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Drug Abuse by Athletes

Prescription Drugs
       Prescription medications that are intended as a physician's recommended treatment should be only used by the person whose name is on the prescription. Unfortunately some of the medications are targets by close family members for their self medication and ultimately can lead to drug misuse that results in addiction.

      Unintentional misuse of medications becomes more common as we age. Individuals may have trouble recalling if they have taken their medications and either miss a medical or take the medication twice. Pill boxes can be purchased that can be fill to contain the daily medications for an entire week.  The care giver needs assistance in correctly filling the pill box from a list of medications and the dosage. The list should also indicate when they were last filled and when they should be renewed.

      Individuals, of all ages, tend to want simple solutions to solve problems and enhance physical/mental performance. This desire, combined with pressure to excel, has increase in the number of individuals who have resorted to attempting to get multiple prescription from different doctors. Ultimately they may resort to illegally obtaining black market drugs as a solution to acquire an increasing addictive need for consuming even higher doses of the medication(s).

      Parents and coaches should become aware of the stress that athletes place upon themselves to perform well in competition. The stress levels are similar to the academic stress of achieving high grades to be ranked at the top of their class for admission into their preferred college choice and/or scholarships.

Age, puberty, body dissatisfaction, and physical activity decline in adolescents. Results of the German Health Interview and Examination Survey (KiGGS) 
Authors - Emily Finne1*, Jens Bucksch1,3, Thomas Lampert2 and Petra Kolip1

1 Bielefeld University, School of Public Health, PO Box 10 01 31, D-33501 Bielefeld, Germany
2 Robert Koch Institute, Department of Epidemiology and Health Reporting, General-Pape-Str. 
   62-66, D-12101 Berlin, Germany
3 University of Stuttgart, Department of Sport and Exercise Science, Allmandring 28, D-70569
   Stuttgart, Germany

Published in International Journal of Behavioral Nutrition and Physical Activity 2011, 8:119 doi:10.1186/1479-5868-8-119

The electronic version of this article is the complete one and can be found online at:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


       Physical Activity (PA) shows a marked decline during adolescence. Some studies have pointed to pubertal status or timing as possible PA determinants in this age group. Furthermore, it was supposed that the impact of pubertal changes on PA might be mediated by psychological variables like body dissatisfaction (BDS).

       Chronological age showed a significantly negative association with PA in both sexes, independent of puberty. The odds of inactivity in contrast to nearly daily PA increased about 70% in boys and 35% in girls for each year of age, respectively. Adjusted for age and other possible confounders, inactivity was significantly less likely for boys in late pubertal stages (OR = 0.27, 95% CI = 0.09-0.78). The risk of inactivity was more than doubled in boys maturing earlier than peers in terms of relative pubertal timing (OR = 2.20, 95% CI = 1.36-3.56). No clear significant puberty effects were found in girls, but the inactivity was more likely for those with irregular menstruation (OR = 1.71, 95% CI = 1.06-2.75). BDS also contributed to the prediction of PA in both sexes. It partially mediated puberty effects in boys but not in girls.

       Overall, chronological age was a far more important predictor of PA in German adolescents than absolute pubertal status or relative pubertal timing. Further possible explanatory variables like sociocultural influences, social support or increasing time requirements for education should be analyzed in conjunction with chronological age in future studies.

      Various health benefits of Physical Activity (PA) have been demonstrated in adolescents. Despite this, most youths from Europe are not sufficiently active to meet current PA recommendations. Furthermore, the adolescent years have been identified as a risk period for declining PA levels in studies using different methods, including accelerometry.

       In Germany, only PA prevalence rates based on self reported data have been published so far, but these point in the same direction with boys being physically more active than girls and a steep decline occurring in PA during adolescence for both. The 2005/2006 WHO-Health Behavior in School-aged Children study showed that the proportion of German adolescents fulfilling the PA guidelines of 60 minutes of moderate-to-vigorous PA on most days of the week fell from 25% in 11-year-old boys and 20% in girls to only 16% in 15-year-old boys and 10% in girls, respectively. In addition, the percentage of girls and boys who reported daily exercise in the German Health Interview and Examination Survey for children and adolescents (KiGGS) fell from 27.6% in girls and 34.9% in boys at the age of 11 to 11.2% and 18.4% at the age of 17, respectively.

       Understanding factors responsible for the PA decline in adolescence is crucial for the promotion of PA. Most studies have only described the PA decline during adolescence in terms of chronological age whilst neglecting pubertal maturation. However, puberty is a major life event accompanied by simultaneous rapid changes with respect to biology, physical appearance, social and psychological capabilities. These changes are often associated with health risk behaviors, psychosomatic syndromes and may also be highly relevant to PA behavior. However, compared to other health behaviors only a small number of studies have been conducted on this issue.

