Many physicians, parents and coaches worry about the effect of performance enhancing drugs (PED) in schools and colleges (Amy, n.d.). The Community Anti-Drug Coalitions of America (CADCA) reports that in every thirty student-athletes, one will use performance-enhancing drugs like steroids (“Coalition addresses abuse of performance-enhancing drugs,” 2004). Research should find out the underlying factors compelling athlete students to use the drugs illegally.
Present literature on performance-enhancing drugs and student athletes has distinct gender patterns. Male athletes appear to have a higher risk of drug use compared to their non-athlete peers (Yusko et al., 2008). Various researches on use of performance-enhancing drugs by student athletes face the limitation of obtaining accurate information. Usually, information sought in surveys is highly sensitive. These studies often fail to qualify the data received as most student athletes associate their participation with negative consequences on their sporting career (Yusko et al., 2008).
Few scholars have looked into the existence of racial and ethnical performance enhancing drug use differences among student athletes (Yusko et al., 2008). Additional sample groups need to form part of future studies, to remove biases associated with self-reporting of coaches and student athletes in surveys. The reliance on coaches, and other school or college staffs, to identify and avail their players for surveys, limits the specificity of the given investigation. In addition, student athletes receive special facilities from their institutions because of their role. For example, they are more likely to use campus housing, and spend more time in campus, than their non-athlete counterparts. Therefore, there is the challenge of obtaining a sampling balance (Fernandez & Hosey, 2009).
Studies on effective student prevention strategies on drug use propose the use of brief interventions and personalized feedback to produce positive results on different samples. However, these studies have no record of empirically testing student athlete trials. In addition, many studies do not differentiate between in and off-season use of performance enhancing drugs (Larance et al., 2008).
Aims and Objectives of the Study
This study will look into the risk factors associated with performance-enhancing drug use between student athletes and their non-athlete peers. The factors under examination will include motivation for use, family history and peer normative perceptions. The exploration will involve findings from literature review of percentage rates, usage patterns and consequences of drug use by student athletes. It will involve the combination of views and opinions of clinicians, school administration, student athletes and non-athlete students. This inquiry will develop hypotheses regarding the broad factors influencing the uptake of performance-enhancing drugs among student athletes. Students take up performance enhancing drugs to enhance performance as a masking effect of their social economic conditions. Association of non-athlete students with athletes, who abuse performance-enhancing drugs, influences their seasonal use.
Race, as a social economic factor, affects the uptake of performance-enhancing drugs among student athletes.
The need to find the edge in both beauty and athletic performance is the most compelling factor for student use of PED (Sherk, Erkenbeck, & Becker, 2003). PED is the solution that science presents to athletes to achieve what they would otherwise be able to do on their own. However, PEDs are not the right answer. Today, student athletes take PED in form of supplements, health products and even prescription or non-prescription drugs. The drugs increase energy, enhance muscular volume, reduce weight and relieve or hide pain. Beginning PED users start with protein powders, sports drinks and steroids in their training programs. Most supplements are obtainable by adolescents without a prescription (Sherk, Erkenbeck, & Becker, 2003).
Below are the major characteristics and consequences of using different kinds of PED. Creatine is a type of PED that improves the recovery time after workouts. It works by hydrating muscles. According to the American Pharmaceutical Association (1999), fifty percent of the studies conducted on the drug showed its effectiveness in improving athletic performance. Continued use of the drug leads to muscle cramps. Severe case includes liver or kidney damage. Another PED example is ephedra, which is an herbal stimulant used for weight loss, energy gain and body building. The extract is commonly found in workout pills and protein powders; use of the drug leads to high blood pressure, tremors, coma and seizures. It works by masking fatigue. Another form of PED is the steroid. This substance promotes the gain of a muscle. It also leads to the development of male sexual characteristics and is therefore, popularly used as an image enhancer.
Prolonged use of steroids could lead to an unchecked or undesired gain in body size. Steroids also lead to kidney damage and stoutness of the adolescent person. Most negative health effects of PED come from steroid use. They include difficulty in urinating, acne, fat deposit formation around breasts, baldness in males and testicular atrophy (Sherk, Erkenbeck, & Becker, 2003). Persons using steroids also suffer from temporary sterility, heart attacks and creation of bad cholesterol (Eckart, Gentlesk, & Shry, 2010). Harmful effects of drug injection and needle sharing also accompany steroid use. Above all, steroids induce “roid rage” (Sherk, Erkenbeck, & Becker, 2003). Users become antisocial, and they fight often. Moreover, users have a tendency of engaging in physical or sexual abuse.
Factors aiding the use of PED among Student Athletes
Parents lack the necessary information to talk to their children about PED. According to Sherk, Erkernberk and Becker (2003), 52 percent of adults in their survey were unable to name potential side effects of PED. Moreover, 42 percent of adults in the same survey knew nothing about the side effects of sport supplements. Parental involvement in interventions against PED use is necessary. However, proposed programs should also include the education of parents to equip them with the essential knowledge of advising their children.
