Drugs and Sports - Athletes on Steroids
By: Venidikt • Research Paper • 1,567 Words • December 14, 2009 • 1,590 Views
Essay title: Drugs and Sports - Athletes on Steroids
As the use of performance enhancing drugs is becoming more popular among athletes, many of them don't understand the risks involved in taking these drugs. Many people are looking for a quick way to build muscle, or to get stronger the fastest way possible. Using these performance aids may very well be a quick fix for many athletes, but taking these supplements is unethical and dangerous. Using special drugs to boost an athletes performance is degrading to sports and to the athlete. The human body can produce the same substances naturally, without taking drugs, but people continue to load up on these supplements such as creatine or androstenedione. If the athlete is patient and works hard he can achieve the same strength that he would obtain using supplements. Athletes are trying to cheat using unnatural shortcuts to gain their muscle instead of spending the long hours in the weight room.
Athletes should not take these supplements because it is harmful to their health, to sports, and to future athletes who follow their example by using these dangerous substances. These ergogenic aids popularity is growing among young teenage athletes which see big superstars taking certain drugs and they expect their athletic ability to be boosted if they take these drugs too. On the contrary, taking these supplements are especially dangers when used by adolescents.
The ergogenic aid called creatine is used to build muscle mass very rapidly. Many people consume this supplement without even knowing the consequences or potential hazardous when they use this drug. It is true that creatine will build muscle mass in most people and it works fast, but in contradiction to that it may not work for everyone and there are side effects which are just barely being found out and many hazardous which are unknown. Beth Fontenot who is a nutrition consultant and freelance nutrition writer wrote, "Athletes taking creatine have reported muscle cramps, pulls, and tears, as well as stomach distress... In addition all of the studies that have been done to date have looked at creatine use for a short period of time, generally about a month. No one knows the effects of long [term] supplementation." This should cause great concern to athletes taking supplements such as creatine. The short term effects are very painful and can cause serious complications in the future. Also the long term effects which are unknown should be very worrisome. Would someone jump off a cliff not knowing how far of a drop it is to the ground" It is common sense to not use a drug when the consequences are unknown.
Body building supplements for the most part will give the extra energy an athlete needs to do a few more reps in the weight room, which will help build muscle faster. However, the dangers greatly outweigh the advantages. Writer for Newsweek, Karen Springen, states that, "If it were so dangerous...it wouldn't be used so widely."(68) In response to that Joannie M. Schrof, writer for U.S. News& world Report, quoted San Francisco Giants head physician William Straw, "Too many athletes decide to use supplements until they are proven dangerous, when they should be holding off until they are proven safe."(53) A lot of supplements claim great strength gains and athletic improvement, but athletes get to caught up in the advantages that they don't even wait to hear what the disadvantages are.
Another common misunderstanding is that because your body produces it naturally that it must be safe. "Americans assume that anything natural must be safe. That's the buzz about creatine, a muscle building supplement that's become as common as sweaty towels in gyms across the country." (Springen, Karen 68) This attitude of natural is safe is very ignorant. This "process...happens naturally: creatine is made in the liver and kidneys and [is] ingested in meat and fish. Yet athletes often consume 20 or more grams a day?the amount found in 20 eight-ounce steaks." (Spingen, Karen 68) Although creatine is naturally produced in your body using creatine supplements is overloading your system with creatine which can cause serious side effects. Short term side effects include: dehydration, muscle cramping and tearing, nausea, diarrhea, and other stomach discomforts. "As with many other alleged ergogenic aids, creatine seems so promising to so many?but in turn may hide dangers that no coach, athlete, or parent should ever accept." (Fontenot, Beth 11) Long term effects are completely unknown at this point. This should strike fear into athletes using these wonder drugs. Athletes might very well be damaging their bodies more than they know by taking these supplements.
Their have been many performance enhancing drugs in the
- MLA 7
(2009, 12). Drugs and Sports - Athletes on Steroids. EssaysForStudent.com . Retrieved 12, 2009, from https://www.essaysforstudent.com/essays/Drugs-and-Sports-Athletes-on-Steroids/25618.html
"Drugs and Sports - Athletes on Steroids" EssaysForStudent.com . 12 2009. 2009. 12 2009 <https://www.essaysforstudent.com/essays/Drugs-and-Sports-Athletes-on-Steroids/25618.html>.
"Drugs and Sports - Athletes on Steroids." EssaysForStudent.com . EssaysForStudent.com, 12 2009. Web. 12 2009. <https://www.essaysforstudent.com/essays/Drugs-and-Sports-Athletes-on-Steroids/25618.html>.
"Drugs and Sports - Athletes on Steroids." EssaysForStudent.com. 12, 2009. Accessed 12, 2009. https://www.essaysforstudent.com/essays/Drugs-and-Sports-Athletes-on-Steroids/25618.html.
- Paper Writer Free >
- Essays Examples >
- Essay Topics >
Good Research Paper On Steroid Use By Athletes
Type of paper: Research Paper
Topic: Sports , Athletes , Drugs , Study , Education , Performance , Medicine , Psychology
It is not easy to be a successful sportsman or an outstanding athlete today, as one has to prove to not only himself and the world, but also be ready to take care of the expectations of their coach, promoter, and sponsor. It seems the world no longer wants athletes but some freaks with incredible power and strength all the time. Thus, it is no surprise to see most athletes turning to taking steroids to up their performance and remain ahead of their rivals. The athletes too are becoming more demanding and have higher expectations from their bodies. The paper looks at the real side of taking those steroids and what risks the athletes are exposed to when taking those drugs to alarming levels and in combinations. Introduction Excelling in athletic competition is the aim of every high school or college as well as amateur and professional athletes. Athletes participate in different fitness and sports activities to pit their skills, strength and abilities against those of their peers. Nothing can be more satisfying than playing to their potential and winning against rivals. Unfortunately, the desire to excel and race ahead of others creates some athletes who are willing to go to any length to win and at any costs. After all, winning will give them instant fame and recognition, and over and, above all, the feeling of being superior. They do not think twice about using steroids to gain a competitive edge. Most of these athletes have little clue as to how those muscle-building supplements work and what positive or negative impacts can they have on their bodies (Anabolic Steroids and Sports). The athletic competition has intensified in the recent years, and this has led to an increasing numbers of athletes working hard to upgrade their performances. The coaches and players, both want to win and get recognized; the game is no longer about being fair and disciplined when competing. Although many athletes out there still follow traditional methods to reach their goals, majority of them are in a hurry and do not mind taking short cuts. The result is that an increasing numbers of athletes rely on anabolic steroids to improve their strength, endurance, and performance. The percentage of intercollegiate athletes using steroids was15%, and the numbers have risen to 20% in the eighties and still rising. What is shocking is that the even high school students are using steroids, and they are just 16 years of age or younger (Paul et al., 1990). The scandals related to anabolic steroid abuse at all levels of athletic competition from high school sports to the Olympics are plenty. The current status of toxicology studies on anabolic steroid use is limited. There is a need to do more studies on the benefits and risks of these drugs. Steroid efficacy studies often look into the anabolic effects of individual drugs (Paul et al., 1990).
