A strategy to reduce illicit drug use is effective in elite Australian football-Peter R Harcourt

The World Anti-Doping Agency (WADA) conducts drug testing for performance-enhancing and illicit drugs on competition days, but recreational illicit drug use by athletes during non-competition periods remains a health and welfare concern. This paper reports on the first 7 years (2005-2011) of the Australian Football League's (AFL) Illicit Drugs Policy (IDP), which introduced non-match day testing.

Methods

Players in the AFL were tested for illicit drugs both in-competition (under the WADA-compliant Anti-Doping Code, ADC) and out-of-competition (under the IDP). IDP tests were random or targeted, with the number of tests increasing annually and focused on high-risk non-competition periods. The IDP utilized a harm minimization approach, including player education, confidential counseling for initial detections, and sanctions only for third detections.

Results

There were no positive match day tests recorded under the ADC. However, during non-competition periods, there was a significant reduction in positive illicit drug tests over the 7 years (from 19 detections in 2005 to 6 in 2011; p<0.0001). The detection rate decreased from 4.03% to 0.4%. This reduction correlated with a 350% increase in testing and strategic targeting of high-risk times. A trend away from cannabinoid use was observed, likely due to their long detection window and increased out-of-competition testing. Most detections were associated with alcohol use and occurred away from teammates, suggesting recreational, opportunistic use rather than performance enhancement. The majority of players (77 out of 80) admitted to drug use after detection.

Conclusions

The study concludes that an illicit drug program employing a harm minimization strategy can effectively run alongside a WADA-compliant Anti-Doping Code. The AFL IDP successfully modified player behavior, improving player health and welfare outcomes. The findings suggest that increased testing can deter illicit drug use, and harm minimization approaches should be considered in managing illicit substance use in elite sports, complementing punitive measures.