According to Beem (2006), the high expectation of athletic achievement leads to a drop in academic achievement as schools lower their grade expectation of student athletes. The lowering of academic expectation shows that student athletes receive a unique treatment in schools. Unfortunately, not all the special treatment they receive positively develops them. Much of the specific treatment comes with a scrutiny of their every choice. Thus, while the student might be motivated to indulge in use of tobacco or alcohol to cope with the stress, they cannot because the two substances are often tested (Beem, 2006). In addition, the substances are hitherto known as harmful and coaches and schools already have a harsh stand against them. Therefore, most athletes remain with performance-enhancing drugs as the best bet for fulfilling the high expectation of their athletic achievement.
Student-athletes combine their sporting career with their academic engagement. Often, being a student and being an athlete concurrently, leads to various conflicts of interest. Student-athletes will view themselves more as athletes rather than as students when they have to choose a single identity (Sturm & Gilson, 2011). They associate more with athletic in-group practices rather than academic in-group practices. Consequently, the student athletes choose simpler courses that barely pass them through the campus curricula, compared to their non-athlete counterparts. Evidently, the student-athletes are more prone to peer-pressure coming from their fellow athletes than from their regular classmates. They spend more time with their athlete peers, hence the higher propensity for habit indulgence from the particular group (Sturm & Gilson, 2011).
Self-identity plays a salient role in the student athlete’s choice of using drugs. Research on self-identity and drug use presents the following views. Drug abuse among student-athletes is a result of the need to be part of a family. Since students spend a large part of their free time with their fellow teammates, they regard their team as family. Drug use is often a communal activity within the team. When the drug use is illegal, it acts as the team’s membership identity. Teammates who fail to conform to the accepted behavior in the team become outcasts. The outcasts receive unfair treatment and may even suffer from verbal and emotional abuse. The ill-treatment extends to practicing sessions and competitive games. Either the victim students give in to the negative treatment and abuse drugs, or they quit the team. The latter choice is unpopular with many student athletes. They identify more as athletes than students identify and do most things, including use of PED, to retain their athletic identity.
Gender affects the degree of using performance-enhancing drugs among athletes. The effect of gender is indirect. Male and female athletes play relatively different sports. Most feminine sports are gentler and less bold than masculine sports. For example, only male athletes play American football, and the game is more aggressive than tennis, which is available for both sexes. The forceful and energy demanding nature of male-only sports influences the use of performance-enhancing drug use among males and females. Thus, gender plays a role through its division of the sporting activity choice. Another way of gender influence occurs in the emotional nature of male and female athletes. Male athletes have the need to hide their emotions, especially those showing their weaknesses. Thereby, they are more likely to engage performance-enhancing drugs to keep them from breaking down emotionally in front of their peers.
As explained in the literature quoted above, the student athlete identity forms a salient basis of their self-esteem. The need to remain part of the team and attract the attention of fans or talent scouts compels the athletes to remain indifferent to fatigue and breakdown, at least publicly. Personal conduct and athletic conduct merge and the student-athlete’s life on the field and off the pitch stay identical. Nevertheless, the similarity does not shield them from the life challenges outside the pitch. They have to deal with their academic requirements like other students. Moreover, they have to meet their scholarship obligation and find incomes to support their social lives. All these aspects of their lives are sources of emotional drain. However, they have no other choice but to do their best while in the pitch. The demand for efficient performance, despite the pressures from other life challenges, pushes the student athlete to consider using performance-enhancing drugs.
Other than the competitive pressures for athletes, other factors also play a role in influencing their use of PEDs. Research shows that students will use PED when their parents and teachers show an implicit approval (Berning et al., 2008). The lack of punishment measures for current users, acts as an approval for new users. The fresh users may have particular reasons for using PED; however, their ultimate goal is usual to enhance their identity as athletes (Sturm & Gilson, 2011). When parents and coaches show a greater affinity and admiration for student-athletes who show an elite level of performance, they indicate their desire for high performance. Unfortunately, when they reward the athlete using PED in the same way as the non-users, the parents and coaches create an illusion that use of PED is normal.
New PED users look to their peers for any negative consequence of PED use. If they find none, or find an explanation that minimizes the threat of consequences, then they are more likely to begin using the PED. The lack of observable threats to their athletic career is one reason for their use of PED (Yusko et al., 2008). Other reasons for PED use arise as opportunistic factors. These factors occur when the conditions for the student athlete favor PED use. First, the lack of a policy leaves potential users with no immediate setback to hold them off the PED. Studies show that, a strict drug-testing policy in schools puts off many aspiring PED users (American Academy of Pediatrics, 2005). A test confirmation of PED leads to the termination of their sport-related scholarships and may signal an end of their sporting career. Since many student-athletes will give up their academic and social life to become pro-athletes, a positive test outcome for PED is the most undesirable result for their career. Mandatory tests prove to be very effective in reducing the effects of peer pressure as a factor, which induces PED use. Students become resistant to peer-pressure of using PED because they affirm their need to pass drug tests and remain in the team (Sturm & Gilson, 2011).
