The prevalence of substance abuse in sports settings might be under-represented in extant literature and poses heightened risk of addiction for individuals who are already vulnerable for other reasons, found a Canadian study.
As she was planning her study to look into the role physical activity and sport play in the development of substance addiction, Laurie de Grace was forewarned that she may have trouble finding any recovering addicts with a sporting background to speak with.
After all, sport and physical activity go hand in hand with good mental health – or so conventional wisdom would suggest. "Instead, what we found is with addiction, the more risks that are present, the greater likelihood it is going to develop," said de Grace, a master's graduate of the faculty of physical education and recreation at the University of Alberta, Canada. "Sport, it appears, has the potential to increase the risk factors."
Rather than looking at individuals in sport and trying to identify the pathway to addiction, de Grace flipped the model and interviewed people in recovery from addiction, virtually all of whom had a sporting background. She categorised the participants based on their level of sport engagement, from recreational athletes to those who played sports as youngsters but dropped out in high school – often because of drugs and alcohol – to the largest group, elite athletes.
Though a full spectrum of sports was represented in the study – including gymnastics, martial arts, rowing and dance – most participants competed in team sports, hockey in particular.
Patterns regarding the culture of sport began to emerge, the most prominent being social acceptance and normalisation of drugs and alcohol, and how role models – if not implicit in the culture of substance use – did little in the way of curbing it.
"The cultures are quite machismo and the pressures on the young people are quite high," said Alex Clark, professor in the faculty of nursing, who helped to model the study. "Coaches turn a blind eye and some actively encourage the teamship that's based on a work-hard, play-hard culture."
One study participant who had played junior A hockey recalled how the team owner would load flats of beer onto the team bus. Now in his 30s, he said it was his participation on the team that started his addiction. "While others on his team were older and may have started drinking prior to age 16, he hadn't because he came from a family with a background of alcoholism. His father sheltered them from drinking and made a point of hiding 'the evil side of drinking,'" said de Grace. "Once he started playing junior A, and as the youngest player, he (drank) to be part of the team, and his substance abuse escalated from there."
Another common trait among the study group was hyper-competitiveness, which de Grace said manifested itself in heavy substance use and abuse. "They wanted to be the best at whatever they did, so if that meant being the best heroin user, that's what they did."
Some elite athletes cited losing their ability to participate in sport through injury or being cut from a team as a factor that contributed to their addiction. One of the recovering addicts who lost his sport to injury was a hockey enforcer – players who find a role on the team standing up physically for teammates. "Enforcers seem to be the most vulnerable because they're scared when they have to fight – there is a physical component but also an emotional component," she said. "It seems they're coping with what they've done, then they're dealing with the pain and taking painkillers, which were readily available on the teams, and it goes from there. You throw in the possibility for concussions and it's a dangerous combination."
Although the majority of athletes who are exposed to this nuance of sporting culture come out the other side none the worse for wear, there is a segment that needs protection.
"Many of the subjects who were interviewed have siblings, none of whom have addiction issues," said de Grace. "Obviously, genetics and other factors come into play, and more work needs to be done."
Wendy Rodgers, a professor in the faculty of physical education and recreation and project supervisor, said it is well documented that if people don't start on the path to using substances before they are 21 years old, they are less likely to develop substance dependence. "There is a vulnerable period of life that seems to correspond with an elite performance level in high school when there are a bunch of things going on that can contribute to problems later in life," she said, adding she was surprised about the extent to which drugs and alcohol were available to underage kids playing sports.
"That is definitely a context where we can take more control of what is happening with teams and how they are behaving and engaging with the rest of the community," she said.
Rodgers cautions that this is just one study and it is from the perspective of a particular group of people, but adds that while the results are not unexpected, the extent was surprising.
She said substance use has become entrenched in the culture of sport, pointing to filling up the Stanley Cup with champagne, beer-filled locker rooms of every stripe and even the lore surrounding the championship Oilers and their hard partying.
"You don't hear these stories found in the study and think, 'That could never happen.' You hear them and say, 'I'm not surprised.'"
And though sport participation in itself is a healthy activity, de Grace noted it is the culture that puts some people at an additional risk of substance addiction. She said some individuals interviewed even expressed concern about engaging in their sport at a recreational level in the future.
"How do they take part in that environment and not take part in the drinking?"
Abstract
Purpose: Potential benefits of participation in sport are widely known. However, sport participation has also been associated with risks, including consumption of alcohol and drugs and such risks may be enhanced among certain populations. The purpose of this study was to examine the possible links between participation in sport and the subsequent development of substance addiction.
Method: Realistic Evaluation guided the study, with data collection occurring through semi-structured interviews. Interviews were conducted on a university campus or at a residential treatment center. The study included a total of 21 participants: 7 people who had between 3 and 29 years of sobriety, 13 people in a residential addiction treatment program, and 1 counselor.
Results: Participants were grouped according to their sport backgrounds as 1) limited sport backgrounds, 2) recreational sports, 3) competitive athletes or 4) competitive athletes whose sport was terminated. Five main contexts were identified: 1) Familial History, Stability, and Illness, 2) Perceived Acceptability of Alcohol, 3) School and Social Atmosphere, 4) Sport Culture, Demands, and Expectations, and 5) Termination of Sport Involvement. The three main mechanisms were identified as: 1) Psychological Characteristics, 2) Coping Strategies, and 3) Availability of Substances.
Conclusions: The prevalence of substance abuse in sports settings might be under-represented in extant literature. The prevalence of substance abuse in sport contexts poses heightened risk of addiction for individuals who are already vulnerable for other reasons such as the presence of predisposing behaviors, psychological characteristics, or circumstances.
Authors
Laurie A de Grace, Camilla J Knight, Wendy M Rodgers, Alexander M Clark
[link url="https://www.ualberta.ca/news-and-events/newsarticles/2017/january/study-reveals-surprising-link-between-athletics-and-addiction"]University of Alberta material[/link]
[link url="http://www.sciencedirect.com/science/article/pii/S1469029216301819"]Psychology of Sport and Exercise abstract[/link]