Anabolic steroids are the derivatives of natural hormone testosterone and are used to treat certain anemias and stimulate sexual growth. Athletes believe that the drugs can improve their strength and aerobic performance, helping them gain muscle and body mass. There is a need for more research in this directions. However, these drugs do leave one with a feeling of euphoria followed by fatigue (Engel, 1989). Testosterone is the main anabolic steroid hormone that is made by the body, and it promote muscle building naturally as well as induces male traits such as deeper voice, facial hair, etc. Synthetic modifications of testosterone are used by athletes to boost their performance. Those synthetic hormones were made for medical uses, and were not meant for athletic performance. The anabolic steroids or the so-called designer drugs are created for athletes specifically illegally and do not carry approved medical use. Theory, these have not been not been approved by the Food and Drug Administration, and thus carry a potential threat Mayo Staff, (2015). It is a common understanding among athletes that they can improve their fitness level and strengths plus improve competitiveness and their performance only if they take anabolic steroids. Anabolic steroids are the chemical imitative of testosterone, the "male sex hormone." However, these athletes are only getting misguided by their parents, coaches, peers into believing that those steroids can help them archive their dreams. Athletes are known to take two or more anabolic steroids together and will even add painkillers and stimulates. The athletes believe that using different drugs will bring in faster results as compared to one drug (Anabolic Steroids and Sports).
Why Athletes take Steroids
Serious athletes are very serious about winning, and their drive to win can be fierce. There is nothing wrong with being competitive as long as the lines of sanity are not crossed. It is no surprise to see most of the athletes taking the short cuts to enhancing their power and building muscles by taking performance enhancing drugs that are company referred to as the ”roids.” These drugs are Anabolic steroids, erythropoietin, diuretics, human growth hormone, pump, etc. One should not confuse Anabolic steroids with the steroid medications that are very different. Anabolic steroids are known to build muscle tissue and increase body mass (Anabolic Steroids and Sports). As those drugs can make muscles bigger and help athletes to recover from a muscle damage quickly, they sound appealing to them. The athletes to work out harder without feeling over-trained or fatigued. Moreover, some athletes like those aggressive feelings that they get when they take the drugs Mayo Staff, (2015).
Do those steroids work?
Athletes taking steroids are not aware, but those steroids cannot help build their agility or skill. The athletic ability relies on several factors such as age, sex, diet, body size, as well as the persona training and stamina of the athlete. The dosage taken by athletes can be thirty times higher than the therapeutic amount, and this can lead to undesirable effects such as premature fusion of long bones and short stature in adolescent. They may also cause abnormal liver function, leading to hemorrhagic condition of the liver. They can result in a predisposition to atherosclerosis, and other adverse effects compose of acne as well as an increased number of injuries in the tendons, aggressiveness, hypertension (Engel, 1989). Subjects taking steroids do report noteworthy gain in bodyweight and strength. However, there are symptoms of depression, aggression, and paranoia (Paul et al., 1990). Controlling the abuse of anabolic steroids There has been an increasing interest in the scientific community regarding the use of anabolic-androgenic steroid use among the athletes. Recent evidences have shown that hundreds of thousands of Americans make use of anabolic steroids (Katz & Pope, 994). It is still not known as to how many of those athletes abuse anabolic steroids. There are several athletic associations such as Olympics, Major League Baseball (MLB), National Football League (NFL), National Collegiate Athletic Association (NCAA) that ban the use of drugs. The athletes are tested for the use of steroids, and there have been plenty of controversies relating to those issues. Players who test positive face suspension and if found positive for a second time are expelled from the League. The studies on Steroids Anabolic steroids are well tolerated and effective when administered under proper medical guidance. However, the abuse of anabolic steroids by athletes and sports person is getting common. About 3% of young American adults admit having taken anabolic steroids at least once in their lifetime. Another study points that the abuse of anabolic androgenic steroids has increased by 50% since the nineties (M & T, 2002). Another point to note is that the past studies on anabolic steroid efficacy are irrelevant by today’s standards. The athletes today are not only using higher doses, but taking multiple drugs at the same time. The sports medicine specialists need to become experts in an anabolic steroid pharmacology so that they can prevent the athletes from turning towards underground advice. According to some studies, there are side effects but they are temporary most of the time. In the real world, healthy athletes have not experienced drastic reactions such as liver cancer, sex changes, baldness, etc. There are personality disturbances seen in the steroid user group, but there is no individual personality disorder noted (Paul et al., 1990). Results were taken and compared with laboratory studies of steroids, clinical studies of steroids and naturalistic studies of athletes. The studies where steroids are given under prescription, and medical guidance do not reveal any major psychiatric effects. This is because the doses pf the steroids are far lower than used by the athletes. Laboratory studies where the doses were high led to modest but significant psychiatric effects. In contrast, the naturalistic studies of athletes showed marked psychiatric symptoms due to the use of steroids. Increase in aggressiveness, irritability, euphoria and depressive symptoms were seen during steroid withdrawal (Katz & Pope, 994).
Effects of steroids
The anabolic steroids carry anabolic, androgenic and anticatabolic effects, and they encourage size and strength gain. If used in large doses, they can interact with numerous receptors such as estrogen-, progesterone-, as well as minerals- and glucocorticosteroid receptors. This is the reason one finds adverse effects in the athletes abusing them. Animal studies on male monkeys and rats have shown that anabolic steroids can lead to direct toxic effects, and the changes are very similar to the phase of cardiac failure in humans. The animals showed an aggressive behavior and rats showed liver damage with a shortened life span (M & T, 2002). Anabolic steroids are taken by athletes in cycles that last from 6 to 12 weeks. However, there are athletes who are using those drugs on a relatively continuous basis. Athletes often take that steroid as combinations and move from lower daily dose at the beginning of the cycle to higher. Athletes further use diuretics, stimulants, human chorionic gonadotropin, antiestrogens and anti-inflammatories to improve physical capacity or to overcome the adverse effects of the steroids. Gradually they become dependent on the pattern of steroid use that tend to get longer as well as frequently repeated ( M & T, 2002).
The evidence from laboratory, medical and naturalistic studies suggest that use of steroids and their withdrawal may produce psychiatric effects. These effects are subtle when steroids are given in moderate doses but become prominent with marked increase doses, which are common among athletes (Katz & Pope, 994). Taking steroids may enhance athletic performance, but it is illegal and prohibited by most sports organizations, is illegal.
