Examining Drugs, Alcohol and Supplement Use in Sport: What do we know? AVCA 2008

1. Examining Drugs, Alcohol and Supplement Use in Sport: What do we know?AVCA 2008 Kathy Turpin The National Center for Drug Free Sport, Inc. www.drugfreesport.com Mary E. Wilfert National Collegiate Athletic Association www.ncaa.org/health-safety /

2. Who is The National Collegiate Athletic Association? • Higher Education Association with services to support athletics departments at over 1000 IHE • Membership-ledassociationabiding by the NCAA principles of student-athlete welfare: shared responsibility to provide an environment that protects the health safety of student-athletes.

3. NCAA Committee on Competitive Safeguards and Medical Aspects of Sports • University staff that work in sports medicine, law, athletics administration, research. • Researches student-athlete health and safety issues. • Oversees NCAA drug-education and testing policy. • Develops sports medicine handbook guidelines. • Ensures fair and credible drug-testing and appeals processes.

4. NCAA Study of Substance Use • Conducted every four years • Over 20,000 student-athletes complete anonymously (out of 380,000 S-A) • Trends help determine policy and practice • Reported use is within last twelve months, unless otherwise indicated • Following slides are from the 2005 study.

9. Out of about 20,000 student-athletes, 214 males and 13 females reportedhGH* use Males:   Females: • 106 FB                                                       6 basketball • 33 baseball                                                 4 golf • 30 basketball                                             3 soccer • 14 soccer                                                   3 indoor • 13 wrestling                                               2 outdoor • 12 outdoor                                                 2  lacrosse                                                        • 9 indoor                                                    2 VB/ 871 surveyed • 8 lacrosse • 8 golf • 7 Tennis • 6 cross country • 3 Ice Hockey • Smattering of other • 0 VB / 85 surveyed *reports of hGH use may not accurately reflect true use of growth hormone, as many “hGH” products don’t actually contain growth hormone. . . . .

16. Alcohol on Performance • Causes dehydration which slows healing • Requires increased conditioning to manage weight • Slows muscle recovery • Inhibits absorption of nutrients • Interferes with ability to sharply focus • Hampers memory and retention

17. Ergogenic Drug Use in Women’s Sports

18. Ergogenic Drug Use Patterns in Other Women’s Sports

19. Social Drug Use in Women’s Sports

20. Social Drug Use Patterns in Other Women’s Sports

21. Initial Use of Ergogenic Drugs Percentages Based on Those Who Continue to Use *Nutritional Supplement related question was not included previous to the 2001 survey.

22. Initial Use of Social Drugs Percentages Based on Those Who Continue to Use

23. Dietary Supplements US Dietary Supplement Health and Education Act of 1994: Puts burden onto FDA to prove that a nutritional supplement is harmful before it can regulate its sale.

24. Dietary Supplements • Do not need to be proven effective • Do not need to be proven safe • Lack standards on potency and PURITY

25. Where do athletes get supplement information?

26. What Athletes tell us about supplement use • Can’t gain weight without it • Can’t meet nutrient needs without • Want the extra edge • Can’t be all bad – everyone is using • I only use legal supplements

27. What we know about supplements? • In 2001, the IOC conducted a study of 634 non-hormonal supplements from around the world • Products included – vitamins, minerals, protein powders, creatine, herbal extracts, etc. • Looked at 13 nations and 215 different companies • Supplements were tested in IOC accredited lab • Only looked for anabolic steroids • Results:

28. What we know about supplements? Is your athlete willing to take a 14.8 % chance they will test positive?

29. What we know about supplements? • In 2007, HFL a British laboratory that does sport drug surveillance, conducted a study of dietary supplements sold in the USA • Study was overseen by Informed Choice • Of the 52 products analyzed, 25% contained traces of anabolic steroids and 11.5% contained banned stimulants • Report concluded: “It is clear that not all supplement manufacturers follow good manufacturing practices and the necessary control are not always implemented to ensure the safety of athletes and the general public who use supplement products.” • Bottom line: Nothing has changed!

