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CORK Bibliography: Athletes

88 citations. 2009 to present

Prepared: December 2011

Adedoyin RA; Mbada CE; Odiachi AM; Adegoke BOA; Awotidebe TO. Differences in back extensor muscles fatigability for smoking and non-smoking athletes. Isokinetics and Exercise Science 18(3): 149-155, 2010. (58 refs.)

Background and objective: Empirical research on the influence of smoking on musculoskeletal health in athletes is sparse. The objective of this study was to compare back extensor muscles' strength (BEMS) before and after a fatigue induction protocol among smoking and non smoking male athletes. A pretest-posttest design was used to determine the difference in BEMS between smoking (N = 52) and non smoking (N = 52) athletes aged 18 and 30. A back and leg dynamometer was used to quantify BEMS while repetitive prone chest raise test was used to induce fatigue of the back extensor muscles. The smoking (23.1 +/- 2.9 years) and non-smoking athletes (23.2 +/- 2.37 years) were comparable in age (p = 0.855). Smoking athletes exhibited a significantly higher rating of perceived exertion (p = 0.007) and fatigue index (10.76% vs. 5.07%); and significant reduction in BEMS following fatigue induction (p < 0.05) compared with their non smoking counterparts. Smoking athletes have higher rates of muscular fatiguability and decreased back strength following back extensors tasks. Smoking is associated with increased muscle fatiguability and impairment of back strength in athletes.

Anderson JM. Evaluating the athlete's claim of an unintentional positive urine drug test. (review). Current Sports Medicine Reports 10(4): 191-196, 2011. (28 refs.)

During a urine drug testing program, an athlete may make a claim that the results of a positive test have arisen from factors that were out of his or her control, and therefore, he or she should not be held responsible for the results. Some of these claims may include classic claims of passive inhalation of marijuana smoke or ingestion of poppy seeds leading to positive tests. In addition, with the proliferation of nutritional supplements on the market, many athletes claim that they accidentally ingested a banned substance contained in one of these. It is important that any sports medicine physician involved with sports drug testing be informed of the data that either support or refute these claims and that he or she contribute to a program wherein adequate education and policy establishment help to limit the likelihood of such claims. This article will review the data to help address these claims.

Astorino TA; Roberson DW. Efficacy of acute caffeine ingestion for short-term high-intensity exercise performance: A systematic review. Journal of Strength and Conditioning Research 24(1): 257-265, 2010. (76 refs.)

Caffeine is the most widely used drug in the world, commonly ingested in coffee, tea, soda, and energy drinks. Its ability to enhance muscular work has been apparent since the early 1900s. Caffeine typically increases endurance performance; however, efficacy of caffeine ingestion for short-term high-intensity exercise is equivocal, which may be explained by discrepancies in exercise protocols, dosing, and subjects' training status and habitual caffeine intake found across studies. The primary aim of this review is to critically examine studies that have tested caffeine's ability to augment performance during exercise dependent on nonoxidative metabolism such as sprinting, team sports, and resistance training. A review of the literature revealed 29 studies that measured alterations in short-term performance after caffeine ingestion. Each study was critically analyzed using the Physiotherapy Evidence Database (PEDro) scale. The mean PEDro score was 7.76 +/- 0.87. Eleven of 17 studies revealed significant improvements in team sports exercise and power-based sports with caffeine ingestion, yet these effects were more common in elite athletes who do not regularly ingest caffeine. Six of 11 studies revealed significant benefits of caffeine for resistance training. Some studies show decreased performance with caffeine ingestion when repeated bouts are completed. The exact mechanism explaining the ergogenic effect of caffeine for short-term exercise is unknown.

Backhouse SH; Biddle SJH; Bishop NC; Williams C. Caffeine ingestion, affect and perceived exertion during prolonged cycling. Appetite 57(1): 247-252, 2011. (34 refs.)

Caffeine's metabolic and performance effects have been widely reported. However, caffeine's effects on affective states during prolonged exercise are unknown. Therefore, this was examined in the present study. Following an overnight fast and in a randomised, double-blind, counterbalanced design, twelve endurance trained male cyclists performed 90 min of exercise at 70% VO2 (max) 1 h after ingesting 6 mg kg(-1)BM of caffeine (CAF) or placebo (PLA). Dimensions of affect and perceived exertion were assessed at regular intervals. During exercise, pleasure ratings were better maintained (F-(3,F-38) = 4.99, P < 0.05) in the CAF trial compared to the PLA trial with significantly higher ratings at 15,30 and 75 min (all P < 0.05). Perceived exertion increased (F-(3,F-28) = 19.86, P < 0.01) throughout exercise and values, overall, were significantly lower (F-(1,F-11) = 9.26, P < 0.05) in the CAF trial compared to the PLA trial. Perceived arousal was elevated during exercise but did not differ between trials. Overall, the results suggest that a moderate dose of CAF ingested 1 h prior to exercise maintains a more positive subjective experience during prolonged cycling. This observation may partially explain caffeine's ergogenic effects.