Anabolic Steroids and Sports: Winning at any Cost. (2008). Retrieved from https://www.health.ny.gov/publications/1210/Katz, D. L., & Pope, H. G. (1994). Psychiatric and medical effects of anabolic-androgenic steroid use: A controlled study of 160 athletes. Archives of General Psychiatry, 51(5), 375-382. doi:10.1001/archpsyc.1994.03950050035004M, P., & T, S. (2002). Steroid use and long-term health risks in former athletes. Sports Medicine, 32(2), 83-83. doi:10.2165/00007256-200232020-00001 Engel, N. S. (1989). Anabolic steroid use among high school athletes. MCN, the American Journal of Maternal/Child Nursing, 14(6), 417-417. doi:10.1097/00005721-198911000-00011Mayo Staff, (2015). Performance-enhancing drugs: Know the risks. Retrieved from http://www.mayoclinic.org/healthy-living/fitness/in-depth/performance-enhancing-drugs/art- 20046134 Paul J. Perry Kathleen H. Andersen William R. Yates. (1990). Illicit anabolic steroid use in athletes. The American Journal of Sports Medicine, 18(4), 422. doi:10.1177/036354659001800416
Share with friends using:
- Example Of Mental Health Of Children In Foster Children Literature Review
- Millet Essays
- Body Language Essays
- Model Essays
- Listening Essays
- Happiness Essays
- Belief Essays
- Strengths Essays
- Planning Essays
- Utilitarianism Essays
- Progress Essays
- Nonverbal Communication Essays
- Reflection Essays
- Integrity Essays
- Safety Essays
- Concentration Essays
- Attitude Essays
- Speech Essays
- Discipline Essays
- Vision Essays
- Beauty Essays
- Memory Essays
- English Essays
- Gold Essays
- The Outsiders Essays
- Gun Control Essays
- Constitution Essays
- Citizenship Essays
- Amendment Essays
- High School Essays
- Hazard Essays
- Bill Of Rights Essays
- Love Essays
- Trends Essays
- Chicago Essays
- Movies Essays
- Population Essays
- Cinema Essays
- Reality Essays
- Personality Essays
- Contrast Essays
- Reputation Essays
- Truth Essays
- Immigration Essays
- Fear Essays
- Fake News Essays
- Donald Trump Essays
Wait, have you seen our prices?
Sample research paper about steroids
Drugs generally referred to as ‘steroids’ can be categorized as anabolic and corticosteroids. Corticosteroids are drugs prescribed by the doctors to help managing inflammation in the human body and mostly used in conditions such as lupus and asthma. They are, in fact, not similar to the anabolic steroids which receive a high degree of media attention as they are used by some bodybuilders and athletes. Anabolic steroids can boost the ability of body to prevent breakdown of muscle and increase muscle growth. (Llewellyn, 2007)
To understand steroids and how they work in the body, it is pertinent to define the concept of Anabolic steroids. Anabolic means building up, as contrary to catabolic which means breaking down. The term ‘Anabolic steroids’ is related to synthesizing or manufacturing derivatives specifically of the male hormone, testosterone. There are two major functions of testosterone on the body, the androgenic and anabolic effect. The anabolic effect is mainly responsible for muscular development, growth and the adult male’s masculine body contour. The androgenic impact provokes the growth of the male secondary features after puberty, resulting in the growth of pubic hair, beard, voice change and development of penis.
Anabolic steroids basically work by arousing the anabolic effect either by binding or plugging into the cells that ultimately help in generating new proteins specifically in the cells. This enhanced biological activity is known as an enhancement in Ribonucleic Acid Activity. The creation of new proteins ultimately results in increasing muscle strength and size. The steroids increase or stimulate this particular biological process by connecting to the receptor sties.
Steroids can also increase retention of nitrogen which is also a biological activity. Nitrogen is present in proteins where it performs building tissues. The users of steroids experience a constructive nitrogen balance which is a preferred condition where ingestion of nitrogen from protein is much more than excretion of nitrogen.
Anabolic steroids are particular drugs similar with the chemical structure of the human body’s sex hormone ‘testosterone’, made naturally within body. Testosterone ultimately directs the body to enhance or produce male features discussed above. When the level of testosterone is increased by the anabolic steroids in blood, they result in stimulating muscle tissue to grow stronger and larger. However, the impact of excess testosterone circulating in the human body can be much harmful in the long run. (Willey, 2007)
There is no concrete evidence that exclusive high steroids doses can result in muscle growth through a specific chemical effect. In most of the animal species, the much higher quantity of anabolic steroids produces no significant muscle growth as a normal dose would. Nevertheless, evidence suggests that steroids increase muscle growth provided they are taken with scrupulous physical training and also an increased protein diet.
Once a person takes drug, it is processed in the body including four major processes; absorption; distribution; metabolism; and excretion. In ‘Absorption’, drugs are generally administered orally or intravenously. In case, drugs are processed orally, then absorption is more complex as compared to the scenario when administered intravenously. The ‘Distribution’ process involves the drug transportation all the way through blood stream. ‘Metabolism’ can be described as the chemical change created by the drug in the body. The main place where this change occurs is the liver where most of the people face problems by using steroids. ‘Excretion’ is the removal of drug from the person’s body. (Willey, 2007)
Anabolic steroids are, in fact, more toxic to the liver where they are excreted and metabolized. It is firmly believed that the side effects resulting from usage of steroids are actually dose related. Most of the body builders take high steroids than they actually need to view the desired results. However, it is not necessary to take four tablets when only one is effective.
The major risk associated with the steroids is a serious damage to liver. As is the case, the liver is more amazing and versatile organ in the body. Almost three pints of blood, in every minute, pass through liver. At one particular time, about ten percent of entire blood in the body is found in the liver. Liver stores, glycogen, copper, sugar, vitamin A, some B vitamins and also vitamin D. (Willey, 2007)
In case a liver is not working properly, the human body can face high complexities. When steroids are taken orally, they should be detoxified by liver via metabolism process already discussed. The liver then has to work much harder for abolishing toxins or poisonous substances produced by steroids. Resultantly, inflammation or hepatitis of the liver can take place. Hepatitis can lead directly to cirrhosis of the liver, a state of progressive scarring. Cirrhosis is a severe disease that kills all cells in the liver, ultimately resulting in liver failure. (Roberts, 2006)
Effects of steroids on Young Athletes
A primary objective of youth sports is to support young athletes observe and experience significant life lessons, developing a physically, healthy active lifestyle. Continuous improvement of young athletes is a vital part of the entire process. As discussed above, the anabolic steroids impact the metabolism in each and every cell. However, in some cells metabolism produce the required adaptation such as increase in the size of muscle, while in other cells creating complexities like changed lipid metabolism specifically in the liver.
Training, exercise or proper nutrition is needed for muscle growth without any extra amount of fat. For instance, in football, Olympic weight lifting and different other sports, the aim is to become explosively strong. In such cases, the steroids work in combination with a certain weight training and dietary regime particular to those sports. On the other hand, for long distance runners or road cyclists, the aim is to be capable in maintaining an extensive training load and at the same time keeping light body weight. As such anabolic steroids may be used to support these athletes recovering from such training. (More, 2004)
Anabolic steroids are specifically designed to take off the bodybuilding features of testosterone. The amount of testosterone can be significantly increased in the human body by using these anabolic steroids, which further supports the human body in muscle growth. As such the anabolic impact of steroids attracts attention of athletes who require an increase in strength and muscle mass.
An increasing number of young athletes use steroids as an instant shortcut for the purpose of performing better. However, when younger athletes use steroids either through injection or orally, they are, in fact, exposing their health and body to a wide array of threats. Buying or using steroids without a physician’s prescription is dangerous as well as illegal. (More, 2004)
Anabolic steroids have considerable effects on the moods of young athletes. Athletes taking steroids on regular basis become more irritable, aggressive and angrier, ultimately becoming depressed after they have stopped using steroids. In some cases, usage of steroids can also cause psychotic episodes. In case of boy athletes, steroids can not only terminate the growth of athlete but may cause facial blemishes, shrinking of testicles, the development of breasts and increased weight.
In girl athletes, steroids can result in the development of some male characteristics and acne can also be aggravated. More grave reactions, in young athletes of both sexes, have been associated with steroids like heart attacks, suicidal behavior and liver damage. As such it is essential for the coaches and parents to realize the phenomenon that anabolic steroids can have different grave side effects. Moreover the long-term risks associated with using steroids far outweigh the possible short-term benefits.
