Addiction Disorder in Athletes: Drugs and Gambling

Addiction Disorder in Athletes

Drugs and Gambling

Examples of Addiction

  • 30 Famous Athletes Who Have Battled Drug Addiction & Alcoholism

    • Reference: drugabuse.com

    • Notes:

    • Article includes examples of high-profile athletes struggling with addiction.

    • Some athletes struggle publicly, while many others suffer in silence.

Substance Definitions

  • Sources: US Dept of Health and Human Services, 2016

    • Substance Use:

    • Occasional, social, recreational, experimental use without associated problems.

    • Substance Misuse:

    • Heavy, risky, harmful use; may include:

      • Illicit or improper use

      • Problematic use that typically progresses to regular or serious use

    • Substance Use Disorders:

    • Clinically significant stress or impairment characterized by:

      • Excessive use

      • Excessive time spent using or recovering from use

      • Unsuccessful efforts to cut down on use

      • Intense cravings

      • Failure to meet significant obligations due to use

      • Continued use despite negative consequences

      • Reduced time spent on important activities due to use

      • Physically hazardous use

      • Tolerance or withdrawal symptoms when halting use

Gambling Definitions

  • Gambling Disorder:

    • Defined as persistent and recurring gambling behavior that leads to clinically significant distress or impairment (APA, 2013).

    • Classification: Non-Substance Related Disorder within the Substance-Related and Addictive Disorders Section

    • Characteristics include:

    • Need to gamble with increasing amounts to achieve excitement

    • Restlessness or irritability when attempting to stop or cut down

    • Unsuccessful efforts to control, cut back or stop gambling

    • Preoccupation with gambling or persistent thoughts about gambling experiences

    • Failure to meet important obligations due to gambling

    • Gambling as a response to distress

    • “Chasing losses” by returning to gamble after losses

    • Lying to conceal the extent of gambling involvement

    • Jeopardizing important aspects of life (job, relationships, education) due to gambling

    • Relying on others to relieve financial distress caused by gambling

Reasons for Substance Use and Gambling

  • Substance Use:

    • Experimentation

    • Pleasure and enjoyment

    • Socialization

    • Boost confidence

    • Increase alertness and energy

    • Relieve stress and negative emotions

    • Pain relief

  • Gambling:

    • Desire to win money

    • Enjoyment and fun

    • Social reasons and excitement

    • Thrill of competition

Prevalence of Substance Use Among Athletes

  • General Trends:

    • Athletes tend to use substances at lower rates compared to the general population.

    • US college athletes report lower use of:

    • Alcohol

    • Cigarettes

    • Marijuana

    • Stimulants (such as amphetamines and cocaine)

    • Ecstasy and LSD

    • Some sports or genders report higher use of specific substances than non-athletes.

  • Gambling:

    • Estimates indicate disordered gambling occurs in 2.9% to 15% of athletes, with a higher prevalence among men.

    • Elite athletes are particularly susceptible due to pressures associated with their sport.

Alcohol Use Among Athletes

  • General Findings:

    • Overall alcohol use rates are lower among many cohorts of athletes.

    • Binge drinking rates, however, are disproportionately high among elite male athletes in sports such as lacrosse, ice hockey, rugby, wrestling, and swimming.

    • Common reasons for alcohol consumption:

    • To alleviate performance anxiety before competitions

    • To reduce stress and foster social connections after competitions

Effects of Alcohol on Athletes

  • Negative impacts include:

    • Dehydration

    • Insomnia or poor sleep quality

    • Increased injury risk

    • Slower healing of injuries

    • Impaired psychomotor performance

    • tardiness and missing obligatory commitments due to use

    • Reduced glycogen resynthesis

    • Weight gain

    • Academic difficulties that may threaten athletic eligibility

    • Adverse mental health outcomes (e.g., depression, suicide tendencies)

Cannabinoids and Athlete Use

  • Cannabinoids:

    • The most widely used illicit substance among the general population and many athlete cohorts.

    • Notably, athletes use cannabis less than the general population.

    • Increased use in areas where cannabis is legally permitted for medical and recreational purposes.

    • Higher rates of cannabis use are observed among Division III athletes compared to Division I athletes.

    • Cannabidiol (CBD):

    • A natural compound found in cannabis plants that does not produce the psychoactive effects associated with THC (the component responsible for marijuana's high).

    • Important Note: Approximately 25% of CBD products may be contaminated with THC, leading to positive drug tests.

Nicotine Use Among Athletes

  • Forms of Nicotine Use:

    • Includes smoking (cigarettes, cigars), oral consumption (snuff), and vaping.

