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©William E. Prentice


When you finish this chapter you will be able to:

  • Discuss the issue of substance abuse in the athletic and physically active population.

  • Identify the signs of substance abuse.

  • Describe the effects of performance-enhancing drugs commonly used by athletes.

  • Discuss the negative effects of alcohol and tobacco on an athlete's health.

  • Identify the primary recreational drugs and their effects.

  • Briefly discuss drug-testing programs to identify the substance abuser.

The use of nutritional supplements by athletes to improve performance was discussed in Chapter 5. This chapter focuses on the abuse of a variety of substances, particularly drugs and medications, performance-enhancing drugs, and the negative impact they can potentially have on the health of the athlete.28

Certainly, concern about the number of athletes engaging in substance abuse is increasing (Focus Box 24–1).6 Some athletes use performance-enhancing drugs in an attempt to improve performance, whereas others use drugs as a recreational pursuit.15 The use of performance-enhancing drugs among recreational, middle school, secondary school, collegiate, professional, and Olympic athletes has been much written about and discussed.20 Clearly, use and abuse of performance-enhancing drugs has no place in the athletic population.17

image FOCUS BOX 24–1 Identifying an individual who may be using performance-enhancing drugs

The following are signs of potential abuse:

  1. Sudden personality changes

  2. Severe mood swings

  3. Changing peer groups

  4. Decreased interest in leisure activities

  5. Worsening grades

  6. Disregard for household chores and curfews

  7. Feeling of depression most of the time

  8. Breakdown in personal hygiene habits

  9. Increased sleep and decreased eating

  10. Sudden weight loss

  11. Lying, cheating, stealing, etc.

  12. Defensiveness at the mention of drugs

  13. Increased isolation (spends time in room)

  14. Deterioration of family relationships

  15. Others making observations about negative behavior

  16. Constantly missing appointments

  17. Falling asleep in class or at work

  18. Financial problems

  19. Missing assignments or deadlines

  20. Diminished productivity

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In sports medicine, the administration of a drug that is designed to improve the competitor's performance is known as doping.23 Doping has been defined as "the administration 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 in performance in sports."12

doping The administration of a drug that is designed to improve the competitor's performance.

The abuse of illegal substances is no longer the only risk for the athlete. There are many examples of medications prescribed by a physician that are being used to enhance performance in sport.18,19


The intention of the athlete when he or she ingests a stimulant may be to increase alertness; reduce fatigue; or in some instances, increase ...

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