There are some exclusive factors related to using steroids by young athletes. Steroids load up a young athlete, especially in teenage, with synthetic testosterone. As discussed above, it can lead ultimately to premature puberty while among complexities are; premature puberty in young athletes using steroids with growth plates that are particularly open in bones causing such growth plates to close before time. (Roberts, 2006)
Several studies have highlighted a relation of steroid usage with different other high-risk attitudes such as having insecure sex, driving drunk and using other illegal drugs. Young athletes are placed in a high-risk group and as such using steroids intensifies the problem. A better solution to increase awareness about the negative and long-term effects of steroids in young athletes is to provide education about risks associated with steroids and programs for supervised confrontation training to increase substantial strength.
Difference of Steroid Abuse in Men and Women
Steroids, similar to all drugs, have many side effects- most of them can be dangerous for health while other simply undesirable. Because drugs treated as steroids can affect women and men differently, it is pertinent to separately focus on steroids abuse in both. Steroid abuse is found to be higher in men as compared with women, although the trend of abusing steroid among young women is increasing. People are motivated to abuse the steroid due to an intense desire for reducing fats in body, building muscles and improving performance in sports. Bodybuilders, according to an estimate, are the high users of anabolic steroids, while it is also widespread in other sportspersons. Some of the men abusing anabolic steroids view their body as weak and small, even if they are muscular and large. On the other hand, women abuse such drugs as they perceive their looks are obese, although they are actually muscular and lean.
Other reasons of abusing anabolic steroids by women include endeavors to lose weight. Many women eat healthy and attend gym when they are just few pounds away from normal weight, resorting to drugs. These women are more focused on different celebrities who although look thin but have considerable muscles. (Assael, 2007)
Even though, anabolic steroids assure a toned human body with specific muscle mass, yet thin. Women are of the view that recovery time from exercises is far less when they use anabolic steroids. Moreover, they also think that their mental capabilities become much shaper by using steroids. Women also abuse anabolic steroids as they perceive it to improve body image and self esteem along with increased sexual energy.
Most of the men abuse steroids to attain perfect body as they are in continuous scrutiny. Even though, the motive is becoming thin, it is, in fact, muscular body, that remains as the main attraction for abusing steroids by men. The general consensus is that the issues relating to body image commence in high school as well as in college, when men are viewed as sexual. The overall atmosphere of high schools and colleges is competitive and boys feel much insecure as compared with their friends. It has been highlighted that serious risks are related with steroid abuse, but most of the time people ignore the threats or not seeks support because they do not view themselves as drug users. (Assael, 2007)
Assael, S (2007) Steroid Nation: Juiced Home Run Totals, Anti-aging Miracles, and a Hercules in Every High School: The Secret History of America’s True Drug Addiction. ESPN; Ist edition
More, J (2004) Steroids, Sports, and Body Image: The Risks of Performance-Enhancing Drugs. Enslow Publishers
Llewellyn, W (2007) Anabolic 2007: Anabolic Steroids Reference Manual. Body of Science.
Roberts, A (2006) Anabolic Steroids: Ultimate Research Guide. Anabolic Books, LLC.
Willey, W (2007) Better Than Steroids. Trafford Publishing; Ist edition
An official website of the United States government
The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.
The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
- Account settings
- Advanced Search
- Journal List
- Subst Abuse Rehabil
Drug abuse in athletes
Claudia l reardon.
Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
Drug abuse occurs in all sports and at most levels of competition. Athletic life may lead to drug abuse for a number of reasons, including for performance enhancement, to self-treat otherwise untreated mental illness, and to deal with stressors, such as pressure to perform, injuries, physical pain, and retirement from sport. This review examines the history of doping in athletes, the effects of different classes of substances used for doping, side effects of doping, the role of anti-doping organizations, and treatment of affected athletes. Doping goes back to ancient times, prior to the development of organized sports. Performance-enhancing drugs have continued to evolve, with “advances” in doping strategies driven by improved drug testing detection methods and advances in scientific research that can lead to the discovery and use of substances that may later be banned. Many sports organizations have come to ban the use of performance-enhancing drugs and have very strict consequences for people caught using them. There is variable evidence for the performance-enhancing effects and side effects of the various substances that are used for doping. Drug abuse in athletes should be addressed with preventive measures, education, motivational interviewing, and, when indicated, pharmacologic interventions.
Doping, defined as use of drugs or other substances for performance enhancement, has become an important topic in virtually every sport 1 and has been discovered in athletes of all ages and at every level of competition. 2 – 4 See Table 1 for rates of use of a variety of substances, whether doping agents or recreational substances, among different populations of athletes as reported in various recent research studies. 5 – 10 Of note, self-reports are generally felt likely to yield under-reported figures. 5 Importantly, performance-enhancing drugs (PEDs) are not restricted to illegal drugs or prescription medications, such as anabolic steroids. 11 They include dietary supplements and a variety of compounds that are available at grocery and health food stores and online. 12
Substance use rates among different populations of athletes as reported in various recent research studies
Abbreviation: WADA, World Anti-Doping Agency.
Drug abuse in the athlete population may involve doping in an effort to gain a competitive advantage. Alternatively, it may involve use of substances such as alcohol or marijuana without the intent of performance enhancement, since athletes may develop substance use disorders just as any nonathlete may.
Athletes may turn to substances to cope with numerous stressors, including pressure to perform, injuries, physical pain, and retirement from a life of sport (which happens much earlier than retirement from most other careers). 13 Additionally, athletes may be significantly less likely to receive treatment for underlying mental illnesses such as depression. 14 Athletes receive comprehensive treatment and rehabilitation for physical injuries, but this may be less often the case for mental illness, because of their sometimes viewing mental illness as a sign of weakness. 14 Untreated mental illness is often associated with substance use, perhaps in an effort to self-treat. Alternatively, substances of abuse may cause mental illness. 15
We will especially focus on doping in this review, which specifically aims to serve as a single paper that provides a broad overview of the history of doping in athletes, the effects of different classes of drugs used for doping, side effects of doping, the role of anti-doping organizations, and the treatment of affected athletes.
Materials and methods
For this review, we identified studies through a MEDLINE search. Search terms included the following, individually and in combination: “doping”, “athletes”, “steroids”, “drug abuse”, “mental illness”, “drug testing”, “anti-doping”, “psychiatry”, “sports”, “depression”, “substance abuse”, “substance dependence”, “addiction”, “history”, “side effects”, “drug testing”, “treatment”, “androgens”, “testosterone”, “growth hormone”, “growth factors”, “stimulants”, “supplements”, “erythropoietin”, “alcohol”, “marijuana”, “narcotics”, “nicotine”, “Beta agonists”, “Beta blockers”, “diuretics”, “masking agents”, “gene doping”, “National Collegiate Athletic Association”, and “World Anti-Doping Agency”. We restricted results to the English language and used no date restrictions. We retrieved all papers discussing drug abuse in athletes. We reviewed the findings of each article, and reviewed the references of each paper for additional papers that had been missed in the initial search and that might include findings relevant to the scope of our review. Ultimately, 67 manuscripts or chapters were felt relevant and representative for inclusion among those referenced in this paper.