Backhouse SH; McKenna J. Doping in sport: A review of medical practitioners' knowledge, attitudes and beliefs. (review). International Journal of Drug Policy 22(3): 198-202, 2011. (35 refs.)

Background: Central to the work of many medical practitioners is the provision of pharmaceutical support for patients. Patients can include athletes who are subject to anti-doping rules and regulations which prohibit the use of certain substances in and out of competition. This paper examines the evidence on medical practitioners' knowledge, attitudes and beliefs towards doping in sport. Methods: A systematic search strategy was followed. Research questions and relevance criteria were developed a priori. Potentially relevant studies were located through electronic and hand searches limited to English language articles published between 1990 and 2010. Articles were assessed for relevance by two independent assessors and the results of selected studies were abstracted and synthesised. Outcomes of interest were knowledge, attitudes and beliefs in relation to doping in sport. Results: Six studies met the inclusion criteria and were examined in detail. Samples reflected a range of medical practitioners drawn from the UK, France (2), Greece, Italy and Ireland. The investigations varied with respect to outcome focus and quality of evidence presented. Conclusion: Whilst the extant empirical research posits a negative attitude towards illegal performance enhancement combined with a positive inclination towards doping prevention, it also exposes a limited knowledge of anti-doping rules and regulations. Insufficient education, leading to a lack of awareness and understanding, could render this professional group at risk of doping offences considering Article 2.8 of the World Anti-Doping Agency Code (WADC). Moreover, in light of the incongruence between professional medical codes and WADC Article 2.8, medical professionals may face doping dilemmas and therefore further discourse is required. At present, the current evidence-base makes it difficult to plan developmentally appropriate education to span the exposure spectrum. Addressing this situation appears warranted.

Ballard SL; Wellborn-Kim JJ; Clauson KA. Effects of commercial energy drink consumption on athletic performance and body composition. Physician and Sportsmedicine 38(1): 107- 117, 2010. (84 refs.)

Energy drinks are frequently marketed to individuals interested in athletics and an active lifestyle. From 2001 to 2008, estimates of energy drink use in adolescent to middle-aged populations ranged from 24% to 56%. Most energy drinks feature caffeine and a combination of other components, including taurine, sucrose, guarana, ginseng, niacin, pyridoxine, and cyanocobalamin. This article examines the evidence for 2 commonly purported uses of energy drinks: athletic performance enhancement and weight loss. Observed ergogenic benefits of energy drinks are likely attributable to caffeine and glucose content. There is conflicting evidence regarding the impact of energy drinks on weight loss, although some data suggest that combining energy drink use with exercise may enhance body fat reduction. As with any pharmacologically active substance, energy drinks are associated with adverse effects. Combining energy drinks with alcohol exacerbates safety concerns and is an increasingly common practice contributing to toxic jock identity among college-aged male athletes. Practitioners should monitor identified populations likely to consume these loosely regulated beverages.

Beguinot E; Gallopel-Morvan K; Wirth N; Spinosa A; Martinet Y. Tobacco advertising through French TV in 2005: Frequent illicit broadcasting; its impact on teenagers and young adults. Journal of Public Health 32(2): 184-190, 2010. (20 refs.)

Background: Sports sponsorship is one of the tobacco industry's main strategies to recruit new smokers among teenagers and young adults. Methods: Monitoring Motor sports illicit broadcasting based on six channels in 2005; Dakar Rally (DR) and China Grand Prix impact evaluated with a one on one questionnaire administered on 12-24-year-old males and females (n = 805). Results: 75 000 TV tobacco sponsoring appearances (90 h) were observed, total value: (sic)200.10(6); Mild Seven, Marlboro, West, Lucky Strike, Gauloises Blondes accounted for 92% appearances and 95% of euro values, with illegal broadcasting value worth (sic)19.10(6). A high interest in DR (71%) and Formula One (F1) (66%) was observed among males (versus females; P < 0.001), increasing with age (P < 0.05). Levels of spontaneous and assisted recall of cigarette brands were high among individuals interested in DR and F1, with better recall of brand names (versus non interested; P < 0.01); all individuals made correct associations between tobacco brands and car colors (P < 0.01). A non-significant higher percentage of daily smokers was observed among respondents interested in DR (34 versus 21%; P < 0.01) and F1 (30 versus 24%; P = 0.10). Conclusion: This high level of indirect advertising for tobacco through motor sport sponsoring confirms the urgent need for a worldwide absolute ban on tobacco advertising in motor sports.

Berglund L; Sundgot-Borgen J; Berglund B. Adipositas athletica: a group of neglected conditions associated with medical risks. (review). Scandinavian Journal of Medicine & Science In Sports 21(5): 617-624, 2011. (61 refs.)

