Sports and Substance Abuse

Sports have long been touted as a way to prevent teenagers from using drugs and/or alcohol at a young age. However, recent studies indicate that sports participation may actually increase the risk of substance abuse in some teenagers.1,2 While performance enhancing drugs are part of the problem, participation in some sports is correlated with higher rates of alcohol consumption and illicit drug use, especially marijuana.1

Considering this information, parents should be aware of the risks and warning signs for teenage substance abuse as it relates to sports participation, as well as where to get help if they believe their child has a problem with substance abuse.

A Surprising Correlation

Tired drug abused teenager resting after the sports holding his hands on the head

Historically, many parents have held the belief that getting a son or daughter into sports will give them an activity to occupy their time, promote physical fitness and health, and keep them away from negative peer influences. However, some research indicates that sports may actually increase the likelihood that some teens will use drugs.1

That said, it is important to note that each teenager is different, and that this information does not mean that sports participation is a negative influence for all teenagers in all situations. Rather, it simply means that parents should be aware of risk factors and warning signs that a teenager could abuse substances while participating in athletic programs.

Risk Factors

Many student athletes enjoy competitive sports immensely and find that sports influence their lives in a positive manner. Such positive outcomes include:

  • Increased physical fitness.
  • College scholarship opportunities.
  • Friendships.
  • Discipline.
  • Teamwork.
  • Perseverance.
  • Goal-setting abilities.

However, participating in sports can place too much stress and pressure on some teens. Like most other teenagers, student athletes already experience common pressures such as:

  • Trying to keep good grades.
  • Coping with the social pressure to fit in with peers and be popular.
  • Exploring dating relationships.
  • Dealing with family issues.
  • Experiencing anxiety, depression, and other emotional issues.
  • Feeling self-conscious about their appearance.
  • Juggling time demands.

In addition to these stressors, athletes are under pressure to perform athletically, perhaps well enough to earn a college scholarship. Athletes often have more time constraints due to practices and games, which can make it difficult for them to keep up with schoolwork. The additional pressures of sports participation may be too much for some teen athletes, who turn to alcohol and other drugs as a coping mechanism.1

In some cases, teen athletes may start using performance enhancing drugs such as growth hormones, steroids, or certain types of stimulants to try to gain an edge on the competition.3 Other athletes may abuse opioids or other medications to cope with pain from injuries.4

One of the most noted risk factors is the correlation of high-contact sports—such as football, ice hockey, wrestling, and lacrosse—with higher levels of alcohol and marijuana use, both in high school and into young adulthood.1,2 Researchers believe this may be because these sports socialize youth to accept pain, violence, and risk as normal within the context of the sport, which may influence risky behavior both on and off the field.1

One study found that high school athletes across all sports were more likely than non-athletes to engage in drug and alcohol use in young adulthood, suggesting that participation in any sport is a risk factor.1

How to Help

Parents may wonder how to spot the signs that their teen is under a great deal of pressure, feeling stressed, and at risk for developing substance abuse issues. While a little stress is normal and even healthy for teenagers, signs of excessive stress can include: 5

  • Acting irritated and angry.
  • Crying spells.
  • Withdrawing from people and regular activities.
  • Sleeping too much, or having trouble sleeping.
  • Frequent worrying.
  • Changes in eating habits.
  • Experiencing frequent headaches or stomachaches.
  • Seeming exhausted and without energy.

Parents play a role in helping their children cope with stress and learn to work through it without turning to drugs or alcohol.

Some proactive steps to take include: 5

  • Spend time with your teen and get involved with their interests.
  • Listen openly to your teen, without offering advice or casting judgement.
  • Be a role model by managing your own stress through healthy habits.
  • Make sure your child gets enough sleep.
  • Teach your child about productive work habits and time-management skills.
  • Provide healthy meals and snacks.
  • Have a family ritual, like a weekly game night or special dinner.
  • Don’t set unreasonably high or unattainable standards.

From Pain Management to Addiction

Opioid abuse is a potential concern for athletes of all ages, as these drugs are frequently prescribed (or taken illicitly) to manage pain from injuries sustained in competitive sports.

Some college and professional athletes have publicly spoken out about becoming addicted to opioid painkillers after an injury. The pressure to perform comes into play here, as injured athletes who don’t want to sit out of competition may take opioids to allow themselves to play through the pain before their injury has fully healed.4

Around 2 million injuries occur each year in high school sports, and about 1/4 of all emergency room visits by children and adolescents are due to a sports-related injury.4

Teen athletes are more likely than non-athletes to be prescribed an opioid by their doctor.4

They are also more likely to misuse an opioid prescription (taking the drug in greater quantity or more frequent doses than prescribed) or without a prescription at all.4 Opioids may be provided by coaches or trainers without consulting the athlete’s personal physician, or teens may obtain the drugs themselves from teammates or other peers. Given opioids’ high potential for abuse and addiction, plus the risk of overdose, their use among teen athletes is cause for grave concern.