History of doping in athletes
The belief that doping is only a recent phenomenon that has arisen solely from increasing financial rewards offered to modern day elite athletes is incorrect. 16 In fact, doping is older than organized sports. Ancient Greek Olympic athletes dating back to the third century BC used various brandy and wine concoctions and ate hallucinogenic mushrooms and sesame seeds to enhance performance. Various plants were used to improve speed and endurance, while others were taken to mask pain, allowing injured athletes to continue competing. 17 – 19 Yet, even in ancient times, doping was considered unethical. In ancient Greece, for example, identified cheaters were sold into slavery. 1
The modern era of doping dates to the early 1900s, with the illegal drugging of racehorses. Its use in the Olympics was first reported in 1904. Up until the 1920s, mixtures of strychnine, heroin, cocaine, and caffeine were not uncommonly used by higher level athletes. 16
By 1930, use of PEDs in the Tour de France was an accepted practice, and when the race changed to national teams that were to be paid by the organizers, the rule book distributed to riders by the organizer reminded them that drugs were not among items with which they would be provided. 20
In the 1950s, the Soviet Olympic team began experimenting with testosterone supplementation to increase strength and power. 16 This was part of a government-sponsored program of performance enhancement by national team trainers and sports medicine doctors without knowledge of the short-term or long-term negative consequences. Additionally, when the Berlin Wall fell, the East German government’s program of giving PEDs to young elite athletes was made public. 1 Many in the sporting world had long questioned the remarkable success of the East German athletes, particularly the females, and their rapid rise to dominance in the Olympics. Young female athletes experienced more performance enhancement than did male athletes. Unfortunately, they also suffered significant and delayed side effects, including reports of early death in three athletes. 19
The specific substances used to illegally enhance performance have continued to evolve. 21 The “advances” in doping strategies have been driven, in part, by improved drug testing detection methods. 21 To avoid detection, various parties have developed ever more complicated doping techniques. 21 Further, new doping strategies may result from advances in scientific research that can lead to the discovery and use of substances that may later be banned. Over the past 150 years, no sport has had more high-profile doping allegations than cycling. 16 However, few sports have been without athletes found to be doping.
Many sports organizations have come to ban the use of PEDs and have very strict rules and consequences for people who are caught using them. The International Association of Athletics Federations was the first international governing body of sport to take the situation seriously. 22 In 1928, they banned participants from doping, 22 but with little in the way of testing available, they had to rely on the word of athletes that they were not doping. It was not until 1966 that the Federation Internationale de Football Association and Union Cycliste Internationale joined the International Association of Athletics Federations in the fight against drugs, closely followed by the International Olympic Committee (IOC) the following year. 23
The first actual drug testing of athletes occurred at the 1966 European Championships, and 2 years later the IOC implemented their first drug tests at both the Summer and Winter Olympics. 24 Anabolic steroids became even more prevalent during the 1970s, and after a method of detection was found, they were added to the IOC’s prohibited substances list in 1976. This resulted in a marked increase in the number of doping-related disqualifications in the late 1970s, 24 notably in strength-related sports, such as throwing events and weightlifting.
While the fight against stimulants and steroids was producing results, 24 the main front in the anti-doping war was rapidly shifting to blood doping. 25 This removal and subsequent reinfusion of an athlete’s blood in order to increase the level of oxygen-carrying hemoglobin has been practiced since the 1970s. 25 The IOC banned blood doping in 1986. 25 Other ways of increasing the level of hemoglobin were being tried, however. One of these was erythropoietin. 25 Erythropoietin was included in the IOC’s list of prohibited substances in 1990, but the fight against erythropoietin was long hampered by the lack of a reliable testing method. An erythropoietin detection test was first implemented at the 2000 Olympic Games. 25
In the 1970s and 1980s, there were suspicions of state-sponsored doping practices in some countries. The former German Democratic Republic substantiated these suspicions. 25 The most prominent doping case of the 1980s concerned Ben Johnson, the 100 meter dash champion who tested positive for the anabolic steroid stanozolol at the 1988 Olympic Games in Seoul. 25 In the 1990s, there was a noticeable correlation between more effective test methods and a drop in top results in some sports. 25
In 1998, police found a large number of prohibited substances, including ampoules of erythropoietin, in a raid during the Tour de France. 25 , 26 The scandal led to a major reappraisal of the role of public authorities in anti-doping affairs. As early as 1963, France had been the first country to enact anti-doping legislation. Other countries followed suit, but international cooperation in anti-doping affairs was long restricted to the Council of Europe. In the 1980s, there was a marked increase in cooperation between international sports authorities and various governmental agencies. Before 1998, debate was still taking place in several discrete forums (IOC, sports federations, individual governments), resulting in differing definitions, policies, and sanctions. Athletes who had received doping sanctions were sometimes taking these sanctions, with their lawyers, to civil courts and sometimes were successful in having the sanctions overturned. The Tour de France scandal highlighted the need for an independent, nonjudicial international agency that would set unified standards for anti-doping work and coordinate the efforts of sports organizations and public authorities. The IOC took the initiative and convened the First World Conference on Doping in Sport in Lausanne in February 1999. Following the proposal of the Conference, the World Anti-Doping Agency (WADA) was established later in 1999.
Performance-enhancing effects of substances used by athletes
There is a research base demonstrating that many doping agents are in fact performance-enhancing. However, some substances (eg, selective androgen receptor modulators, antiestrogens, and aromatase inhibitors), used in an effort to enhance performance, have little data to back up their effectiveness for such a purpose. Note that the studies cited in this paper are chosen as being historically important or representative of the bulk of the research on the topic, and the broad overview provided in this paper does not aim to cite all evidence on the effects of these substances. Additionally, research on this topic is limited by the difficulty in performing ethical studies due to the high doses of doping agents used, potential side effects, and lack of information on actual practice.
Androgens include exogenous testosterone, synthetic androgens (eg, danazol, nandrolone, stanozolol), androgen precursors (eg, androstenedione, dehydroepiandrosterone), selective androgen receptor modulators, and other forms of androgen stimulation. The latter categories of substances have been used by athletes in an attempt to increase endogenous testosterone in a way that may circumvent the ban enforced on natural or synthetic androgens by WADA.
Amounts of testosterone above those normally found in the human body have been shown to increase muscle strength and mass. For example, a representative randomized, double-blind study involved 43 men being randomized to four different groups: testosterone enanthate 600 mg once per week with strength training exercise; placebo with strength training exercise; testosterone enanthate 600 mg once per week with no exercise; and placebo with no exercise. This was a critical study in demonstrating that administration of testosterone increased muscle strength and fat-free mass in all recipients, and even moreso in those who exercised. 27 A second study from the same investigators 5 years later further demonstrated a dose–response relationship between testosterone and strength. 28 Another double-blind trial of exogenous testosterone involved 61 males randomized to five different doses of testosterone enanthate, ranging from 25 mg to 600 mg, along with treatment with a gonadotropin-releasing hormone agonist to suppress endogenous testosterone secretion. That study demonstrated findings similar to the previous one, in showing a dose-dependent increase in leg power and leg press strength, which correlated with serum total testosterone concentrations. 29
Androgen precursors include androstenedione and dehydroepiandrosterone (DHEA). We found no evidence that androstenedione increases muscle strength. 30 DHEA is available as a nutritional supplement that is widely advertised in body building magazines as a substance that will improve strength. However, results from placebo-controlled studies of DHEA in males have been mixed. 30 , 31 One study involved 40 trained males being given DHEA 100 mg per day, androstenedione, or placebo, with no resulting differences in muscle mass or fat-free mass between groups. 30 A second study involved nine males and ten females randomized to receive DHEA 100 mg daily or placebo for 6 months, who were then crossed over to the other group for a further 6 months. The males but not females showed increased knee and lumbar back strength during DHEA treatment. 31
Selective androgen receptor modulators are not approved for use in humans in any country, but athletes are able to obtain these substances on the Internet. 32 No studies were found looking at the effects of selective androgen receptor modulators on muscle strength or mass in humans.