       In girls a negative influence of the degree of pubertal maturation on PA is to be expected. First of all, girls' increase in body fat is not matched by an increase in lean body mass, whereas in boys there is an increase in muscle mass during puberty with the result of a performance advantage in different kinds of sports. Second, the storage of fat in certain body parts of girls (e.g. hips, thighs, buttocks) results in a deviation from the current western female beauty ideal.

       Boys, in general, tend to approximate an athletic male ideal, but the social pressure to reach this ideal seems to be increasing, too. Bodily changes may impact psychological outcomes in terms of body dissatisfaction (BDS) in adolescents of both sexes. Concurrently, physical self-perceptions are one of the key correlates of PA, especially for girls. Several hypotheses and studies also point to the importance of the timing of puberty (relative to same-aged peers), instead of absolute state of pubertal maturation for the choice of health behaviors and for body image [e.g. with partially different implications for boys and girls 

       Studies which examined the association between puberty and PA revealed inconsistencies. Some studies found PA levels varying with absolute pubertal status or with pubertal timing in relation to same-aged peers , sometimes with different effects in both sexes. Other studies could not find any association between puberty and PA.

       In their longitudinal study Davison and colleagues found that a PA decline in early maturing girls was partially mediated by weight- and shape-related maturity fears, low self-worth, and depression. Another study highlighted an association between the deterioration of physical self-perceptions and the decrease of PA over 12 months in early adolescent girls, but maturation only had a limited influence on PA behavior. These results point to the importance of psychological factors, like body image, as possible reactions to physical maturation that may foster the PA decline.

       The aim of the present study was to shed further light on the complex relationships between chronological age, pubertal maturation, BDS, and PA using data of a large-scale representative sample of German youths. According to the comments above our objectives were to examine
a) the associations between chronological age, absolute pubertal status, relative pubertal timing, and PA
b) the role of BDS as a possible mediator.

       Two concepts of pubertal development were distinguished. With absolute pubertal status we refer to the stage of secondary sex characteristic development of boys or girls at a given time regardless of what is the average progress of sexual development at this age. In addition, we introduce pubertal timing as the extent of sexual maturation that a boy or girl has reached in relation to others of the same year of age. The latter refers to adolescents being relatively early, late or average ('on-time') maturing when compared to others of the same sex and age within our sample. Pubertal status does not imply this comparison, but refers to the absolute state of development (i.e. degree of pubertal hair growth or voice change independent of the average degree).

       Due to sex-specific physiological changes occurring during puberty (i.e. increase in muscle mass in boys versus increase in fat mass in girls) we expected a negative association of pubertal development with PA in girls, while in boys a positive association was expected after controlling for chronological age. In terms of pubertal timing we expected negative effects in 'off-time' youths, especially in early maturing girls and late maturing boys, related to PA and BDS. We also expected lower PA levels for youths dissatisfied with their weight.

Sports and Recreational Physical Activities
       In recreational sports activities there generally are no rules against using legally prescribed medications to treat medical conditions. The regulating organizations of amateur and professional sporting events have a requirement of drug testing which are intended to detect very small quantities of drugs.  They allow some prescription drugs, but do not allow performance enhancing drugs or medical procedures.

       Parents and coaches should lead by example and firmly support a "zero" policy for this type of conduct that must extend from how every athlete conducts their private life and this carries over into their public life.

       Even though alcohol and nicotine consumption are legal in the USA and most other countries, there are laws as to the minimum age to purchase and the circumstances allowed for consumption. In the case of alcohol, there are maximum blood levels which determine the criminal state of drunkenness. It is advisable that young athletes should be actively discouraged from starting to use either nicotine or alcohol.

       Voluntary drug testing should be a policy that is used by high schools. An education program by coaches should make athletes aware of the mandatory drug testing that the International Olympic Committee and World Sporting Organization have had in place for decades.

       An athlete who desires to become a winner should be aware that others, within their sport and the general public, will hold them up as an example representative of their sport and country. It is important to be aware skaters selected for the USFSA world or Olympic teams understand they are perceived as  ambassadors of the USA. People in other countries will form opinions about the USA based on the personal conduct and ethical choices they observe or see reported in the news about our athletes.

       A relatively small percentage of college athletes who participate in NCAA sports will become professional sports athletes. Those that do earn a living as an owner of a sports team, coach, or play as a professional athlete, must understand that the public takes a dim view of negative images of athletes who are associated with marketing corporate products.  A moral turpitude clause is usually part of all endorsement contracts.


The following internet links have been gleaned from personal communications
combined with information from public institutions and athletic organizations/
associations that have a web presence with information concerning team and
individual sports programs:

Alcohol Abuse
Drug Abuse
Caffeine Use
Nicotine Use
Response to Stressors
Learning to be Helpless
Depression and Elation
Eating Disorders
Learning Disorders
Stress and Anxiety
Athlete Motivation
Flow/Peak Performance
Focus & Concentration
Goals and Objectives
Goal Setting
Personal Sabotage
Self Fulfilling Prophecy

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