Chapter 20
Drug Abuse in Sports:
Causes and Cures
Mark H. Anshel
“It’s a good day for baseball. Nobody wants an uneven playing field. I’m glad this
happened. You want everybody on the same page. We shouldn’t be competing against
guys who use drugs like that. You always want to compete on the same level. That’s all I
want. That’s all everyone else wants. Today is bad for baseball and the fans. But as a
player, this is what you want.”
Boston Red Sox star Dustin Pedroia
in response to the suspensions by MLB
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History
• The use of drugs in sport is NOT new
• Ancient Greeks (3rd century B.C.) ingested certain plants before
races believing it would give them an edge in competition
• 1976 International Olympic Committee started widespread drug
testing and penalized athletes for testing positive
• Even with present more rigorous testing, drug use has continued
to grow among both the world’s best and less elite athletes
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Why are certain substances banned from competitive
sport, and why should sport administrators, coaches,
parents of athletes, and athletes themselves be
concerned about the use of drugs categorized as
“performance-enhancing”?
Drug use by athletes:
•
•
•
•
may cause physical and psychological harm
often violate state and federal laws
is considered cheating and violates the team rules and
organizational policies of almost every sport
contaminates performance results, which are obtained by
unnatural means.
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Two Categories of Drug Use
• Performance-Enhancing Drugs
• Intent is to improve performance
• E.g., anabolic steroids, narcotic
analgesics, beta blockers
• Recreational Drugs
• Alter the state of mind with no intention
of improving performance
• E.g., marijuana, cocaine, heroin
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How prevalent is drug use among
competitive athletes?
• 2012 NCAA study, reported findings from 20,474 studentathletes across 23 sports showed within the past 12 months:
• 3.7% admitted using amphetamines
• 0.4% indicated using anabolic steroids
• Less than 1% used ephedrine
• 83% drank alcohol
• 22.6% used marijuana
• 3.3 used of narcotics
• 6.4% used adderall or ritalin without a prescription
• 4.9% used of Vicodin, Oxycontin or Percocet without a
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Doping
• The act of ingesting banned drugs
• The IOC says, “The administering or use of
substances in any form alien to the body or
of physiological substances in abnormal
amounts and with abnormal methods by
healthy persons with the exclusive aim of
attaining an artificial and unfair increase of
performance in competition.”
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Legal Substances
• Alcohol
• Nicotine (e.g., tobacco products)
• Diet regimens (e.g., carbohydrate loading)
• Amino acids
• Caffeine (within limits)
• Antidepressants
• Vitamins
• Supplements such as creatine, human growth hormone
(HGH), and tetrahydrogestrinone (THG) have been banned
by some sport organization
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Anabolic Steroids
• Best-known category of performanceenhancing drug
• Improves strength and power
• Increases male hormone androgen and
decreases female hormone estrogen
• Steroids enhance recovery, build skeletal
muscle tissue
• Used for medicinal purposes to promote
muscle growth and tissue repair as part of
injury rehabilitation (legal)
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Harmful Effects of Steroids
• When testosterone levels become too high, the
hypothalamus in the brain starts to shut down the body
processes involving the hormone
• Females: increase facial and body hair, lower the voice,
increase muscularity and strength, reproductive
problems
• Males: stimulation and maintenance of the sex organs,
reduced facial and body hair, reduced sperm
production, and impotence
•  injuries to muscles, tendons, ligaments
• Adolescents: stunted growth
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Harmful Effects of Steroids (cont.)
• Liver cancer, high blood pressure, premature heart disease,
heart attack, stroke
• Roid Rage – heightened, uncontrolled aggression
• May appear as child abuse, domestic violence, suicide,
attempted murder
• Steroids are addictive – psychologically and physiologically
• Clinical depression when stop use
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Anabolic Steroids: Drug Holidays
• Athletes attempt to overcome above issues by
“pyramiding” or “stacking”
• Pyramiding:
• Beginning with lower dose, increasing to maximum dose and
then tapering down
• Stacking:
• Using numerous drugs and varying the dosage throughout the
cycle
• No scientific evidence to support either technique to be
more effective or to minimize harmful side effects
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Stimulants
• Increase the rate of heart, nervous, and respiratory
system
• Enhance performance by increasing alertness or weight
loss (amphetamines) to compete at lower weight
• Psychomotor - Amphetamines and diet supplements
• Sympathomimetic amines - Stimulate sympathetic and
autonomic nervous system
• Hallucinogens - Recreational/mind altering drugs
• Central nervous system - Ephedrine, and many over the
counter stimulants including caffeine in high amounts
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Hallucinogens
• Influence the individual’s perceptions of incoming stimuli by
slowing response and decision-making time, and inhibiting
attentional focusing
• Actually impairs sport performance
• Stimulants (e.g., cocaine) – increase somatic arousal
• Narcotic analgesics (e.g., marijuana, LSD, PCP) –reduce
pain (as an anti-inflammatory) and anxiety (as a sedative)
• These drugs are also against the laws of most countries
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Narcotic Analgesics
• Used by athletes as pain suppressants and enable an injured
competitor to continue playing despite tissue damage and
injury
• Anti-inflammatory effect
• Can also slow performance due to a sedative effect
• Codeine, heroin, opium, morphine
• Harmful effects = gastrointestinal disturbances, physical and
psychological dependence, and depressed respiration,
including respiratory arrest
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Beta-Adrenergic Blockers
• Aid performance by slowing the heart rate,
decreasing anxiety, and steadying natural
body tremors
• Used predominantly in rifle/pistol shooting,
archery, bowling, golf
• Harmful effects = bronchospasms, CNS
disturbances, hypotension, impotence
• Sport adverse effects: interfere with high
intensity, longer endurance tasks.