Warning signs that your child could be misusing opioids include:6

  • Using higher or more frequent doses of opioids than prescribed.
  • Claiming medications are lost or stolen and a new prescription is needed.
  • Taking opioids from other sources than the original prescription, such as from a friend.
  • Complaining about increasing pain, even as injury is healing.
  • Excessive drowsiness or sedation.
  • Loss of interest in normal activities and/or relationships.

There are steps parents can take to help their child avoid opioid abuse if they suffer a sports injury:

  • Openly discuss the benefits and dangers of opioids with your child and their doctor.
  • Discuss limiting the use of opioids to no longer than absolutely necessary for pain with your child’s doctor.
  • Monitor how often your child takes opioids and dispose of unused medication.
  • Work with your child’s doctor to explore physical therapy and other treatments that do not require opioids.
  • Encourage your child to rest and heal, even if it means sitting out a few games or even a season.

Performance-Enhancing Drugs

Athlete using sport enhancing drugs


Performance-enhancing drugs (PEDs) have been an issue for decades among both amateur and professional athletes trying to improve their strength and endurance. Athletes at all levels—even high school—have been implicated in PED use, and many sports organizations now perform regular testing for banned substances, with severe consequences for those who get caught using them.3

The term “steroids” is often used to encompass all forms of PEDs, but there are actually several different types that affect the body in different ways. Some, like anabolic steroids, have been the subject of extensive research due to their widespread abuse and the potentially-harmful effects of such misuse.7 Others, like beta antagonists, have very little research supporting their effectiveness or examining their long-term effects.3 Some even include over-the-counter dietary supplements like creatine as a class of PED.

Risks of Anabolic Steroids

The use of anabolic steroids by professional athletes across multiple sports has been extensively covered in the media for decades. Despite the negative consequences imposed on those who get caught, impressionable teenagers may look to these star athletes and internalize the belief that taking steroids is the key to athletic superstardom. Parents can use media coverage of doping athletes as a teaching tool to discuss the professional repercussions of getting caught.

Although some athletes may benefit in the short term from PED use, well-known cases like those of Lance Armstrong, Barry Bonds, and Marion Jones demonstrate that steroid use has serious consequences. Lost endorsements, tarnished legacies, banishment from the sport, and even criminal charges have all resulted for athletes who were discovered to have used banned substances. Reminding your children of the negative legal and athletic-career consequences of PEDs may be an effective way to discourage their use.

More importantly, long-term anabolic steroid use has been linked to serious side effects. These include:8

  • Kidney failure.
  • Liver damage.
  • High blood pressure.
  • Increased risk of stroke and heart attack.

Teenagers who start using anabolic steroids before their bodies are done growing may be at risk of stunted growth and height.8 This is because the artificially elevated hormone levels resulting from steroid use prematurely signal the body to stop bone growth.8

Anabolic steroid use can also have pronounced short-term side effects, which may help parents detect if their teen is doping. Some warning signs of steroid use include:8

  • Extreme irritability.
  • Delusions.
  • Paranoia.
  • Severe mood swings (commonly called “roid rage”).
  • Acne.
  • Swelling in the hands and feet.

If you suspect your child is using or considering using steroids, the best approach is to talk to them directly. Consult with their teachers, coaches, and/or school administration to help your child find the help and support they need to get back on track.

Don’t Wait

If you suspect that your teenager is using drugs of any kind, reach out for help. It is never too soon to intervene. If you think that your child has a substance abuse problem, seek help now; don’t wait. The earlier your child gets help, the more likely they’ll be able to recover and achieve long-term sobriety.

Sources

  1. Veliz, P., Schulenberg, J., Patrick, M., et. al. (2017). Competitive Sports Participation in High School and Subsequent Substance Use in Young Adulthood: Assessing Differences Based on Level of Contact. International Review for the Sociology of Sport52(2), 240­–259.
  2. Veliz, P., Boyd, C., & McCabe, S. (2015). Competitive Sport Involvement and Substance Use Among Adolescents: A Nationwide Study. Substance Use & Misuse, 50(2), 156–165.
  3. Reardon, C. & Creado, S. (2014). Drug abuse in Athletes. Substance Abuse and Rehabilitation5, 95.
  4. Veliz, P., Epstein-Ngo, Q., & Meier, E., et. al. (2014). Painfully Obvious: A Longitudinal Examination of Medical Use and Misuse of Opioid Medication Among Adolescent Sports Participants. Journal of Adolescent Health54(3), 333–340.
  5. U.S. National Library of Medicine. (2016). Help Your Teen Cope with Stress.
  6. National Institute on Drug Abuse. (2008). Recognizing Opioid Abuse.
  7. Barbalho, M., Barreiros, F. (2015). The Use and Effect of Anabolic Androgenic Steroids in Sports. International Journal of Sports Science5(5), 171–179.
  8. National Institute on Drug Abuse. (2016). Anabolic Steroids.
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