Is Pro Football More Dangerous Than Substance Use?

By Tom Horvath, PhD

Stanton Peele suggested this idea in one of his recent blogs. As we await Super Bowl Sunday (2/11/24) the question seems worth re-visiting.

It would require a careful analysis of outcomes from pro football and substance use to provide an accurate comparison. The data about substance problems is easy to find. Pro football’s data is harder to find, but generally we know that playing football can result in concussions, broken bones, chronic traumatic encephalopathy (CTE), and other injuries. For further details search for the NFL concussion settlement. However, it seems unlikely than an accurate comparison between pro football and substance use will occur because professional football is popular, and substance use seems to be unpopular. We often condemn substance users.

However, this condemnation is inconsistent given that most of us use substances! That statement may startle you. Perhaps it is intoxication, not substance use, that we mean. Caffeine in typical doses does not dramatically impair consciousness. Nor does nicotine, alcohol, or any other substance in low enough doses. There are low doses of all “substances of abuse” that are pleasurable and meaningful for most people. (Of course, some people will experience even low doses as unpleasant, such as if cocaine makes you paranoid). To repeat, when you add up everyone who uses substances at some level, it appears that most of use them.

Should we revise our perspective and condemn substance intoxication, rather than substance use? That change would be beneficial and allow us to have a more detailed and accurate discussion about substance use. Although our risks go up when intoxicated, especially if regularly intoxicated, intoxication itself has both benefits and risks/harms.

When we project ourselves into football players, we like what we see: Strong individuals who work hard to win games by combining individual excellence and teamwork. Substance users are at the other end of the spectrum. We may see selfish, impulsive, pleasure-seeking individuals who have little regard for their own futures or for those who love them.

What these projections leave out are the motivations of football players for income and attention, and the efforts expended by substance users to minimize harm and hold their lives together. Our projections onto these two groups are more all-or-none than the reality of these two groups.

Could football be made safer? Of course! Would we enjoy it as much? Maybe not. Flag football seems unlikely to catch on the way the NFL has. But flag football might be the only version of football that is clearly safer than substance use.

The NFL, like any good business, caters to its customers. The dangers of football are ultimately supported by its fans. If you are opposed to people harming themselves with substances, should you be opposed to pro football as currently played?