  • Prevalence:

    • Most common among lacrosse, baseball, and hockey players (men) and female lacrosse players.

    • Growing trend in vaping, with 8% of U.S. college athletes reporting recent use.

    • Reasons given for use (though unsupported by research):

    • Improvements in alertness and concentration

    • Increased energy and muscular strength

    • Enhanced endurance and relaxation

    • Weight control and relief from boredom

    • Reality: Performance decrements due to anxiety, insomnia, and respiratory infections.

Stimulants Use Among Athletes

  • Types of Stimulants:

    • Include caffeine, nicotine, prescription medications (most commonly for ADHD), methamphetamine, and cocaine.

  • Consumption:

    • Athletes often consume large amounts of caffeine through dietary supplements.

  • Purposes for Use:

    • To improve reaction time and concentration

    • Increase arousal and boost energy

    • Enhance memory and trigger relaxation and confidence

    • Responsibly administered doses may provide some performance benefits, but high doses or combination use (stacking) can impair performance.

Prescription Drug Misuse Among Athletes

  • Commonly Misused Substances:

    • Stimulants for ADHD and opioids for pain management are frequently misused.

  • Risks:

    • Athletes may begin by using opioids for pain management but develop physical and psychological dependence.

  • Effects of Opioids:

    • Sedation and impaired cognitive and psychomotor function

    • Slow reaction times, increasing injury risk

    • Muscle weakness and delayed recovery

    • Risks of slowed breathing and respiratory acidosis

    • Increased risk of depression, anxiety, and suicidal thoughts.

Sport Gambling

  • Overview:

    • Sport wagering involves betting on individual players and sporting events, including fantasy sports.

    • Fantasy sports evolved from seasonal formats to daily formats, increasing betting frequency.

    • Inplay or prop bets involve wagering on specific events or player performances during games.

    • Integrity implications due to potential anonymous betting against oneself for financial gain.

    • Betting can be done via peers, a bookmaker (manager of bets), or online platforms.

  • Relevant Resources:

    • Documentary reference: "The Fantasy Sports Gamble" from FRONTLINE for a deeper understanding of gambling addiction.

Mental Health Consequences of Gambling

  • Potential outcomes include:

    • Risky behaviors

    • Decreased academic and athletic performance

    • Underperformance in responsibilities at home or work

    • Social isolation and relationship difficulties

    • Mental health disorders (e.g., anxiety, depression, substance use disorders).

Prevention of Substance Use and Gambling

Drugs

  • Drug Testing:

    • Ensures fairness in competition.

    • Promotes athletes' health (via fear of a positive drug test).

  • Challenges:

    • Athletes may use masking agents to avoid detection.

    • Competition day testing may underestimate substance use prevalence.

    • More reliable methods include:

    • Team urine surveillance

    • Post-game testing

    • Repeat testing

    • Hair testing

    • Off-season and frequent testing

    • Healthcare providers should utilize:

    • Doping attitude scale and indirect questioning techniques (e.g., assessing thoughts on cannabis use without drug testing)

    • Interviews with athletes, teammates, parents, and coaches.

Gambling

  • Commonly referred to as the "hidden addiction" due to its undetectability.

    • Few educational programs exist in athletic institutions to address gambling prevention.

    • Need for comprehensive educational or in-service training initiatives in this domain.

Management of Drug Addiction

  • Strategies for Early Detection and Management

    • Implement substance screenings and general health screenings.

    • Conduct pre-participation physicals by licensed health professionals.

    • Motivational interviewing by licensed professionals may effectively prevent or decrease substance misuse.

    • Inclusion of key family members or support systems in sessions recommended.

    • Athletic trainers and advisors can utilize motivational interviewing to reduce binge drinking.

    • Individual and group therapy are vital components of treatment strategies.

    • Medication may aid in managing withdrawal, cravings, and comorbid symptoms (depression, anxiety, insomnia).

Management of Gambling Addiction

  • Comprehensive approach required, including:

    • Expanded screening processes

    • Brief interventions

    • Referrals for extensive treatment

    • Cognitive Behavioral Therapy (CBT) as primary treatment method

    • Brief motivational treatments and self-help groups as supportive measures

    • No approved medications available for gambling disorder currently.

Practical Action Steps Moving Forward

  • Encourage discussion among social support networks about substance use and gambling.

  • Screen athletes to identify potential issues.

  • Educate athletes on the negative impact of substance use and gambling on performance.

  • Remind athletes of rules prohibiting substances or gambling set by their leagues or associations.

  • Develop educational programs addressing substance use and gambling specific to the athlete population.

  • Refer athletes for screening and treatment regarding substance use disorders or gambling addiction.