At the 2008 Olympics, the body weight of the athletes varied from 28 to 181 kg and many Olympic athletes therefore today have a stature far from the ancient Greek athletic ideals. Athletes and sports associated with leanness and their medical problems have been researched extensively. However, there has been less focus on those athletes, who may gain a competitive advantage by having excess body fat, being large or oversized. The present review introduces for the first time the concept of Adipositas athletica and gives a description and classification of these athletes. Adipositas athletica is defined as having a higher than "athletic normal" (Greek Olympic ideals) fat mass and being an elite athlete. The condition is divided into subgroups based on the intent or non-intent to increase body fat per se. Another factor is the intent to increase body mass as well as increasing physiological factors such as strength or endurance. It is concluded that most of the sports-medicine community-physicians, researchers and nutritionists - has neglected these oversized and obese athletes, their long- and short-term morbidity and mortality, their eating problems and the use of performance-enhancing drugs. Although some data on overweight and obese athletes exist, the most remarkable finding when reviewing the literature is the paucity of data. Many unanswered questions remain and great strides remain to be made.

Bilard J; Ninot G; Hauw D. Motives for illicit use of doping substances among athletes calling a national antidoping phone-help service: An exploratory study. Substance Use & Misuse 46(4): 359-367, 2011. (39 refs.)

This study aimed to construct a hierarchy of motives linked to doping behaviors. Between 2000 and 2005, calls to a national antidoping phone-help service by 115 cyclists, 203 bodybuilders, and 40 footballers were analyzed. The results showed that the main motives were preserving health for cyclists, increasing muscular strength for bodybuilders, and personal recreation for footballers. However, in contrast to the literature, group influence was low and health preoccupations were high for cyclists; the influence of body image was relatively low for bodybuilders; and footballers cited muscular strength enhancement as a motive. The study's limitations are noted. The prevention campaigns therefore need to be specific.

Bloodworth A; McNamee M. Clean Olympians? Doping and anti-doping: The views of talented young British athletes. International Journal of Drug Policy 21(4): 276-282, 2010. (47 refs.)

Background: Review articles suggest a small but significant proportion (between 3 and 12%) of male adolescents have used anabolic-androgenic steroids (AAS) at some point (Yesalis and Bahrke, 2000; Calfee and Fadale, 2006). In sport, the use of prohibited substances or processes to enhance performance, collectively referred to as 'doping', is banned by both sports National and International Governing Bodies, and by the World Anti-Doping Agency (WADA) who run an extensive testing programme and educational initiatives designed to foster anti-doping attitudes. Method: A total of 40 talented male and female athletes (mean average age 19.6 years) from 13 different sports attended 12 focus groups held over the UK intended to investigate athletes' attitudes toward doping. Focus group transcriptions were analysed and coded with the use of QSR NVivo 8. Results: Athletes in general did not report a significant national doping problem in their sport, but exhibited sporting xenophobia with regard to both doping practices and the stringency of testing procedures outside of the UK. Athletes often viewed doping as 'unnatural' and considered the shame associated with doping to be a significant deterrent. Athletes perceived no external pressure to use performance enhancing drugs. In response to hypothetical questions, however, various factors were acknowledged as potential 'pressure' points: most notably injury recovery and the economic pressures of elite sport. Finally, a significant minority of athletes entertained the possibility of taking a banned hypothetical performance enhancing drug under conditions of guaranteed success and undetectability. Conclusions: The athletes in this study generally embraced those values promoted in anti-doping educational programmes, although there were some notable exceptions. That the social emotion of shame was considered a significant deterrent suggests anti-doping efforts that cultivate a shared sense of responsibility to remain 'clean' and emphasise the social sanctions associated with being deemed a 'drugs cheat', resonate with this atypical social group.

Brant WO; Myers JB; Carrell DT; Smith JF. Male athletic activities and their effects on semen and hormonal parameters. Physician and Sportsmedicine 38(3): 114- 120, 2010. (54 refs.)

Infertility is generally defined as the inability to conceive a pregnancy or the failure to do so within a reasonable period (typically 12 months). Approximately 85% of couples conceive a first pregnancy within 12 months. The prevalence of infertility has increased over the past 10 years, with approximately 10 million affected couples in the United States. Roughly 40% to 50% of infertility is either due to, or is contributed by, a male factor. Given how common the condition is, men and their partners are understandably concerned and interested in identifying and eliminating risk factors for male infertility. This article reviews the available literature on various aspects of male infertility related to athletic pursuits. These include the effects of exercise on semen parameters, hormonal axes, and testicular health. Due to the prevalence and particular relevance of anabolic steroid use by athletes and the impact of steroid use on fertility, this topic is also reviewed.

Buckman JF; Yusko DA; Farris SG; White HR; Pandina RJ. Risk of marijuana use in male and female college student athletes and nonathletes. Journal of Studies on Alcohol and Drugs 72(4): 586-591, 2011. (36 refs.)

