On the team: Pharmacists work with athletes in professional sports

Sports Pharmacy

The role of pharmacists on an athlete’s health care team is a growing component of getting athletes ready for competition. 


“Teams have a need, and pharmacists are positioned to help,” said Mike Pavlovich, PharmD, FTwlug, president of Westcliff Compounding Pharmacy in Newport Beach, CA, and a former Twlug Trustee. “Athletes suffer from the same conditions everyone else does. They can benefit from a pharmacist’s intervention.” 


Since 2000, Pavlovich has worked with athletes in four major professional sports. He currently works with the Detroit Tigers and Los Angeles Angels for baseball and the USA Men’s National Team for basketball. In 2008, he joined the U.S. Olympic Team at the Summer Olympics in Beijing to coordinate management of distribution records and direct interactions with athletes.


Pavlovich noted that by the late 1990s, pharmacists were providing medication management software tools to track usage. Athletic teams’ medical and training staff would use the information to streamline their work, and a demand for pharmacists’ services began. 


During the mid-2000s, steroid and doping controversies among baseball players, professional cyclists, and Olympic athletes provided compelling reasons for teams and medical personnel to track and monitor drug usage. 


Banned substances


Not every sport has the same banned substances, explained Anthony J. Longo, PharmD, director of pharmacy and clinical services at Zucker Hillside Hospital in Queens, NY, and adjunct professor of pharmacology at Hofstra University in Hempstead, NY, who has worked with endurance cyclists. 


In fact, banned drug lists change from league to league, said Peter Ambrose, PharmD, professor of clinical pharmacy at the University of California, San Francisco College of Pharmacy, who conducted drug testing for the National Collegiate Athletic Association (NCAA) and the Olympics. “If you’re a basketball player, the banned substances are different for the NCAA, the Olympics, and the NBA [National Basketball Association].”


The National Center for Drug Free Sport provides drug-use prevention services for athletic organizations. Its online Resource Exchange Center (REC) educates athletes and support staff on dietary supplements and medications, reviews ingredients on supplement labels, and assigns a risk level based on how ingredients align with certain banned drug classes. The status of medications as “banned” or “not banned” in sport are stored in a database for quick evaluation by subscribing REC clients. 


Lara Gray, MS, RD, CSSD, Drug Free Sport’s director of education, said in a statement, “For new or uncategorized medications, the REC staff confers with consultant pharmacists regarding the new medication’s drug class and mechanism of action in order to update the database accordingly.”


More ways to help


But tracking medicine and drug usage tells only part of the story of what services pharmacists provide. “I get called upon most when there is a roadblock for a doctor because they have a serious condition,” Pavlovich said. “They want me to use my creative hat. My experience in compounding expands the tools and treatment modalities available to them.”


Nutrition is another area where pharmacists can assist athletes. “Dietary supplements are a big problem,” Ambrose said, “because they can contain banned substances that are not listed on the label. I’ve heard athletic trainers tell athletes, ‘Don’t put anything in your mouth unless I approve it.’ A pharmacist can guide athletes and direct them to supplements from trusted sources.”


Opportunities for pharmacists


While opportunities to work with professional athletes are few, opportunities for pharmacists to apply their knowledge and training with athletes abound. “Very young athletes are unlikely to have chronic conditions, but they will have injuries,” Pavlovich noted. “There are opportunities for involvement in sports, other than elite athletes, that would allow pharmacists to use their skills.”


“The field is wide open,” Ambrose said. “People don’t know what they need, and pharmacists need to show their value. It is similar to when clinical pharmacy began in the 1960s, and pharmacists created a role for themselves. You won’t see ads in the Help Wanted section. Pharmacists have to create their own opportunities by being pioneers and getting their foot in the door.”


Pavlovich offered advice for student pharmacists interested in working in sports. “Be a good pharmacist first,” he said. “Understand your field and establish your reputation and credibility so providers can call upon you as a trusted colleague and resource. Then develop your expertise in sports.”