …and, it was probably a little bit of a problem. I was able to, kind of… snap out of it early enough that it didn’t become a huge problem’ (P1).
This participant continued that access to these products was relatively easy:
P1: ‘Uh, those were prescribed out pretty, pretty regularly.
I: Were they prescription or did you get them from…?
P1: They were prescription, well the doctor would write a prescription for you (clears throat) and then, you essentially just share them with everybody on the bus’.
P6 described it this way:
‘probably in like the late 80s, 90s is probably when the pill, the pill mill started rolling in. I really got introduced to it in my first-year pro… it was around everywhere. …I started …like you know a 5 mg Percocet here, a 5 mg Percocet here, and there was sleeping pills …when I got with the NHL team is when I started flying now, and that’s when I started …to feel the wear and tear so I’d be on the plane and I’d be like, “hi team trainer I need a muscle relaxer or you know a sleeping pill” …then you’re out at the party, …you think that a guy’d be smoking a joint or something like that. It’s like oh I got some Percocet 10s, it was, it was just passing them around, eating them and washing them down with, well beer at that time …that was just normal’ (P6).
While P2 stated that he rarely utilised these substances, he saw how their use affected his teammates:
‘But definitely played with guys who were addicted …and when one guy got it, like “hey can I have some, can I have some?” And if you wanted some of your own it was not hard to get. You could say anything… Whether you wanted to sleep… I had guys who were popping two Ambiens a night to sleep now because they were just hooked now, they couldn’t sleep without it’ (P2).
This participant made an interesting observation linked to the summer of 2011 and the deaths of three ice hockey enforcers. He stated: ‘… before all those suicides happened it was just go (to) the doctor, “Hey I got a sore shoulder. There you go.” But then after I think it was Boogaard …they clamped down hard’ (P2). Another participant described how sleep aids were used recreationally by other players:
‘they called it the Ambien Olympics. …we were in NHL city and we got a game tomorrow night, they flew in today, they’d go over to some restaurant and they’d order some wine and some food and they’d eat it and towards the end of the meal there would be one guy that wouldn’t, the other guys would all pop a couple Ambien, and they’d call it the Ambien Olympics to see if they could find their way back to the (expletive) hotel’ (P10).
During the later era, participants also had first-hand knowledge of AAS. Two participants reported using AAS prior to training camp to add weight and gain strength with the hope of improving their chances for a roster spot on a team. P1 shared: ‘…it was pills, it was, uh, Dianebol… D-Bol. I did one cycle. I guess you could call it one bottle for a month’ (P1). P6 added: ‘I was doing steroids even before that, from 18–22, you know, did six to seven cycles of steroids in that amount time. In juniors ya … year, and then ah, my first couple years pro, but it was my, it was in the off-season’ (P6). Both participants mentioned that they believed the use of AAS did not help them significantly in their ice hockey careers.
Illicit substances
One participant described the use of cocaine late in his career and into retirement. His use of cocaine co-occurred with what he believed was an alcohol addiction. A different participant, while not taking cocaine himself, shared: ‘it’s such a no–no now for these kids to come in and even smell like a little bit of beer. So, they (expletive) do the pills, they snort coke, like cocaine’s (making) a huge (expletive) comeback in the NHL. It’s awful.’ (P10). A third participant has used cannabis in various forms since his teens and at various times in substitution for other substances such as opioids to manage pain. He continues to use cannabinoids to this day and advocates for their potential medicinal benefits.
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