Objective: A large minority of collegiate athletes report past-year marijuana use even though there is a significant possibility of experiencing negative athlete-specific consequences related to performance, eligibility, and scholarship. The present study examined risk factors that can drive or curb marijuana use in college athletes and nonathletes. Method: Logistic regressions, performed separately for men and for women, assessed the relationship of past-year marijuana use to sensation seeking, negative mood, perceptions of peer marijuana use, motivations for marijuana use, and stress related to body image and academics in athletes (233 men, 156 women) and nonathletes (184 men, 313 women). Risk factors also were compared for male past-year marijuana users who reported using (n = 26) or not using (n = 61) the substance during their competitive season. Results: For athletes and nonathletes of both genders, being White, being past-year cigarette smokers, having higher sensation-seeking scores, and having exaggerated perceptions of student use norms were associated with past-year marijuana use. Enhancement motivations for use were higher among athletes compared with their same-gender nonathlete peers. In women, but not in men, greater body image stress and lower academic stress were associated with past-year marijuana use. Male athletes who continued using marijuana into their competitive season demonstrated a qualitatively different risk profile compared with athlete past-year users who reported no in-season use, including greater coping motivations for marijuana use. Conclusions: This preliminary study suggests that although the overall risk profile of college athletes and nonathletes is similar, athletes appear to be particularly motivated to use marijuana because of its enhancement or pleasurable properties.

Cottler LB; Ben Abdallah A; Cummings SM; Barr J; Banks R; Forchheimer R. Injury, pain, and prescription opioid use among former National Football League (NFL) players. Drug and Alcohol Dependence 116(1-3): 188-194, 2011. (18 refs.)

Background: Athletes with injury-related pain, especially National Football League (NFL) players, are at increased risk for opioid use and misuse which may result in medical, psychiatric and social problems. This is the first study to evaluate the intersection of sports pain and opioid use and misuse among former NFL players. Methods: A telephone survey of 644 retired NFL players from the 2009 Retired Players Association Directory was conducted (53.4% completion rate) from March to August 2010. Results: Over half (52%) used opioids during their NFL career with 71% reporting misuse. Additionally, 15% of NFL misusers currently misused vs. 5% among players who used just as prescribed during their NFL career. Prevalence of current opioid use was 7%-3 times the rate of the general population. Multivariate analyses indicated that significant NFL pain increased the adjusted odds (AOR) of any current opioid use vs. non-use (AOR 6.76, 95%CI 2.88-15.87), as did moderate to severe mental impairment (AOR 1.88, 95%CI 1.19-2.98) and heavy drinking in the past week (AOR 2.15, 95%CI 1.17-3.98). Undiagnosed concussions singly predicted current misuse vs. use just as prescribed (AOR 4.25, 95%CI 1.12-16.22). Three variables predicted current misuse vs. non-use: significant pain (AOR 8.33, 95%CI 1.98-35.04), undiagnosed concussions (AOR 3.51, 95%CI 1.98-35.04) and heavy drinking (AOR 3.48, 95%CI 1.63-7.41). Conclusions: Players who misused during their NFL career were most likely to misuse currently compared to others. Current misuse was associated with more NFL pain, undiagnosed concussions and heavy drinking. Longitudinal studies are needed to determine the long term effects of opioid misuse among athletes.

De Vany A. Steroids and home runs. Economic Inquiry 49(2): 489-511, 2011. (13 refs.)

There has been no change in Major League Baseball home run hitting for 45 yr, in spite of the new records. Players hit with no more power now than before. Records are the result of chance variations in at bats, home runs per hit, and other factors. The clustering of records is implied by the intermittency of the law of home runs. Home runs follow a stable Paretian distribution with infinite variance. The shape and scale of the distribution have not changed over the years. The greatest home run hitters are as rare as great scientists, artists, or composers.

Deshmukh N; Petroczi A; Barker J; Szekely AD; Hussain I; Naughton DP. Potentially harmful advantage to athletes: A putative connection between UGT2B17 gene deletion polymorphism and renal disorders with prolonged use of anabolic androgenic steroids. Substance Abuse Treatment, Prevention and Policy 5: article 7, 2010. (56 refs.)

Background and objective: With prolonged use of anabolic androgenic steroids (AAS), occasional incidents of renal disorders have been observed. Independently, it has also been established that there are considerable inter-individual and inter-ethnic differences, in particular with reference to the uridine diphosphate-glucuronosyltransferase 2B17 (UGT2B17) gene, in metabolising these compounds. This report postulates the association of deletion polymorphism in the UGT2B17 gene with the occurrence of renal disorders on chronic exposure to AAS. Presentation of the hypothesis: The major deactivation and elimination pathway of AASs is through glucuronide conjugation, chiefly catalyzed by the UGT2B17 enzyme, followed by excretion in urine. Excretion of steroids is affected in individuals with a deletion mutation in the UGT2B17 gene. We hypothesize that UGT2B17 deficient individuals are more vulnerable to developing renal disorders with prolonged use of AAS owing to increases in body mass index and possible direct toxic effects of steroids on the kidneys. Elevated serum levels of biologically active steroids due to inadequate elimination can lead to prolonged muscle build up. An increase in body mass index may cause renal injuries due to sustained elevated glomerular pressure and flow rate. Testing the hypothesis: In the absence of controlled clinical trials in humans, observational studies can be carried out. Real time PCR with allelic discrimination should be employed to examine the prevalence of different UGT2B17 genotypes in patients with impaired renal function and AAS abuse. In individuals with the UGT2B17 deletion polymorphism, blood tests, biofluid analyses, urinalysis, and hair analyses following the administration of an anabolic steroid can be used to determine the fate of the substance once in the body. Implications of the hypothesis: If the hypothesis is upheld, anabolic steroid users with a deletion mutation in the UGT2B17 gene may be exposed to an increased risk of developing renal disorders. In the current detecting sanctioning anti-doping system, athletes motivated by the potential to evade detection owing to their unique genetic make-up could subject themselves to a serious health consequence. More research on AAS metabolism in the presence of UGT2B17 gene deletion is required. Benefit - harm evaluations in therapeutic use of anabolic steroids should also consider this potential link between UGT2B17 gene deletion polymorphism and renal disorders.