Other forms of androgen stimulation include exogenous human chorionic gonadotropin, antiestrogens such as tamoxifen, clomiphene, and raloxifene, and aromatase inhibitors such as testolactone, letrozole, and anastrozole. These substances may result in increased serum testosterone. 33 However, we found minimal research demonstrating an effect on muscle strength. 34 While androgens of different forms have been shown to improve muscle strength and mass, they have not been shown to improve whole body endurance per se. 35
Growth hormone and growth factors
Growth hormone and growth factors are also banned by WADA. Research shows recombinant human growth hormone to increase muscle mass and decrease adipose tissue. One representative study randomized male recreational athletes to growth hormone 2 mg/day subcutaneously, testosterone 250 mg weekly intramuscularly, a combination of the two treatments, or placebo. 36 Female recreational athletes were randomized to growth hormone 2 mg daily or placebo. In both males and females, growth hormone was associated with significantly decreased fat mass, increased lean body mass, and improved sprint capacity (although with no change in strength, power, or endurance). Sprint capacity improvement was even greater when growth hormone and testosterone were coadministered to males.
Growth factors include insulin-like growth factor and insulin. They are presumed to have similar effects to growth hormone, but have not been studied in athletes. 37 Athletes use these substances because of their apparent anabolic effect on muscle. 37
Stimulants include amphetamine, D-methamphetamine, methylphenidate, ephedrine, pseudoephedrine, caffeine, dimethylamylamine, cocaine, fenfluramine, pemoline, selegiline, sibutramine, strychnine, and modafinil. Research has shown stimulants to improve endurance, increase anaerobic performance, decrease feelings of fatigue, improve reaction time, increase alertness, and cause weight loss. 38 Of note, while WADA bans stimulants as a class, it does allow use of caffeine. Energy beverages now often include a variety of stimulants and other additives including not only caffeine, but also the amino acids taurine and L-carnitine, glucuronolactone, ginkgo biloba, ginseng, and others. 39 Caffeine content can be up to 500 mg per can or bottle. The potential performance benefits of the other ingredients in energy beverages are unclear. For example, taurine may improve exercise capacity by attenuating exercise-induced DNA damage, but the amounts found in popular beverages are probably far below the amounts needed to be of performance-enhancing benefit. 39
Of note, the number of athletes, especially at top levels of competition, reported to be using stimulant medications has markedly increased in recent years. In the USA, the National Collegiate Athletic Association acknowledged that the number of student athletes testing positive for stimulant medications has increased three-fold in recent years. 40 There has also been concern about inappropriate use of stimulants in major league baseball in the USA. According to a report released in January 2009, 106 players representing 8% of major league baseline players obtained therapeutic use exemptions for stimulants in 2008, which was a large increase from 28 players in 2006. 41 Therapeutic use exemptions allow athletes to take otherwise banned and performance-enhancing substances if their physician attests that they should for medical reasons.
Nutritional supplements include vitamins, minerals, herbs, extracts, and metabolites. 39 Importantly, the purity of these substances cannot be guaranteed, such that they may contain banned substances without the athlete or manufacturer being aware. Studies have shown that many nutritional supplements purchased online and in retail stores are contaminated with banned steroids and stimulants. 42 Thus, athletes could end up failing doping tests without intentionally having ingested banned substances. 42 Creatine is not currently on the WADA banned list and is the most popular nutritional supplement for performance enhancement. 3 Studies demonstrate increased maximum power output and lean body mass from creatine. 43 , 44 As such, some allowable nutritional supplements may have ergogenic effects, but may have insufficient evidence supporting their ergogenic properties to rise to the level of being banned.
Methods to increase oxygen transport
Substances athletes use to increase oxygen transport include blood transfusions, erythropoiesis-stimulating agents such as recombinant human erythropoietin and darbepoetin alfa, hypoxia mimetics that stimulate endogenous erythropoietin production such as desferrioxamine and cobalt, and artificial oxygen carriers. Transfusions and erythropoiesis-stimulating agents have been shown to increase aerobic power and physical exercise tolerance. 45 However, the ergogenic effects of the other agents are debatable. 45
Other recreational drugs
Other recreational drugs that may be used in an attempt to enhance performance include alcohol, cannabinoids, narcotics, and nicotine. 13 WADA does not currently ban nicotine but bans cannabinoids and narcotics. Alcohol is banned in six sports during competition only. All of these substances may be used by athletes to reduce anxiety, which may be a form of performance enhancement, but we found little research looking at actual performance enhancement from these agents. Narcotics are used to decrease pain while practicing or playing. Nicotine may enhance weight loss and improve attention. 46
There is debate as to whether beta-2 adrenergic agonists, for example, albuterol, formoterol, and salmeterol, are ergogenic. 47 There is anecdotal evidence of improvements in swimmers who use these substances prior to racing. 48 Additionally, oral beta agonists may increase skeletal muscle, inhibit breakdown of protein, and decrease body fat. 48 However, there is some evidence suggesting that swimmers may have a relatively high prevalence of airway hyperresponsiveness due to hours spent breathing byproducts of chlorine, such that beta agonists may be needed to restore normal, not enhanced, lung function. 49
Beta blockers such as propranolol result in a decreased heart rate, reduction in hand tremor, and anxiolysis. These effects may be performance-enhancing in sports in which it is beneficial to have increased steadiness, such as archery, shooting, and billiards. 48
Other prescription drugs
Diuretics and other masking agents may be used as doping agents. 12 Diuretics can result in rapid weight loss such that they may be used for a performance advantage in sports with weight classes, such as wrestling and boxing. 12 Diuretics may also be used to hasten urinary excretion of other PEDs, thereby decreasing the chances that athletes will test positive for other banned substances that they may be using. 12 Masking agents in general conceal prohibited substances in urine or other body samples, and include diuretics, epitestosterone (to normalize urine testosterone to epitestosterone ratios), probenecid, 5-alpha reductase inhibitors, and plasma expanders (eg, glycerol, intravenous administration of albumin, dextra, and mannitol). 50
Glucocorticoids are sometimes used by athletes in an attempt to enhance performance because of their anti-inflammatory and analgesic properties. 12 However, there is minimal research to show any performance benefits of this class of drugs.
Athletes may also use phosphodiesterase-5 inhibitors in an attempt to attain increased oxygenation and exercise capacity, since they have vasodilatory effects. 51 However, again, little research exists to support a performance benefit from these substances.
