ADD and Heatstroke: What Every Coach Should Know

Heat stroke deaths are preventable.  No question.  Enough is known about the human body to identify the signs of these events.

So why do they continue to occur?

Exertional Heat Stroke, or heat stroke, occurs when a person’s internal temperature reaches levels that cause major organ failure.  At approximately 104 degrees [for most people] the human body’s first defense is to “pass out” or become unconscious.  This mechanism prevents further activity and further temperature rise.

When we ignore signs of exhaustion and push beyond our natural shut down mechanism, the extreme internal temperatures cause organs to fail and often result in death.  

So how is it possible we push beyond this internal temperature limit and why would anyone want to?

It has been discovered that amphetamines, often used to enhance athletic performance, delay the point of exhaustion and increase the upper limits internal body temperatures can reach.  While measures to discourage and prevent illicit usage should be taken by individual athletic departments, another likely culprit is an athlete's prescribed medication.

In 1991, Ritalin usage increased as ADHD diagnoses in children exploded. From 1991-2011, 52 heat stroke deaths were reported in the sport of football.  Going back to 1931 there have been 137 recorded heat stroke deaths in football.  So, just about 40% of heat stroke related deaths occurred during this Ritalin boom.  Yes, correlation isn’t causation… but consider this graph:

  

As you see, another spike in heat stroke deaths in football occurred between 1959-1973.  During this period 60 heat stroke related deaths were recorded.  This dovetails with a time period of well-documented recreational drug usage, where amphetamines were found to be “widely used by NFL players during the 1960-70s".

Combine the two time periods, where suspected amphetamine use by athletes was elevated, and these 33 yrs account for over 80% of recorded heat stroke related deaths in football.  A noteworthy parallel.  

Regardless of this connection, we know the use of Ritalin, Adderall and Concerta allows for increased body temperature.  This means coaches must know which of their athletes is taking medication that alters normal body temperature limits.  This information should be provided by the parents on a Pre-ParticipationExamination (PPE) or medical clearance form.

In 2008, Max Gilpin died from heat stroke during football practice in Kentucky, with a measured core body temperature of 107.  Head coach Jason Stinson was charged with reckless homicide.  While Mr. Stinson was later acquitted, it was discovered that Gilpin was taking Adderall at the time of the incident.

The time is now, to identify which athletes are taking the medication, and take progressive action, mindful of documented side effects.  Lives are at stake.