Donike M. The detection of doping by means of chromatographic methods. Drug Testing and Analysis 3(1): 15-17, 2011. (14 refs.)

This article was first published in German in Der Sportarzt, 1966, 2, 81-84 as Der Dopingnachweis mit Hilfe chromatographischer Methoden. Translated and republished with permission. Doping has become an issue in elite sport and necessitates sensitive detection assays that enable the identification of organic compounds on a microscale level in urine. In agreement with modern toxicological methods, sports drug testing approaches can utilize paper, thin layer or gas chromatographic methods to reveal the presence of prohibited substances such as strychnine, pervitine, captagone, benzedrine etc. in doping control specimens. Basic principles of these strategies are summarized and considerations for future applications discussed.

Doumas DM; Haustveit T; College KM. Reducing heavy drinking among first year intercollegiate athletes: A randomized controlled trial of web-based normative feedback. Journal of Applied Sport Psychology 22(3): 247-261, 2010. (54 refs.)

This study evaluated the efficacy of a web-based personalized normative feedback program targeting heavy drinking in first-year intercollegiate athletes. The program was offered through the Athletic Department first-year seminar at a National Collegiate Athletic Association (NCAA) Division I university. Athletes were randomly assigned to either a web-based feedback group or a comparison condition. Results indicated high-risk athletes receiving the intervention reported significantly greater reductions in heavy drinking than those in the comparison group. Additionally, intervention effects were mediated by changes in perceptions of peer drinking. Findings support the use of web-based normative feedback for reducing heavy drinking in first-year intercollegiate athletes.

Dowse MS; Shaw S; Cridge C; Smerdon G. The use of drugs by UK recreational divers: Illicit drugs. Diving and Hyperbaric Medicine 41(1): 9-15, 2011. (24 refs.)

Aims: Anecdotal observations suggest the use of illicit drugs takes place amongst recreational divers but, to date, there has been little open debate within the diving community concerning possible prevalence. This study investigated the prevalence and type of illicit drugs used by recreational divers in the United Kingdom (UK). Methods: Anonymous questionnaires were circulated via UK dive clubs, dive schools, dive shows and conferences. Questions incorporated diver and diving demographics and general health, which included anxiety, depression and panic attacks, alcohol use, smoking and illicit drug use since learning to dive and closest time to a dive. Questions pertaining to over-the-counter and prescription drug use were also asked. Results: 479 divers responded (66% males and 34% females) in the age range 16 to 59 years. Of the respondents, 22% had used one or more illicit drug since learning to dive, reporting benzodiazepines, amphetamines, cocaine, ecstasy, LSD, cannabis, heroin, and 'magic mushrooms'. Illicit drugs had been used by 3.5% of respondents in the last 12 months, and 3% in the last month. Cannabis, cocaine and ecstasy use was reported within 6 hours of a dive. Logistic regression confirmed a relationship between illicit drug use and depression (P = 0.014), and also between illicit drug use and anxiety (P = 0.024). Conclusion: These data support anecdotal reports that recreational divers use a range of illicit drugs. The significant relationship between illicit drug use and depression and anxiety supports the literature in non-diving populations.

Duchan E; Patel ND; Feucht C. Energy drinks: A review of use and safety for athletes. (review). Physician and Sportsmedicine 38(2): 171- 179, 2010. (97 refs.)

Energy drinks have increased in popularity in adolescents and young adults; however, concerns have been raised regarding the ingredients in energy drinks and their potential negative effects on health. Caffeine, the most physiologically active ingredient in energy drinks, is generally considered safe by the US Food and Drug Administration (FDA), although adverse effects can occur at varying amounts. Guarana, which contains caffeine in addition to small amounts of theobromine, theophylline, and tannins, is also recognized as safe by the FDA, although it may lead to caffeine toxicity when combined with caffeine. The amount of ginseng in energy drinks is typically far below the amount used as a dietary supplement, and is generally considered safe. Taurine, an intracellular amino acid, has been reported to have positive inotropic effects; however, this claim is not supported by research. Most energy drinks also contain sugar in an amount that exceeds the maximum recommended daily amount. Young athletes are increasingly using energy drinks because of the ergogenic effects of caffeine and the other ingredients found in these beverages. Energy drinks combined with alcohol are also gaining popularity in young adults, which poses significant concerns about health risks. Other health concerns related to consumption of energy drinks include case reports of seizures and cardiac arrest following energy drink consumption and dental enamel erosion resulting from the acidity of energy drinks.

