Substance Use Disorders In Professional Athletes

Many people look up to professional athletes as role models. However, despite their income, ambition, and talent, professional athletes are not exempt from succumbing to drug or alcohol use disorders.

For many professional athletes, training begins at a very young age. As they grow older and decide to pursue sports as their career, it becomes one of the most important elements of their life, consuming a great deal of time and energy. Sometimes, this pressure can lead to unhealthy coping mechanisms, like drug and alcohol misuse.

Profession-related reasons that can lead to substance abuse include:

  • Performance enhancement
  • Self-treatment of injuries
  • Self-treatment of mental illness
  • Stress management
  • Early retirement (triggering feelings of depression and worthlessness)

Professional Athletes And Mental Health Disorders

According to the National Institute of Mental Health, about 1 in 5 American adults live with a mental health condition. A professional athlete who has a mental illness may postpone seeking treatment or attempt to hide it from their peers, fearing the disruption it could cause to their career.

Research has found that athletes are significantly less likely to receive treatment for underlying mental illnesses, like depression, compared to non-athletes. This may be because they view their illness as a weakness and attempt to self-medicate.

Untreated mental illness is associated with substance abuse. Studies have uncovered that there is an increased consumption of alcohol, tobacco, and other drugs in high-performance athletes when compared to the general population. This may be because they view their illness as a weakness and attempt to self-medicate.

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Steroid Abuse In Professional Athletes

Appearance and performance enhancing drugs (APEDs) differ from other drugs like cocaine and marijuana in that they do not produce a euphoric high. Athletes who use anabolic-androgenic steroids to enhance their athletic performance or to improve muscle mass can cause irreversible damage to their bodies and develop a substance use disorder (SUD).

When used correctly and under medical supervision, anabolic steroids are used to treat certain types of anemia and breast cancer and help patients gain weight or muscle after a serious illness or injury. It becomes abuse when someone starts using this drug outside of a doctor’s orders, often to get an advantage in athletic performance.

There are severe consequences for professional athletes that are caught using APEDs. Individuals can be suspended or banned from their sport, putting their entire livelihood at risk. Despite the risks, athletes still abuse these drugs, potentially to try and deal with the pressure to perform. This demonstrates the motivation athletes have to achieve victory at any cost, ignoring the detriments that performance enhancing drugs can have on the body.

Researchers asked 198 Olympic athletes if they would use performance-enhancing drugs to achieve victory, without the risk of getting caught, hypothetically. Out of the 198, 195 said they would use the drugs.

Anabolic steroids can be taken orally, applied to the skin in cream or gel form, or injected intramuscularly. Users may practice “plateauing,” a technique where steroids are staggered, overlapped, or substituted with another type of steroid to avoid developing tolerance.

Steroids are used to increase lean muscle mass and strength, and some believe that they make muscles recover faster from injury, although this has not been proven. Depending on how long someone is abusing steroids, side effects may subside when they stop taking the drug or become permanent. According to the National Institute on Drug Abuse, side effects include:

  • High blood pressure
  • Blood clots
  • Heart attacks
  • Stroke
  • Artery damage
  • Short stature (if taken during adolescence)
  • Tendon injury
  • Aggression
  • Mania
  • Delusions
  • Peliosis hepatis
  • Tumors
  • Hepatitis
  • Severe acne and cysts
  • Abscess at injection site
  • Jaundice

In Women:

  • Excessive body hair growth
  • Male-pattern baldness
  • Voice deepening
  • Decreased breast size
  • Coarse skin

In Men:

  • Shrinking of the testicles
  • Male-pattern baldness
  • Testicular cancer
  • Decreased sperm production
  • Enlarged breasts

Substance Use Guidelines For Professional Athletes

Substance use guidelines and regulations, including banned substances, change often and vary greatly among collegiate and professional sports leagues.

For example, the National Basketball Association (NBA) and Major League Baseball (MLB) have removed cannabis from their lists of prohibited substances, while the National Football League (NFL) allows off-season use but will still test for it and, in some cases, discipline those who use it during the regular season.

While sports organizations try to state their drug policies clearly, the ever-changing rules and attached repercussions can cause confusion, sometimes making it difficult to stay within use guidelines.

In response to this, many sports organizations have dedicated agencies and associations committed to the oversight of drug use and abuse prevention. For example, the United States Anti-Doping Agency is the official agency for the US Olympic and Paralympic Committee, providing education and testing to Olympic athletes. Its website provides resources where athletes can check their medications against the list of banned substances and stay up to date on the latest news. Likewise, the NFL Players Association provides information on their banned substances and testing policies on their website, including approximate testing dates and exemptions for therapeutic use.

While these resources are beneficial, they may not be enough to dissuade or help someone with an established SUD. Fortunately, there are rehabs for professional athletes that can help them get back on a path towards health and success.

Rehab For Professional Athletes

Seeking treatment is vital for athletes facing substance and alcohol use disorders. However, professional athletes have considerations that the general population does not have when deciding on a treatment center for a drug or alcohol program.

Privacy And Confidentiality

Confidentiality is a major concern, as professional athletes may fear their reputation being harmed if it is public knowledge that they struggle with substance abuse. While strict privacy and confidentiality policies are ensured for all in treatment, extra precautions, like the signing of non-disclosure agreements by staff, can be implemented for athletes.

Emphasis On Physical Health

To maintain their physical health, professional athletes may need health-focused amenities, such as specialized gyms, pools, or tennis courts. On-site personal trainers or trainers brought in by their agency are often available so that the athlete can maintain their regular workout routine.

Health And Wellness

Professional athletes often have specific, regimented diets, which are important to maintain in rehab. Rehab facilities will often have personal chefs who can easily accommodate any diet restrictions or modifications the athlete requests.

Many treatment centers may be able to provide some of these services; however, luxury rehabs can offer high-end amenities that allow athletes to recover and heal in the most comfortable environment. Private rooms, private therapy, and 24-hour medical care are other beneficial services often found at luxury rehab.

Treatment For Professional Athletes

At the start of the treatment process, a plan will be created to include detox, treatment, and successful aftercare. For those addicted to drugs like benzodiazepines or alcohol, a medically supervised detox will be conducted to start ridding the body of the substance. It is never recommended to try and detox alone, as detoxing from certain substances can be fatal.

Counseling and psychiatric support will be a major facet of rehab for professional athletes. Some research has found success with the counseling approach of motivational interviewing. This approach helps patients change their behavior by exploring their motives. Along with clinician empathy, research published by the National Institutes of Health states that part of this tactic includes, “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.”

A Note On Treatment Medications

Depending on the substance, pharmacologic interventions may be implemented to ease the process. These medications can help ease withdrawal symptoms and reduce the likelihood of relapse during detox and recovery. However, while beneficial to many, athletes and their providers need to be aware of any contraindications or career complications the use of these medicines could cause.

For example, given in low doses, methadone is often used in the treatment of those with opioid use disorders. However, its effects of sedation and cardiac complications would not be compatible with an athlete’s lifestyle. It is also listed as a banned substance by the World Anti-Doping Agency, so it could be a harmful treatment option for active athletes.

It’s important for the athlete, their personal care team, and their treatment team in rehab to discuss all banned substances and take into consideration any adverse effects before utilizing treatment medications.

Get Help Today

Rehab can provide the tailored treatment necessary to help athletes take back their lives from substance and alcohol misuse. Contact a treatment provider today to answer any rehab-related questions and explore your treatment options.