Peers, parents and coaches admire the always fit and composed athlete who is unaffected by life challenges, which he or she is facing. He or she has the highest chance of becoming a pro-athlete after graduation. If the athlete is still in high school, he or she has a good chance of winning a sports scholarship to a prestigious higher learning institution. The ideal athlete is a condition that all student athletes seek. They forgo their social and academic life for the single purpose of building their athletic identity (Sturm & Gilson, 2011). In itself, the focus is good. However, when the single mindedness leads to a disregard for consequences of an imbalanced life, then it becomes undesirable (American Academy of Pediatrics, 2005).
The admiration from the various stakeholders of a student’s athlete performance is a source for their pressure to perform. Student-athletes face the expectations of always increasing their performance even when it is humanly impossible. Teenagers and young adults have to prove how good they are at a particular sport to get a socially rewarding recognition. An all-round athletic performance is no longer desirable (Coalition addresses abuse of performance-enhancing drugs, 2004). The society now expects young people to perfect their talent in one sporting area (Beem, 2006). Professional sport has become an alternative career to jobs obtainable after an academic scholarship. Pro-athletes earn better than doctors and magistrates among other professions. In addition, they get fame. The social capital that comes with the pro-athlete career is enticing for many student athletes. Moreover, parents and coaches advise them to strive at being pro-athletes. In college sports changing rooms, conversation wanders around encouragement and aspiration for future stars. The social recognition of the pro-athlete partly explains why student athletes reach out for PED. It happens because the society sets the performance bar too high (Sherk, Erkenbeck, & Becker, 2003).
Effects of Drug Testing Initiatives on PED usage
Goldberg et al. (2003) demonstrated that the presence of drug test effectively alters the attitudes of athletes during the trial period. In their study, student athletes altered their 30-day use of drug even when the presence of risk factors favored a greater substance abuse. In their research, Goldberg et al. (2003) identified risk factors as the belief that there were fewer negative consequences of drug use, presence of risky behaviors and the perception that authority figures were tolerant. In their research, Goldberg et al. (2003) note that differences in behavior change only occurred in the student athlete group compared to the non-athlete group. The evidence confirmed that student-athletes hold their sporting identity in high regard. Therefore, they show a higher likelihood of changing their attitude and resist PED when they know the drugs can lead to the termination of their athletic career.
Peretti-Watel et al. (2003) show that drug-usage among elite student athletes (ESA) is considerably low compared to their adolescent peers. They explain the disparity to the fact that ESA faced a higher number of drugs test on average than the rest of the students. However, the study did not specifically measure the use of PED. Therefore, it only presents a general interpretation of immediate consequences and behavior change. Peretti-Watel et al. (2003) prove that regular testing for drugs lowers their usage within the testing period.
An interesting fact out of the research by Goldberg et al. (2003) was that, there was no alteration of alcohol and tobacco use among the student-athletes in their study. The scholars explain the indifference to the fact that alcohol was difficult to test after one day of use. Moreover, tobacco use was not part of the tested substances. The lack of behavior change in the use of the two substances shows that, drug-tests only change the attitudes of students towards the specific drugs tested. Therefore, if a particular type of PED is intestable, a strict drug policy will be ineffective in deterring regular and potential users of the precise drug. Above all, the testing policy informs students that their schools and parents are explicit about intolerance to drug use. Consequently, they indulge less in PED use. Parents rarely carry out drug tests. However, drug tests in schools require their consent; hence, the student athlete’s association of drug intolerance of both schools and parents.
The immediacy of consequences is the main factor shaping the attitudes of students to the use of PED. Programs that show adverse effects of drugs occurring later in life are less effective compared to those that present the student with an immediate consequence. The immediacy of drug test results and their consequences rank highly in their effectiveness against drug use, compared to the addition and physical or emotional side effects in the long run. While the research by Goldberg et al. (2003) was significant in elaborating the effect of immediate consequences, they acknowledge the need for a more extensive research, which covers a longer period of a few years. The extended period would correct any environmental effects other than the drug test, which alter the student attitudes. Goldberg et al. (2003) also admit that a sampling balance may have limited their research as mentioned by Fernandez and Hosey, (2009).