Psychiatric medications, including antidepressants, anxiolytics, antipsychotics, and anticonvulsants, are generally not on the WADA banned list. 14 Bupropion is an antidepressant that is on the WADA 2014 monitoring list, meaning WADA is monitoring for any concerning trends of inappropriate use. One small study of nine males suggested that bupropion, when used acutely in warm environments, may allow athletes to push themselves to higher body temperature and heart rates without perceiving greater effort. 52 Otherwise, there is very minimal evidence that any of these classes of psychiatric medications enhance performance. 14
Nondrug performance-enhancing measures
Gene doping is a concerning potential method of nondrug performance enhancement and is banned by WADA. The potential to directly affect strength and endurance through gene manipulation has been demonstrated in laboratory mice, but no human athletes thus far have been found to be using this method. 16
Additionally, athletes may legally attempt to improve physical performance in a number of nondrug ways. 53 These have varying degrees of research into their effectiveness and safety, and include hypoxia induction techniques. 53 For example, athletes may train at high altitudes, which can result in erythrocytosis. Some studies suggest that a high–low method of sleeping at high altitude followed by training at low altitude is a better training strategy than training or sleeping at either high or low altitudes alone. 54 Some athletes have tried sleeping at simulated high altitude by using low oxygen tents. Athletes may also make dietary changes to try to increase hemoglobin levels. 55 , 56
Side effects of substances used by athletes
It is presumed that most if not all doping agents have potential short-term and/or long-term side effects. Unfortunately, given the high doses of these agents used by athletes, it is difficult to confirm such effects. It would be unethical to give dosages as high as those used by athletes for performance enhancement effects to participants in research studies. 16 Knowledge about side effects may be gleaned from empirical observation, reports of admitted users, and effects in patients prescribed such agents for medical conditions. Table 2 lists the potential side effects of various forms of doping. 57 – 59
Potential side effects of different substances and methods of doping
Note: Copyright © 2013. John Wiley & Sons. Adapted with permission from Baron DA, Reardon CL, Baron SH. Doping in sport. In: Baron DA, Reardon CL, Baron SH, editors. Clinical Sports Psychiatry: An International Perspective . Oxford, UK: Wiley; 2013. 16
Anti-doping organizations, drug testing in athletes, and rules
Drug testing typically occurs only in organized, competitive sports. At the college level, organizations such as the National Collegiate Athletic Association 60 and individual member institutions conduct standard drug testing programs and enforce penalties for positive tests.
Elite athletes competing at international and national levels are subject to standardized anti-doping guidelines under the auspices of WADA and related national organizations. WADA is the international independent agency that publishes the World Anti-Doping Code, which is the document harmonizing anti-doping policies in all sports and all countries. 61 The Code was first adopted in 2003 and became effective in 2004. The Code sets forth specific anti-doping rules and principles that are to be followed by the anti-doping organizations responsible for adopting, implementing, or enforcing anti-doping rules within their authority, including the IOC, International Paralympic Committee, international sport federations (for example, the International Cycling Union), major event organizations, and national anti-doping organizations (for example, the US Anti-Doping Agency).
WADA revises and publishes its list of banned substances approximately annually. It specifies those banned substances and methods that are prohibited at all times (both in-competition and out-of-competition) because of their potential to enhance performance in future competitions or their masking potential, and those substances and methods that are prohibited in-competition only. The list may be expanded by WADA for a particular sport.
WADA has also taken the lead in the development of the athlete biological passport concept. 61 WADA’s athlete biological passport operating guidelines took effect in 2009. The fundamental principle of the athlete biological passport is based on the monitoring of selected parameters over time that indirectly reveal the effect of doping, as opposed to the traditional direct detection of doping by analytical means. This concept gained momentum as a result of questions raised during the 2006 Olympic Winter Games surrounding suspensions of athletes by their federations following health checks that reported high hemoglobin levels. An athlete’s passport purports to establish individual baseline hormone/blood levels, which are monitored over time for significant changes. A positive test result would consist of too dramatic a change from the established individual baseline. This approach is intended to protect athletes from false-positive tests resulting from naturally occurring high levels of endogenous substances, while catching those attempting to cheat by using naturally occurring substances.
In the event that an athlete and his or her medical providers feel it necessary, for documented medical reasons, that he or she continue to take a banned substance, WADA may consider granting a therapeutic use exemption, a concept mentioned earlier. A therapeutic use exemption must be on file before an athlete tests positive for the substance allowed by that therapeutic use exemption.
Treatment of affected athletes, including counseling and psychiatric support
The first level of addressing the problem of drug abuse by athletes is prevention. 13 Drug screening is used in higher-level athletics both to deter athletes from using drugs and to punish and offer opportunities for rehabilitation to those who are found to have done so. Didactic education is another method aimed at prevention. 62 On the one hand, some authors and clinicians feel that among the most effective preventive strategies for drug abuse in sports is frequent, accurate, very closely observed, truly random urine drug testing. 13 , 63 However, some view drug testing as ineffective at preventing use of PEDs. 64 The argument for the latter is that these interventions target doping behavior rather than athlete attitudes. Athletes ultimately focus on their performance, and thus may view doping as rational behavior. 63 Moreover, knowledge of the potentially dangerous consequences from doping imparted via didactic education does not necessarily dissuade athletes. For example, in 1997, Bamberger and Yaeger surveyed 198 Olympic athletes. When asked if they would use PEDs under the hypothetical conditions of knowing they would not be caught and knowing their use would result in victory, 195 of 198 responded “yes”. Moreover, if the caveat was added that they would die within 5 years, 61% of the athletes still said they would use them. 65
There is little research available to guide counseling and psychiatric approaches to treatment of athletes who abuse drugs. 64 However, motivational interviewing approaches have been suggested for athletes with drug abuse or doping problems, since athletes may often present in the precontemplation stage of change. 13 , 64 Important elements of motivational interviewing include: 64
- Clinician empathy
- Developing discrepancies between where the athlete wants to go in life after sport and the impact that continued use of the substance might have on those goals. During this process, the provider helps athletes to clarify conflict among their values, motives, interest, and behaviors.
- Rolling with resistance. When resistance inevitably occurs, providers should avoid arguing with athletes, as that can exacerbate resistance to change. The provider may “agree to disagree” on certain points with some athletes. Providers may propose or “wonder about” certain alternative viewpoints or actions, but they do not impose or insist upon them.
- Encouragement of self-efficacy. Athletes may need to shift their viewpoint from one of being willing to do whatever it takes to win, to acknowledging that they would use PEDs only if ultimately incapable of succeeding without them (with the hope that athletes will never get to that point). If an athlete is physically dependent on a drug, then additional strategies may be needed. These may include pharmacologic interventions such as naltrexone, acamprosate, or disulfiram for alcohol dependence, or buprenorphine for opiate dependence. 13 Additionally, providers should assess for comorbid mental illness, since co-occurrence of physical dependence and mental illness is commonplace. 13 Any underlying mental illness should be treated. 13 A recent review paper on the epidemiology of mental illness in athletes noted that some mental illnesses such as depression are probably as common in athletes as nonathletes. 14 Twelve-step facilitation, cognitive behavioral therapy, and network therapy are also approaches that may be helpful for athletes who are abusing drugs, although studies are preliminary. 10 , 13 , 66
Conclusion and suggestions
Drug abuse in athletes is a significant problem that has many potential underlying causes. The drive to be the best in sport dates to ancient times, as does the use of performance-enhancing substances. With the ever-mounting pressures faced by athletes, it is not surprising that drug abuse by athletes exists across essentially all sports and age groups.