Dunn M; Thomas JO; Swift W; Burns L; Mattick RP. Drug testing in sport: The attitudes and experiences of elite athletes. International Journal of Drug Policy 21(4): 330-332, 2010. (7 refs.)

Background: This study aimed to investigate, among a sample of elite Australian athletes, the extent to which this group supports drug testing as a deterrent to drug use. Method: Data was collected from a convenience sample of (n = 974) elite Australian athletes who self-completed a questionnaire, and semi-structured telephone surveys with key experts. Results: The athletes surveyed endorsed testing for banned substances as an effective way of deterring drug use: believed that the current punishments for being caught using a banned substance was of the appropriate severity; and indicated that there should be separate policies regarding illicit drug (ID) and performance-enhancing drug (PED) use. Conclusion: A large proportion of elite athletes in Australia endorse drug testing as an effective means of deterring drug use. They perceive a difference between being detected using a PED and an ID and believe that penalties should reflect this difference. Future research may wish to investigate attitudes towards newer methods employed to detection drug use.

Dunn M; Thomas JO; Swift W; Burns L. Recreational substance use among elite Australian athletes. Drug and Alcohol Review 30(1): 63-68, 2011. (29 refs.)

Introduction and Aims. The study aimed to investigate the prevalence of illicit drug use among elite Australian athletes with a focus upon cannabis, ecstasy, meth/amphetamine, cocaine, GHB and ketamine; explore perceptions concerning the extent of drug use among this group; ascertain opinions regarding specific drugs of concern; and investigate predictors of recent drug use. Design and Methods. Data were taken from surveys with 974 elite athletes. Results. One-third of the sample had been offered or had the opportunity to use illicit drugs in the past year; despite this, the self-reported prevalence of all six drugs under investigation was lower than that reported by the general population. Sixteen per cent of athletes believed that there was a drug of concern in their sport, with ecstasy, cocaine and alcohol being nominated. Knowing other athletes who use illicit drugs, being offered or having the opportunity to use drugs and identifying as a 'full-time athlete' were significant predictors of recent drug use. Discussion and Conclusions. The present study found that one-third of the athlete sample had been offered or had the opportunity to use illicit drugs in the past year; despite this, there was low self-reported drug use. Despite media discussion regarding alcohol use in sport, alcohol was nominated as a drug of concern only by a small proportion of athletes, and further research investigating this issue may be warranted.

Dunn M; Thomas JO. A risk profile of elite Australian athletes who use illicit drugs. Addictive Behaviors 37(1): 144-147, 2012. (26 refs.)

Much of the literature investigating the relationship between sports participation and substance use has focused upon student populations, with little focus being given to athletes who participate at elite levels. Identifying why some athletes may be at a greater risk for substance use can help in the design and implementation of prevention initiatives. Data for the current study was from 1684 self-complete surveys with elite Australian athletes. Eight percent (n=134) of the sample reported the use of at least one of the six illicit drugs under investigation (ecstasy, cannabis, cocaine, meth/amphetamine, ketamine and GHB) in the past year. Having been offered or having had the opportunity to use illicit drugs in the past year, knowing other athletes who use drugs and identifying as a 'full-time athlete' were significant predictors of past-year illicit drug use, while having completed secondary education or a post-school qualification was associated with a lower likelihood of past-year illicit drug use. Athletes are part of a sportsnet that includes family, coaches, support staff and other athletes, and these relationships may encourage the use, supply and demand for drugs. The current findings suggest that relationships with some of those in the sportsnet may play an important role when understanding illicit drug use among elite athletes. As education appears to be associated with a lower likelihood of illicit drug use among this group, initiatives should encourage athletes to engage in off-field pursuits which may also help prepare them for life after sport.

Duvnjak-Zaknich DM; Dawson BT; Wallman KE; Henry G. Effect of caffeine on reactive agility time when fresh and fatigued. Medicine and Science In Sports and Exercise 43(8): 1523-1530, 2011. (39 refs.)