The use of PED among professional athletes is diminishing, however; the reverse is true for students. The lack of extensive drug testing programs in schools and colleges contribute to the reported increase. The goal of winning is as important in student sport as it is in professional sports. Naturally, the absence of a control check on one side leads to the exploitation of PED at a higher rate than the other side. Adolescents have an increased propensity of using PED because of their association with risk-taking behaviors (American Academy of Pediatrics, 2005). The development tasks of adolescents include defining their sexual identity, emancipation, achieving mastery and self-efficacy as well as getting into peers groups that identify with them.
The student athlete is an adolescent in most cases. He or she feels invisible, just like other adolescents, thus he or she uses PED to increase his or her visibility in the society. The preoccupation with body image among teenagers also leads to their use of PED. Students in high schools and colleges will seek to increase their size, strength, stamina and build their bodies to the ideal society shapes. The celebrity culture mostly shapes their attitudes towards image and performance. Professional athletes are also celebrities. Their image, wealth and influence motivate young adults to alter their physical image and increase their abilities.
Interventions for PED Users
According to the American Academy of Pediatrics (2005), the focus on student athlete’s use of drug enhancing drugs should move beyond the implementation of drug tests. The main reason of using PED needs a conclusion. Therefore, future research has to focus on providing guidelines for resolving the conflict between desire to win and the need to do right. The American Academy of Pediatrics (2005) notes that there are very few researches that measure the continued drug usage after various interventions. Nevertheless, there was a positive outcome of training student athletes on personal skills to reduce social influences. The training led to a decrease in the intention to use anabolic steroids among football players who participated in the study (American Academy of Pediatrics, 2005).
The prevention of PED use needs to engage adults who manage collegiate, high school and youth sports programs (Beem, 2006). Various studies show that the tolerance of adults has the same effect as active encouragement. It is important that coaches emphasize a health competition. They must demonstrate their intolerance to PED by taking a strong stand against any form of performance cheating. Together with parents, coaches should avoid making sports a ‘win-at-all-costs’ philosophy (American Academy of Pediatrics, 2005). Beem (2006) emphasizes the fact that, parents and school administrators have the responsibility of ensuring that students learn to be all rounded adults. Therefore, despite the benefits of an excellent athletic performance, the student must also receive proper education in other areas of their lives. An all-round development includes ways of coping with the pressure to use PED as well as having skills to help fellow students.
The use of PED often leads to negative consequences in body health. The unwanted health effects are paramount when athletes use needles to inject drugs. Larance et al. (2008) conducted a study in Sydney, Australia on performance and image enhancing drug (PIED) injectors. They found out that needle-sharing practices within the group were minimal, at 5 percent of the total. However, they found higher rates of needle reuse and injection from a shared bladder, at 13 percent and 29 percent respectively. The scholars note that the practices expose the drug users to infections and similar health complications (Cadwallader et al., 2010). One in four injectors experienced fewer or infections (Larance et al., 2008). Other than general injections, users also targeted small muscle groups in the hope that they will trigger localized growth. Thus, they increased their chances of hitting a nerve. The practice of injecting PIED also leads to the injection of other illicit drugs (Larance et al., 2008. The use of anabolic androgenic steroids (AAS) was associated with a wider problem syndrome of using harmful substances, taking risks and aggression (Larance et al., 2008).
The choice of injectable PED over non-injectable ones was a result of mixed messages given to the users. Some preferred others to inject them because they thought that the safer sites for ASS injection were beyond their reach. For others, oral preparations were favorable because they led to less bruising and reduced the chances for skin infections. However, Larance et al (2008) note that, even orals lead to the risk of liver-toxicity in higher doses. The lack of harm reduction programs for PED users leaves them with few sources of medical information. Most users rely in their personal networks on the internet (Larance et al., 2008). This finding confirms the need expressed by the American Association of Pediatrics (2005) to focus on the larger context of the PED usage as a way of addressing the problem. The low profile nature of PED users in rehabilitation centers denies them many harm reduction and health promotion resources (Larance et al., 2008). There is a need to develop and deliver targeted PED-specific interventions through primary care service as a curative measure for the PED problem.
According to Berning et al. (2008), as students move from freshman to senior, they increase their tendency to use AAS. Over 80 percent of AAS users have the intention of reusing the PED in future (Berning et al., 2008). This implies that they do not use AAS for experimental purposes (Berning et al., 2008). A significant number of AAS users did not know how to obtain the drug and depend on their fellow users. Dependence on other users for supplies shows the proliferation of a black market for the drug. Unfortunately, the purity and potency of drugs delivered through the illegal network remains unknown. Moreover, users consider their actions as illicit and have little or no inclination to verify the quality issues of the drugs they receive (Berning et al., 2008). Berning et al. (2008) recommend interveners to understand the underlying issues of why students use drugs. Other than athletic performance, PED users also mention their need to improve their images. Thus, athletes who shunned AAS before, may find an additional need to use the drug, other than for their sport performance. Young adult preoccupation with appearance is a major alarm for the need to enhance PED preventive and curative education (Berning et al. 2008).
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