30. What we know about supplements? Most dietary supplements are ineffective For the fewsupplements that do work: Not everyone benefits equally They don’t help for all events They can  performance in some events Some have significant side effects

31. NCAA 2005 drug use survey • 21,000 athletes surveyed • 41% reported nutritional/dietary supplement use within last year • Most commonly used: • Creatine • Protein products and amino acids • Thermogenics • Most cited reasons for use were • To improve athletic performance (38%) • For health reasons in general (24%) • For weight loss/weight gain (22%)

32. Creatine Not a banned substance. What does it claim? promote muscle growth reduce recovery time Increase energy production [No evidence of increasing muscle mass without resistance exercise] What does the research say? Short-term use appears safe, but…cramping, heat illness Long-term risks not known and difficult to study. Recommendations are not to provide to youth!

33. “Weight-loss supplement linked to at least 155 deaths” The use of stimulants - including ephedrine – before, during or after exercise, especially when such use is accompanied by hot and/or humid environments is dangerous.

34. Sports drinks vs. “Energy” drinks Sports Drinks • Rehydrate • Help maintain electrolyte balance • Do not contain stimulants Energy Drinks • May contain more concentrated sugar • Contain one or more sources of stimulants (caffeine, guarana) • May contain amino acids and herbals (unregulated)

35. Caffeine Comparison: 360 mg Caffeine 8 cans of Classic Coke 4.5 lbs of milk chocolate

36. Anabolic Steroid Control Act of 2004 • Prohormones are now Anabolic Steroids and classified as Schedule III Controlled Substances • Illegal to possess without a prescription • Carved out an exception for DHEA

37. DHEA • Dehydroepiandrosterone is a pro-hormone, produced by the adrenal gland and is found naturally in the body. • Advocates claim that DHEA supplements can improve mood, increase energy and libido, counteract the effects of stress, preserve muscle, strengthen the immune system, and prevent cancer and heart disease. • DHEA is an NCAA banned substance.

38. What about Multi-Vitamins? • Subject to the same lack of regulation • No guarantees • Added Herbs

39. Before deciding to use a supplement • Do I need this supplement? • Do I know that this supplement is safe? • Does this supplement interact with any drug or food I am consuming? • Do I know that this supplement works? • Can I afford this supplement? • Do I know enough about this supplement?

40. Performance Enhancers Food Hydration Conditioning Rest and Recovery Stress Management Stay Well!

41. The Message . . . . Good Nutrition Promotes Health Enhances Performance!

42. Nutrition Survey n = 9930

43. Female Athlete Triad

44. NCAA Study: Coaches Regarding Amenorrhea • 1%: normal, not serious • 36%: normal, assess after 6 months • 15%: not normal, not harmful • 48%: not normal, medical required Female coaches were more likely to be aware of, talk to athletes about, and refer for menstrual irregularity. 2003 NCAA Coaches Survey

45. Meals and Snacks • institutions must take responsibility for ensuring that the nutritional needs of their student-athletes are met. . . .

46. “Peace sign” eating 2/3 of the plate as carbohydrate foods: bread, bagels, cereal, rice, pasta, sweets, fruit, vegetables, crackers, pretzels, beverages 1/3 protein: meat, poultry, fish, dairy foods, nuts, seeds, soy foods, dried beans, eggs

47. TIMING • Breakfast is a must! • Something to eat/drink every 3-4 hours • Meal 3-4 hours BEFORE games • Snack 1 hour BEFORE games • Carbohydrate food/fluid DURING practices/games • Carbohydrate food/fluid within 15 minutes AFTER practices/games

48. This shows an example or normal, straw colored urine. Anything darker would suggest a level of dehydration Urine color—teach athletes to check color for hydration

49. SALT LOSERS • IF: • Your sweat stings your eyes • Your skin/uniform are coated with a white residue after practices/games • THEN: • Use more salt on foods • Eat salty foods • Don’t overdo with water

50. CSSD: Certified Sports Dietitian • Registered dietitians with expertise in sports dietetics • Board certified by the American Dietetic Association as specialists in sport dietetics • Many CSSD’s also have exercise and/or athletic training credentials • Most are SCAN- the Sports, Cardiovascular and Wellness Nutritionists practice group of the American Dietetic Association