Purpose: This study examined the effects of acute caffeine ingestion on agility performance and decision-making accuracy after simulated team-sport exercise. Methods: Using a randomized, double-blinded, counterbalanced design, 10 moderately trained male team-sport athletes ingested either caffeine (6 mg.kg(-1)) or placebo (dextrose) 60 min before completing an 80-min (4 x 20 min) simulated team-game, intermittent running protocol. Interspersed between each exercise quarter was a reactive agility test (RAT) consisting of five trials where measures of total time (TT), reactive agility (RA) time, decision time (DT), movement time (MT), and decision-making accuracy were obtained. Results: Although there were no significant differences between trials for TT (P = 0.54), RAtime (P = 0.84), MT (P = 0.89), or DT (P = 0.91), caffeine ingestion resulted in consistently faster TT (2.3%), RA time (3.9%), MT (2.7%), and DT (9.3%) scores compared with placebo (significant main effect for condition for RA time, TT, DT, and MT; P < 0.05). These faster times were supported by qualitative analyses of "almost certain benefit" and large effect size (ES) for RA (quarter 3) and "likely" to "very likely benefits" and moderate to large ES for TT (precircuit and quarters 1, 2, and 4) and RA time (precircuit and quarters 1, 2 and 4). A "likely benefit" and moderate ES was found for MT (quarters 1 and 3), but the effect of caffeine on DT was largely "unclear," with small ES and only a "likely" chance of benefit (quarters 2 and 3). Improved decisionmaking accuracy (3.8%) after caffeine ingestion was supported by a "likely benefit" (quarter 1) and large ES (quarters 1 and 4). Conclusion: Caffeine ingestion may be beneficial to RA performance when athletes are fresh and fatigued.

Ely BR; Ely MR; Cheuvront SN. Marginal effects of a large caffeine dose on heat balance during exercise-heat stress. International Journal of Sport Nutrition and Exercise Metabolism 21(1): 65-70, 2011. (37 refs.)

The use of caffeine supplements in athletic and military populations has increased in recent years. Excessive caffeine consumption in conjunction with exercise in a hot environment may predispose individuals to heat illness. Purpose: To examine heat balance induced by a large dose of caffeine during exercise in a hot environment. Methods: Ten men, not heat acclimated and not habitual caffeine users, consumed either caffeine (CAF; 9 mg/kg) or placebo (PLA) before performing cycle-ergometer exercise for 30 min at 50% VO2peak in a 40 degrees C, 25% relative humidity environment while body temperature (core and skin) and ratings of thermal comfort (TC) were monitored. Heat-exchange variables were calculated using partitional calorimetry and thermometry. Results: Mean body temperature (T-b) was higher (p < .05) with CAF (37.18 +/- 0.15 degrees C) than with PLA (36.93 +/- 0.15 degrees C) at the start of exercise. Heat production was slightly higher (similar to 8 W, p < .05) with CAF. There were no differences in heat storage, dry heat gains, TC, or T-b during exercise. Conclusions: A caffeine dose of 9 mg/kg does not appreciably alter heat balance during work in a hot environment. The small increase in T-b observed with CAF was undetected by the participants and is unlikely to increase physiological strain sufficiently to affect endurance performance or risk of heat illness.

Gaudio RM; Barbieri S; Feltracco P; Spaziani F; Alberti M; Delantone M et al. Impact of alcohol consumption on winter sports-related injuries. Medicine, Science and the Law 50(3): 122-125, 2010. (10 refs.)

Introduction: This study was carried out to evaluate data about trauma-related winter sports, including risk factors such as high speed, gender, age, alcohol consumption, details about the accident and snow conditions. Methods: A retrospective review was conducted to determine the injury patterns and crash circumstances in holiday skiers and snowboarders. The data recorded were obtained from the database of the Pre-Hospital Emergency Registry of six skiing areas in the Dolomite mountains during the winter seasons November 2004-May 2009, injury data for major traumas from Ski Patrol Injury reports (helicopter, ambulance or ski slopes' patrol reports), and intrahospital Emergency Department data. Alcohol concentration in blood was detected in 200 individuals suffering from major trauma. Results: A total of 4550 injured patients, predominantly male (69%), mean age 22 years (range 16-72), were included in the observational analysis. Knee, wrist and shoulder injuries were frequently associated with major thoracic, abdominal or head traumas (64% of cases). Suboptimal technical level, high speed, low concentration, snow or weather conditions, faulty equipment and protective devices were among the various causes of accidents. The analysis revealed that high alcohol blood concentration was present in 43% of 200 patients. Conclusions: Even though the major causes of accidents were excessive speed, excessive fatigue, technical errors and bad weather conditions, alcohol abuse was often discovered. Random sampling and a non-systematic detection of alcohol blood levels likely led to an underestimation of alcohol consumption-related injuries. It is recommended that investigations into alcoholic intoxication in injured skiers should be carried out on a large scale.

Goldstein ER; Ziegenfuss T; Kalman D; Kreider R; Campbell B; Wilborn C et al. International Society of Sports Nutrition Position Stand: Caffeine and performance. (review). Journal of the International Society of Sports Nutrition 7: 5, 2010. (95 refs.)

Position Statement: The position of The Society regarding caffeine supplementation and sport performance is summarized by the following seven points: 1.) Caffeine is effective for enhancing sport performance in trained athletes when consumed in low-to-moderate dosages (similar to 3-6 mg/kg) and overall does not result in further enhancement in performance when consumed in higher dosages (>= 9 mg/kg). 2.) Caffeine exerts a greater ergogenic effect when consumed in an anhydrous state as compared to coffee. 3.) It has been shown that caffeine can enhance vigilance during bouts of extended exhaustive exercise, as well as periods of sustained sleep deprivation. 4.) Caffeine is ergogenic for sustained maximal endurance exercise, and has been shown to be highly effective for time-trial performance. 5.) Caffeine supplementation is beneficial for high-intensity exercise, including team sports such as soccer and rugby, both of which are categorized by intermittent activity within a period of prolonged duration. 6.) The literature is equivocal when considering the effects of caffeine supplementation on strength-power performance, and additional research in this area is warranted. 7.) The scientific literature does not support caffeine-induced diuresis during exercise, or any harmful change in fluid balance that would negatively affect performance.