Suggestions for those undertaking research and clinical work with athletes include:
- If providers become aware of an athlete using PEDs, they should educate the athlete about the potential risks of continued use, regardless of any evidence that suggests this may not be influential for all athletes. Providers should encourage discontinuation of the abused substance(s).
- There is great variance in drug testing programs in different sports and at different levels of competition. 13 More high-quality, prospective, randomized trials should be undertaken to determine the deterrent efficacy of various types of PED screening programs, and changes should be made to those types of screening programs found to be ineffective. 8
Common signs and symptoms of substances relatively commonly used by athletes
Note: Copyright © 2013. John Wiley & Sons. Adapted with permission from Morse ED. Substance use in athletes. In: Baron DA, Reardon CL, Baron SH, editors. Clinical Sports Psychiatry: An International Perspective . Oxford, UK: Wiley; 2013. 8 , 13
- The efficacy of education about PED use as a preventative measure needs further study. Early integration of well designed prevention curricula into sports programs may be beneficial. 8 However, as alluded to earlier, at least one preliminary study suggests that educational programs that solely emphasize the negative effects of PEDs may be ineffective for young athletes. 67
- Mental health professionals should be included in the network of team doctors and other health care providers readily available to athletes. Psychiatrists are often helpful in developing strong drug prevention policies that emphasize education and treatment and not just sanctions. 13 Mental health care professionals should have a year-round presence with the athletes and teams with whom they are working so as to build trust. 13
- Screening for and treatment of underlying mental illnesses such as depression that may contribute to self-treatment with drugs by athletes should be increased. The effectiveness of this screening should be studied.
- Athletes who are using drugs are often skeptical of the medical field. This may be partly with good reason, as many health care professionals are unfamiliar with the mentality of athletes or common drug abuse patterns in this population. Accordingly, referral networks or team assistance programs consisting of health care professionals familiar with these issues should be established for athletes and teams. 62 The effectiveness of these models should be studied.
- Research should examine differences in treatment approaches that may be needed for athletes who have been using drugs for a shorter versus longer period of time.
Trainers, coaches, and health care providers should provide evidence-based, safe alternatives to PED use, including optimal nutrition, weight-training strategies, and psychological approaches to improving performance, all of which may help with athletes’ confidence in their natural abilities.
The authors report no conflicts of interest in this work.
- Mission & Purpose
- University leadership
- Academic Annual Report
- Accreditation and Licensures
- Join as faculty
- Campus locations
- Media Resources
- Press Releases
- Workforce Solutions
Bachelor of Science in Business with a Marketing Certificate
We are looking for teachers and leaders who possess a lifelong desire to learn and who want to inspire similar passions in the next generation.
The College of Education encourages students to flex their minds and muscles as teachers, physical therapists, and athletic trainers.
Jalan Zamrud Raya Ruko Permata Puri 1 Blok L1 No. 10, Kecamatan Cimanggis, Kota Depok, Jawa Barat 16452
You get wide range of high quality services from our professional team
The College of Education Manages programs that will help shape the future of FAMU!
Elevate Your Experience
- Lander at University Center of Greenville
- Study Abroad
- EYE Program
Fans help make Padres’ Fernando Tatis Jr. a Platinum Glove winner
Gold, Platinum Gloves the first significant honors for Fernando Tatis Jr. since steroid suspension
- Show more sharing options
- Copy Link URL Copied!
Fernando Tatis Jr. is apparently back in the good graces of fans.
Days after winning his first Gold Glove in his first year in right field, Tatis on Friday was named the NL’s Platinum Glove Award-winner, an honor that combines an international fan vote with the Society for American Baseball Research’s Defensive Index to name the best overall defender in each league.
Online voting began after Tatis was named a Gold Glover on Sunday.
Guardians second baseman Andres Gimenez was named the AL winner.
Presenting the 2023 Rawlings Platinum Glove Winners for the National and American League! Congratulations to Fernando Tatis Jr. & Andrés Giménez! #TeamRawlings pic.twitter.com/wDScOu3tRK — Rawlings Baseball (@RawlingsSports) November 11, 2023
Tatis is the first Padre and the first outfielder from the NL to win the Platinum Glove, which was first awarded in 2011.
The Gold and Platinum gloves are Tatis’ first honors since he was suspended in 2022 for performance-enhancing drugs, a ban that included the first 20 games of this season.
While his numbers at the All-Star break in his first year in right field — .871 OPS, 16 homers, 14 steals in 70 games — were worthy of inclusion, fans did not vote him into the starting lineup as they did in 2021 and . The players left him off the roster as a reserve .
Four months later, Tatis can add two significant pieces of hardware to his mantel, the Gold Glove decided on by a combination of managers/coaches and SABR’s metric and the Platinum Glove awarded by a combination of a fan vote and SABR.
Go deeper inside the Padres
Get our free Padres Daily newsletter, free to your inbox every day of the season.
You may occasionally receive promotional content from the San Diego Union-Tribune.
More from this Author
Padres’ Juan Soto lands fourth straight Silver Slugger Award
Nov. 9, 2023
Minors transaction tracker: Tirso Ornelas remaining with Padres on new deal
Nov. 7, 2023
Offseason leagues: Braden Nett, Jakob Marsee rep Padres in Fall Stars Game
Nov. 6, 2023
Padres’ Fernando Tatis Jr., Ha-Seong Kim both bring home Gold Gloves
Nov. 5, 2023
Seth Lugo will opt out of Padres contract, become free agent
Nov. 2, 2023
Padres’ Blake Snell the players’ choice for NL’s top pitcher
More in this section.
Padres will try to improve club in different offseason environment
Extra playoff spot means more teams believe they can contend. The competition for players should make for a compelling offseason.
Nov. 11, 2023
Padres, military were aligned long before the team began wearing camo jerseys
The most famous is San Diego’s native son, Ted Williams, who, like Jerry Coleman, was a Marine pilot during WWII and Korea.
Nov. 10, 2023
Padres in the process of interviewing Phil Nevin for manager’s job
Former Padres slugger managed Angels past two seasons and makes offseason home in Poway
Padres plan to address Juan Soto’s future with team this offseason
Padres will confer Soto’s camp regarding potential long-term deal while also entertaining trade possibilities
Nov. 8, 2023
Padres notes: Manager soon; challenge of adding starting pitching; improvement in center is a must
Padres focused on players at GM meetings, plan to name manager by next week; team seeks next Seth Lugo, Michael Wacha to bolster rotation
Padres have lots to do this offseason. Signing Shohei Ohtani is probably not one of those things.
Padres, who have a starting rotation to fill with limited funds, are more likely to trade Juan Soto than sign Shohei Ohtani
Check your email inbox for instructions from us on how to reset your password.
How does this work
Viola V. Madsen
- Business Plans
- PowerPoint Presentations
- Editing and Proofreading
- Annotated Bibliography
- Book Review/Movie Review
- Reflective Paper
- Company/Industry Analysis
- Article Analysis
- Custom Writing Service
- Assignment Help
- Write My Essay
- Paper Writing Help
- Write Papers For Me
- College Paper Writing Service
Research papers can be complex, so best to give our essay writing service a bit more time on this one. Luckily, a longer paper means you get a bigger discount!
Verification link has been re- sent to your email. Click the link to activate your account.