Prevalence of Substance Abuse in Sports

1. Prevalence of Substance Abuse in Sports • Accurate assessment is difficult to achieve because of the sensitive and personal nature of the problem. • High profile athletes struggle with drugs:_________________________________ • High profile athletes and banned substances:_________________________________

2. Prevalence of Substance Abuse in Sports • Most studies have focused on alcohol and steroid use: • Alcohol use: 55% of high school athletes, over 80% of college athletes. • Performance-enhancing drugs: up to 5% of high school and college athletes report using them (higher % among elite athletes, especially in past).

3. Why Athletes and Exercisers Take Drugs • Physical reasons include wanting to: • enhance performance • treat injury • look better • control appetite and lose weight

4. Why Athletes and Exercisers Take Drugs • Psychological reasons include wanting to: • escape from unpleasant emotions or stress • build confidence or enhance self-esteem • get buzzed/wasted or seek fun/ excitement • Social Reasons include: • emulating athletic heroes • peer pressure

5. Ergogenic Aids - Definition • Any substance or treatment that either directly improves physiological variables associated with exercise performance or removes subjective restraints that may limit physiologic capacity

6. Ergogenic Aids • Types • Psychological • Mechanical • Pharmacological • Physiological • Nutritional

7. Doping Definition (USOC) • “…..the administration of or use by a competing athlete of any substance foreign to the body or of any physiological substance taken in abnormal quantity or taken by an abnormal route of entry into the body, with the sole intention of increasing in an artificial manner his/her performance in competition is regarded as doping..”

8. Psychological Phenomena • Hypnosis • Music • Performance Enhancement Techniques (PST) • “Placebo Effect” / Superstitions

9. Mechanical Factors • Clothing • Equipment • Heat and Cold Application • Improved Body Mechanics • Environment (Playing Conditions and Surface)

10. Pharmacological Agents • Over the Counter Drugs: • Caffeine, Nicotine, Amphetamines, Melatonin….etc; • “Recreational” Drugs: • Alcohol, Marijuana, Cocaine…….etc; • Prescription Drugs: • Anabolic Steroids, Benzodiazepines, Beta-Adrenergic Agents…….etc;

11. Caffeine’s Proposed Ergogenic Effect • Increased mental alertness/concentration • central nervous system stimulant • Elevated mood • Decreased fatigue • Enhanced catecholamine release • Improved muscular strength

12. Caffeine (Con’t) • Effect Depends on: • Individual caffeine status • Individual variability • Caffeine dosage and administration • Illegal (>12ug/ml) • approx.. 5-6 cups of strong coffee or 4 vivarin for a 150 pound person consumed 2-3 hours before performance • Problems: • caffeine is a diuretic; impairs heat tolerance; • stomach upsets; nervousness

13. Alcohol as an Ergogenic Aid • source of energy (?); one beer appr. 150 calories, 13 grams of carbohyd. and 13 grams of alcohol • “uneconomical” - more oxygen needed to metabolize a gram of alcohol than a gram of carbohydrates or fat • psychological effect: reduced anxiety, less muscle tremor (archery, not supported by research); greater self-confidence

14. Alcohol continued • negative effects on performance; • increased heart rate and oxygen consumption • increased blood pressure and blood lactate • increased reaction time • impaired hand-eye coordination and visual perception • currently not banned by IOC except for shooting competitions

15. Anabolic Steroids • Testosterone (must be injected or it will be destroyed by digestive enzymes) • Anabolic Androgenic Steroids (AAS) • synthetic drugs designed to mimic the effects of testosterone; taken orally or injected • Human Growth Hormone (anabolic) • used like steroids to increase muscle mass • Beta Adrenergic Agents (Clenbuterol)

16. Ergogenic Effect and Side Effects of AAS • Increase muscle mass; decrease body fat; improve strength even without training • Side Effects (AAS): • acne; hair loss; male secondary sex characteristics like deepening of the voice; • increased aggression, depression, hostility, suicide attempts, tendency to commit violent acts; • cardiovascular disease (elevated cholesterol, blood pressure) • severe liver damage;tumors (Alzado)….. etc

17. Effects and Side Effects of Growth Hormone • hormone secreted by pituitary gland; stimulates bone and muscle growth; effects protein, carbohydrate and fat metabolism • currently no data showing ergogenic effects beyond the effect generated by strength training • may lead to diabetes; thickening of soft tissue in face, hands and feet; enlargement of organs such as liver

18. Effects and Side Effects of Clenbuterol (asthma; illegal in U.S.) • increase lean muscle mass and strength; decrease body fat • less potent than anabolic steroids • side effects: • tachycardia • muscle tension • headaches and dizziness

19. Physiological Agents • Bicarbonate Loading • Blood Doping • Erythropoietin (EPO) • Altitude Training • Glycerol • Phosphate Loading

20. Erythropoietin - EPO • Hormone produced by kidneys to stimulate the bone marrow to produce red blood cells • Has same effect as “blood doping” and altitude training (more efficient use of O2) • Illegal • Dangers: increased blood viscosity, clotting potential, increased risk for stroke and heart failure, or pulmonary edema

21. Nutritional Agents / Supplements • Amino Acid Supplementation • Bee Pollen • Carbohydrate Loading • Carnitine • Coenzyme Q-10 • Creatine Phosphate • Water or Special Beverages

22. Ergogenic Effect Supported by Research • Legal Supplements • Creatine Phosphate (equivocal) • Caffeine • Altitude training (equivocal)

23. Vitamins as Ergogenic Aids • Bee Pollen: • mixture of vitamins, minerals, amino acids and other nutrients thought to improve performance • Coenzyme Q10 (ubiquinon): • facilitates aerobic metabolism as part of the electron transport chain (classified as a vitamin) • Ergogenic Effect not supported by Research

24. “There is still no sphere of nutrition in which faddism, misconceptions, ignorance, and quackery are more obvious than in athletics..”(M.H. Williams in Nutrition for Fitness and Sport, 4th ed., 1995)