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Diuretics
• Increase the rate water and salt leave the body as urine
• Jockeys, wrestlers, and boxers use diuretics to make weight
for a competition
• Harmful effects = nausea, stroke, heat exhaustion, impairs
thermoregulatory control, blood clotting, reduced blood
volume, and muscle cramps
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Caffeine
• Caffeine increases alertness and arousal, thereby preventing
or overcoming mental and physical fatigue
• Prolongs endurance performance and high-intensity shortduration exercise
• Moderate caffeine intake commensurate with less than 18
ounces of coffee (IOC)
• Harmful effects = acts like a diuretic, so combined with
insufficient water intake, athletes internal body temperature
rises inducing premature fatigue and dangerous heat-related
illnesses
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Blood Doping
• Removing one liter of the athlete’s blood 1-2 months before
competition and freeze it, then inject red blood cells back
into the athlete before competition
• Increases oxygen uptake and thus aerobic (endurance)
performance
• Lasts 2 weeks
• Harmful effects = Hepatitis B or C as well as the HIV virus if
blood samples get mixed up
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Erythropoietin (Epo)
• Another kind of blood doping
• Ingest EPO – naturally secreted by the kidneys in
response to hypoxia that stimulate production of red
blood cells
• Enhances the body’s ability to transport oxygen to
peripheral exercising muscle
• Reduces onset of muscular fatigue and improves
regulation of internal body temperature, thus providing
an unfair advantage
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Creatine
• Regarded as both a nutritional and physiological
ergogenic aid
• NOT considered a steroid
• Assumed safe in reasonable amounts
• Legally available in health stores and fitness clubs
• Creatine supplementation may have a beneficial effect
only in certain types of performance like repetitive, highintensity, very short-term tasks with brief recovery
periods
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Human Growth Hormone (HGH) and
Gamma-Hydroxybutyrate (GHB)
• HGH is naturally secreted through the pituitary gland, but
has also been created through DNA technology
• Medically used to treat HGH deficiency, Turner’s syndrome, and
for relief from excessive burns
• It increases body mass while reducing fat mass
• Mixed evidence on performance enhancement
• Harmful effects = skull thickens, forehead and eyebrow
ridge becomes especially prominent; hands and feet grow
out of proportion with body
• GHB stimulates the release of human growth hormone
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Rationale for Anti-Drug Policy in Sport
• Legal, ethical, and medical issues:
• Violates state and federal laws if use for non-medical
purposes
• Cheating -- violates team rules and organizational policies
• Allowing athletes to ruin their health for short-term gain is
immoral
• May cause athletes physical and psychological harm
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How Widespread Is Drug Abuse in Sport?
• Anecdotal Evidence
• Information provided by individuals based on their own
experiences or perceptions
• 50% of athletes in high-performance sports…coaches
passively or actively encouraging drug use…examples from
history
• Scientific Evidence
• Centered primarily on performance-enhancing drugs like
anabolic steroids
• Asking athletes to honestly self-report drugs use is very
difficult, if not impossible
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Likely Causes of Drug Abuse in Sport
• Physical Causes
• Enhance sport performance
• Cope with pain and injury rehabilitation
• Weight control
• Psychological Causes
• Stress and anxiety
• Boredom
• Personal problems
• Low self-confidence and self-esteem
• Superman (Adonis) complex
• Negative Perfectionism
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Causes of Drug Abuse (cont.)
• Social Causes
• Peer pressure and acceptance
• Models (particularly with adolescents)
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Strategies for Controlling Drug Abuse
• Depends on:
•
•
•
•
The individual’s perceived needs for using
The type of drug usage
The sport’s physical demands
Situational factors
• Athletes share similar psychological demands and
performance requirements, so many of the issues can be
applied to competitors from various sports, skill levels,
genders, and cultures
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Strategies for Controlling Drug Abuse (cont.)
• Regulating drug use starts with organizational policy
• BUT the coach is the one person who has the most credibility
with the athlete and who is the most important agent in
preventing drug use on the team
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Cognitive Approaches for Controlling Drug
Abuse
• Influence the athletes’ behaviors and attitudes intellectually
and psychologically through verbal and nonverbal
communication
• Provide education
• Discuss ethical issues
• Recognize the athletes’ use of drugs
• Build confidence and self-esteem
• Professional counseling
• Motivational Interviewing
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Behavioral Approaches for Controlling
Drug Abuse
• Shape the environment to control and influence
subsequent behavior
• Teach sport skills and offer positive feedback
• Develop and implement a drug policy and plan of
action
• Have a continuous, random drug-testing program
• Use behavioral contracting
• Use a support group
• Invite guest speakers
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Intervention Models for Regulating Drug
Use in Sport
• Drugs in Sport Deterrence Model (DSDM)
• Influencing the athlete’s decision about using banned
substances by providing the possible and likely
consequences of using banned substances
• Disconnected Values Model (DVM)
• Assist athletes in acknowledging that taking drugs,
whether it is for performance-enhancing or recreational
purposes, is a negative habit that has benefits, but also
dire costs and long-term consequences
• Encouraging athletes to acknowledge the disconnect
between their values (competitiveness, fairness, health,
etc.) and their conscious decision to ingest substances
they knowCopyright
to be
illegal and unhealthy
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