Weber State University athletic director Jerry Graybeal said athletic programs assume some responsibility for players they recruit. Teams become surrogate families.

"We have to do our part, no doubt," he said, adding that includes education, knowing the injury, monitoring drug prescriptions and following up.

"I know it's something that coaches have to be educated on also," said Graybeal, formerly the Wildcats' head football coach. "It's something you can't take lightly."

Graybeal knows firsthand the power of prescription painkillers. Demorol hooked him 26 years ago after a bout with Guillain-Barre syndrome, a disease in which the body's immune system attacks part of the peripheral nervous system.

"I had to be weaned off it like heroin," he said.

Addictive personalities

Sports psychologist Keith Henschen said athletes are vulnerable to addiction.

"I think most athletes are addictive anyhow. Addicted to working out. Many of them have addictive personalities. They will keep doing things that most (people) will say, 'I won't do that. That's no fun for me."'

Athletes as a whole are driven, doing whatever it takes to compete on the field or court.

Injured players worry about losing their starting spots. They question their usefulness to the team. They perceive themselves as wimpy. They feel like they're being left behind, Henschen said.

And on the collegiate level, they literally are when the team travels to away games. Henschen, who has worked with the Utah Jazz for years, said that unlike pro teams, college teams usually don't take injured players on road trips.

"What message are they sending these kids?" he said. "You're not worth anything to us unless you're healthy."

Coaches, fans, boosters and teammates push athletes to perform when injured.

"There is pressure on some level from us," said Utah assistant gymnastics coach Megan Marsden. But they don't have the final say on whether a gymnast practices or competes.

"We as coaches at the college level are very removed from being able to decide much at all," she said.

The decision, Marsden said, falls to the doctor, trainer, the athlete's parents and the athlete.

Competitive athletes, however, may ignore medical advice; they may not be forthcoming about the injury, or medicate themselves.

Self-monitoring

"Some players figure it's OK to pop a pill here and there," said University of Utah senior safety Steve Tate. "I can definitely see why kids get caught up in it."

Tate has suffered several serious injuries in his collegiate career, including a painful dislocated shoulder. He described it as "on fire" during games last season and frequently popped it back into place between plays.