This study presents empirical evidence on self-medication with analgesics among elite German handball players. The aim is to elucidate the intentions behind therapeutic and preventive analgesic use and identify high-risk profiles for this complex health-risk behavior based on psychosocial factors. Data were collected from 459 handball players (233 female, 226 male athletes) across the highest German divisions (1st – 3rd and German Youth Handball Bundesliga) through a quantitative online survey conducted between October 2021 and April 2022. The survey requested demographic information and details on analgesic use patterns, intentions behind analgesic use, and psychosocial variables. The study shows that athletes use self-medication with painkillers as a coping strategy to manage distractions from acute injuries and pain as well as to prevent expected distractions. Engaging in self-medication allows athletes to navigate the pressures of elite sport. Classification tree analysis revealed distinct risk profiles for therapeutic and preventive analgesic use. Key factors of self-medication include age, athletic identity, willingness to compete hurt, and perceived performance state. The high-risk group for therapeutic self-medication with analgesics consists of senior athletes. The high-risk group for using analgesics preventively, in contrast, is composed of athletes over the age of 17 with strong negative affectivity, a heightened willingness to take risks, and good perceived performance. Our findings highlight the necessity for specific interventions to address the multifaceted motivations behind self-medication and promote safer practices in elite sports. Future research should concentrate on longitudinal studies and diverse athlete populations and use qualitative studies to gain a deeper understanding of the determinants of analgesic use and to develop effective intervention strategies.
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