Major League Baseball is not immune to the opioid crisis.

In fact, as Royals head athletic trainer Nick Kenney explains, the age demographic of the player population adjusting to pro ball at the Minor League level and the demands of the job at all levels can -- if not addressed properly -- play right into the hands of an epidemic that claimed nearly 108,000 lives in the United States just in 2022, according to the most recent numbers available from the National Center for Health Statistics.

“There’s pain, there’s anxiety, there’s depression,” said Kenney, who serves as the president of the Professional Baseball Athletic Trainers Society (PBATS). “We’ve got young kids leaving home and doing something that’s harder than they’ve ever done, with guys that are just as good as them, if not better than them. It’s a struggle out there.”

As the statistics show, it’s a struggle everywhere. MLB is deeply engaged in the effort to combat the epidemic on two fronts -- educating young people about the dangers of opioids and fentanyl by partnering with a non-profit organization called Song for Charlie and increasing training on and access to life-saving opioid overdose reversal medications.

The latter front got needed attention this month, when the Biden administration announced the White House Challenge to Save Lives from Overdose -- a nationwide call-to-action to stakeholders across all sectors to focus on the importance of overdose reversal medications like naloxone.

“I’m hard-pressed to think of a player health or public health issue that’s more important than this one,” said Jon Coyles, MLB’s vice president of drug health and safety programs. “It’s what we’re facing as a country right now. Overdoses are still way, way too high. Because of the public-facing nature of baseball, it’s our hope that creating awareness and educating people on the risks and dangers and on life-saving measures like naloxone will positively contribute to what the government is trying to do.”

MLB has pledged to support the White House’s effort and advance the conversation, be it through social media platforms or public service announcements at the ballparks and during game broadcasts.

Already, the league serves as an example of how a workplace can do its part to address the epidemic.

When Angels pitcher Tyler Skaggs died of an accidental overdose at age 27 in July 2019, the tragedy sparked action from MLB and the MLB Players’ Association. The league had been studying opioid use prior to Skaggs’ untimely death, and, soon after the gutting loss of Skaggs, MLB and the players’ union agreed to begin testing for drugs of abuse (around 12,000 tests were administered during the 2023 season), with those who test positive referred to medical professionals and only those who decline treatment subject to discipline. The league also began encouraging ballparks and trainers to stock naloxone, a medication that can reverse overdose if a patient receives it in time.

The White House challenge is calling upon other organizations -- big and small, public and private -- to act similarly. It calls on leaders to train employees on opioid overdose reversal medications, keeping the medications in first aid kits at worksites and purchasing and distributing the medications to employees and customers so they might save a life at home, work or in their communities. The initiative targets every community nationwide, but the emphasis is especially strong in counties that have been hit hardest by the overdose crisis.

Because of its robust drug testing programs, individual team medical staffs in place and obligation to work with the players’ union on such challenges, MLB is perfectly positioned to be a representative example of how to approach this issue.

“The White House challenge is very much in line with what we have been doing in our workplaces,” Coyles said. “If we can take that experience and that positive message and promote it out to the fans and the general public, it’s a really good place to be.”

The protocols put into place prior to the 2019 season, in the winter after Skaggs’ death, involve multiple workplace stakeholders -- ballpark operations, security and emergency medical staff, etc. -- working together to follow Emergency Action Plan protocols. It also requires educating the entire player population, medical staffs and other employees throughout the industry on the dangers of opioids and the availability of reversal medications.

“That medication could be a life-saving measure, it’s a game-changer,” Coyles said. “It’s an easy thing to promote and something we’ve done for five years now. Now that access has increased and you can obtain it in an easier way, it makes it easier for clubs to meet that requirement.”

Of course, medications like naloxone are only one piece of the puzzle. While these medications can be very effective when used at the right time, they don’t take away from the need to educate and create awareness about the risks of opioid abuse and the importance of proper mental health care.

That’s where Song for Charlie comes in.

MLB and PBATS began a relationship with the national family-run nonprofit charity Song for Charlie to integrate opioid and fentanyl education for young people and their parents at ballparks and online through various efforts this summer, including the public awareness P.L.A.Y. campaign that occurs in-person at ballparks and through the MLB Together community outreach programming at the All-Star Game festivities in Arlington, Texas, in July.

“We were scared about [the opioid epidemic] already, and Song for Charlie gave us the platform to attack it,” Kenney said. “Their motivation and our worry was a match.”

Song for Charlie was created by the family of Charlie Ternan, who loved ones describe as “just a regular guy” who was in college and dealing with back pain. Familiar with Percocet from a previous prescription and not wanting to go through the process of a doctor’s visit, he ordered a pill online, took it and died within 30 minutes.

It turns out, what Ternan had thought was a Percocet was a “fentapill” -- a pill made of fentanyl -- a drug 50 times more potent than heroin. With no quality control in the illegal manufacturing process, the amount of fentanyl can vary greatly from pill to pill and batch to batch, so those who are deceptively sold the pills online are put in great danger without realizing it.

“Over the past decade, chemicals like fentanyl have replaced plants as the active ingredients in street drugs, because they are cheaper to produce and ship, and therefore much more profitable,” Charlie’s father Ed Ternan wrote in an email. “Education is a critical part of our national response to this crisis. People are overdosing and dying in large part because they don’t adequately understand the new chemical drug landscape. By empowering people with knowledge, we equip them to keep themselves and their loved ones safe.”

Ternan said the partnership with MLB and PBATS has been of great help in reaching a wider audience.

“MLB is a revered institution that has enormous credibility with the public,” he wrote. “The PBATS professionals are trusted advisors with deep connections to players and staff across the Major and Minor League systems. Together, we will reach millions of people as our messages cascade from athletic trainers and medical staff to players and coaches to fans and families.”

With drug overdoses having become a leading cause of death among young Americans aged 18-45, it is an issue of particular importance for MLB, given the age of its player population.

“Fentanyl does not discriminate,” Kenney said. “It is really ravaging the group of 17–24-year-olds, and what do we have in our game? A bunch of 17–24-year-olds. We felt like it’s really important to band together with Song for Charlie to walk the cause together and put it to an age group that we’re worried about. The biggest thing is getting them to our Minor League cities along with our Minor League trainers and educating them and branch that into community outreach in those areas that our Minor League teams are in.”

Now the league is in position to be a leading example for how to follow the White House’s call to action.