Sunday, July 18, 2010

Why Do Young Athletes Use Performance-Enhancing Substances?

Watching sporting events such as the Tour de France, one is amazed at the ability of the cyclists to perform day after day. These are truly amazing athletes. Unfortunately, the Tour has a very checkered history of substance abuse and many riders have been disqualified because of illegal use of performance-enhancing substances (PES). But cycling is not alone in battling the problem of illegal drug use in sports. A disturbing trend in this battle is that younger and younger athletes are choosing to use banned or illegal PES as a means to improve performance. Research and news reports suggest that some begin experimenting with drugs as early as upon entering high school. How rampant is PES use? What are the factors that influence an athlete’s decision to use PES? These questions were addressed in a recent Canadian study. The answers provide insight into how the use of PES may be prevented.

The researchers surveyed 3573 male and female athletes in the province of Quebec. Subjects ranged in age from 10-20 years (average of 15.5 years) and came from a variety of sports, including soccer. The questionnaire asked each athlete if they had used individual substances one or more times over the past 12 month. 29 different substances were listed. Of these, 15 were illegal or on the IOC list of banned substances. The athlete were also asked about the factors that influenced their decision to use PES including personal attitudes and external / environmental factors.

A large percentage of the athletes reported using several non-prohibited substances to enhance performance. These included things like chocolate recovery drinks, over the counter medications (aspirin, Tylenol, etc), vitamin supplements and soft drinks.

The most troubling finding is that more than 25% of the athletes reported to having used one or more banned substances to improve performance. Among these compounds were anabolic steroids, caffeine, Sudafed, amphetamines and other stimulants.

The study also focused on the reasons why young athletes turned to banned substances in order to improve performance. There seemed to be four key influences. First, those who felt that PES would help level the playing field and help them make it to the “next level” were more inclined to use banned substances. Factors such as high cost or detection tests did not seem to discourage use. Second, those who surround the athlete influence drug use. If coaches, parents and doctors either encourage or fail to discourage PES use the more likely he/she will use a banned compound. Undue pressure to excel can also push the athlete towards substance use. Third, athletes seem to weight the advantages and disadvantages of PES. If they feel that enhanced performance comes at little risk, they are more likely to use. The reverse is also true – if the disadvantages outweigh the advantages, they are less likely to take PES. Lastly, athletes who feel that it is morally wrong to use illegal or banned substances are much less likely to use that those who see nothing wrong in using.

The bottom line, one in four teenage athletes reported to have used one or more illegal or banned substances in order to improve performance. The factors influencing the athlete’s decision to use illegal PES lies both in his/her attitude towards and knowledge about drug use as well has the psychosocial environment created by parents, coaches and doctors.

So what can be done to dissuade young athlete from using illegal and banned PES? Based on this study it appears that legislation is not terribly effective. Athletes don’t seem to factor in issues such as cost, testing and disqualification. The most effective approach seems to be education and surrounding players with coaches, doctors and parents who will provide a positive environment that discourages use. An environment where drug use is not the norm and excessive pressure to excel is absent. Also, providing athletes with accurate facts regarding the effectiveness and side effects of various substances could help athletes in decision-making. Research has shown that many of the compounds used have questionable benefits. On the other hand, many have very serious side effects, both long-term and short-term. For example, research strongly suggests the performance benefits of human growth hormone are far, far less than is reported in the news media. The adverse effects on young athletes, however, can be quite severe. Finally, the researchers suggest that a final piece of the prevention puzzle is delivering a message that is morally persuasive. Convincing athletes that it is morally wrong to engage in an illegal activity to gain a competitive advantage may be a key to dissuading PES use.


Goulet C, Valois P, Buist A, Cote M (2010) Predictors of the use of performance enhancing substances by young athletes. Clinical Journal of Sports Medicine, 20:243-248.