Table 5.
Summary of substance use studies in elite athletes
| Authors | Type | Purpose | N (male:female) | Sport; country | Main findings |
|---|---|---|---|---|---|
| Dietze et al. [54] | Quantitative; cross-sectional, observational | Alcohol consumption and alcohol-related harms | 582 (582:0) | Australian Rules Football; Australia | In comparison with age- and sex-matched community scores, risky/high-risk consumption for long-term harm in players was lower during the playing season and higher during both the end-of-season period and the vacation period. Risky/high-risk drinking and short-term harm were frequent throughout the year, and reports of harmful effects of drinking and negative consequences were common (e.g. fighting while drinking). Club rules on alcohol consumption had little effect on outcome measures |
| Dunn et al. [55] | Quantitative; cross-sectional, observational | Prevalence of illicit drug use | 974 (736:238) | Various; Australia | One third of the sample had opportunity to use illicit drugs in the previous year; overall prevalence was lower than that reported by the general population. 7 % of the sample indicated use of at least one illicit drug in the previous year, and one fifth reported having ever used cannabis. Knowing other athletes who used illicit drugs, being offered or having opportunity to use drugs and identifying as a ‘full-time athlete’ significantly predicted recent drug use |
| Dunn et al. [57] | Quantitative; cross-sectional, observational | Illicit drug use and consensus estimates | 974 (736:238) | Various; Australia | Participants tended to report that there was a higher prevalence of drug use among athletes in general than among athletes in their sport, and these estimates appeared to be influenced by participants’ drug use history. While overestimation of drug use by participants was not common, this overestimation also appeared to be influenced by athletes’ drug use history |
| Dunn and Thomas [56] | Quantitative; cross-sectional, observational | Factors associated with illicit drug use | 1684 (1212:472) | Various; Australia | 8 % of the sample reported use of at least one illicit drug in the previous year. Predictors of use were identified: being offered or having opportunity to use illicit drugs in the previous year, knowing other athletes who used drugs and status as a full-time athlete. Athletes are part of a sports network (which includes family, coaches, support staff and other athletes), and these relationships may encourage use of, supply of and demand for drugs |
| Harcourt et al. [58] | Quantitative; longitudinal, experimental (no controls) | Illicit drug–testing programme | 640 (640:0) | Australian Rules Football; Australia | Steady decline in the annual number of positive tests over the 7 years of the programme. An association between alcohol consumption and illicit drug use was observed. Illicit drug use was mostly conducted away from team mates. Using a harm minimisation strategy can work effectively alongside relevant anti-doping codes |
| O’Brien et al. [59] | Quantitative; cross-sectional, observational | Hazardous drinking and level of sport participation | 430 (147:283) [270 in elite group] | Various; New Zealand | Elite sportspeople reported higher rates of hazardous drinking than non-sportspeople and non-elite sportspeople. International/country–level sportspeople also reported greater symptoms of dependence than other groups |
| O’Brien et al. [60] | Quantitative; cross-sectional, observational | Hazardous drinking and drinking motives | 1214 (630:584) [275 in elite group] | Various; New Zealand | Elite provincial sportspeople reported the highest level of hazardous drinking, and elite international sportspeople reported the lowest. Elite provincial sportspeople and elite international sportspeople placed more emphasis on drinking as a way to cope with the stresses of participating in their sports |
| Thomas et al. [61] | Mixed method; cross-sectional, observational | Knowledge of illicit drugs and information seeking | 974 (sex not reported) | Various; Australia | Athletes were confident in their knowledge of the effects of illicit drugs, such as cannabis and methamphetamine, but less confident in their knowledge of the effects of others (e.g. GHB and ketamine). Many felt that teammates would benefit from more information, delivered to athletes in a specific and relevant manner. Stigma was attached to information seeking |
| Waddington et al. [62] | Quantitative; cross-sectional, observational | Prevalence of illicit drug use | 706 (sex not reported) | Football; England | Recreational drugs were commonly used by professional footballers; 45 % knew players who used recreational drugs. One third of players had not been tested for drugs within the preceding 2 years, and 60 % felt that they were unlikely to be tested in the next year |
GHB gamma-hydroxybutyrate