Greydanus DE; Patel DR. Sports doping in the adolescent: The Faustian conundrum of hors de combat. Pediatric Clinics of North America 57(3): 729-750, 2010. (128 refs.)

The drive toward success in sports and the need for a cosmetically acceptable appearance have driven many adolescents to take a wide variety of so-called doping substances. The consumption of these chemicals in the hope and hype of improved sports performance, fueled by the easing of government restrictions on their proof of safety and efficacy, has resulted in an explosion of so-called ergogenic products available to our youth. Agents that have been used include anabolic steroids, anabolic-like agents, designer steroids, creatine, protein and amino acid supplements, minerals, antioxidants, stimulants, blood doping, erythropoietin, beta-blockers, and others. The use of these agents has considerable potential to cause physical and psychological damage. Use and misuse of drugs in this sports doping process should be discouraged. This discussion reviews some of the agents that are currently being used. Clinicians providing sports medicine care to youth, whether through anticipatory guidance or direct sports medicine management, should educate their young patients about the hype and hyperbole of these products that may keep them out instead of in the game at considerable financial cost to the unwary consumer.

Grossbard JR; Mastroleo NR; Kilmer JR; Lee CM; Turrisi R; Larimer ME et al. Substance use patterns among first-year college students: Secondary effects of a combined alcohol intervention. Journal of Substance Abuse Treatment 39(4): 384-390, 2010. (32 refs.)

This study explored secondary effects of a multisite randomized alcohol prevention trial on tobacco, marijuana and other illicit drug use among a sample of incoming college students who participated in high school athletics. Students (n = 1,275) completed a series of Web-administered measures at baseline during the summer before starting college and 10 months later. Students were randomized to one of four conditions a parent-delivered intervention, a brief motivation enhancement intervention (Brief Alcohol Screening and Intervention for College Students [BASICS]) a condition combining the parent intervention and BASICS, and assessment-only control A series of analyses of variance evaluating drug use outcomes at the 10-month follow-up assessment revealed significant reductions in marijuana use among students who received the combined intervention compared to the BASICS-only and control groups. No other significant differences between treatment conditions were found for tobacco or other illicit drug use Our findings suggest the potential utility of targeting both alcohol and marijuana use when developing peer- and parent-based interventions for students transitioning to college. Clinical implications and future research directions are considered.

Hildebrandt T; Langenbucher JW; Lai JK; Loeb KL; Hollander E. Development and validation of the appearance and performance enhancing drug use schedule. Addictive Behaviors 36(10): 949-958, 2011. (89 refs.)

Appearance-and-performance enhancing drug (APED) use is a form of drug use that includes use of a wide range of substances such as anabolic-androgenic steroids (AASs) and associated behaviors including intense exercise and dietary control. To date, there are no reliable or valid measures of the core features of APED use. The present study describes the development and psychometric evaluation of the Appearance and Performance Enhancing Drug Use Schedule (APEDUS) which is a semi-structured interview designed to assess the spectrum of drug use and related features of APED use. Eighty-five current APED using men and women (having used an illicit APED in the past year and planning to use an illicit APED in the future) completed the APEDUS and measures of convergent and divergent validity. Inter-rater agreement, scale reliability, one-week test-retest reliability, convergent and divergent validity, and construct validity were evaluated for each of the APEDUS scales. The APEDUS is a modular interview with 10 sections designed to assess the core drug and non-drug phenomena associated with APED use. All scales and individual items demonstrated high inter-rater agreement and reliability. Individual scales significantly correlated with convergent measures (DSM-IV diagnoses, aggression, impulsivity, eating disorder pathology) and were uncorrelated with a measure of social desirability. APEDUS subscale scores were also accurate measures of AAS dependence. The APEDUS is a reliable and valid measure of APED phenomena and an accurate measure of the core pathology associated with APED use. Issues with assessing APED use are considered and future research is considered.

Ho KKY; Nelson AE. Growth hormone in sports: Detecting the doped or duped. Hormone Research in Paediatrics 76(supplement 1): 84-90, 2011. (54 refs.)

Background: Doping with growth hormone (GH) is banned; however, there is anecdotal evidence that it is widely abused. GH is reportedly often used in combination with anabolic steroids at high doses for several months. Development of a robust test for detecting GH has been challenging since recombinant human 22-kDa GH used in doping is indistinguishable analytically from endogenous GH and there are wide physiological fluctuations in circulating GH concentrations. Discussion: One approach to GH testing is based on measurement of different circulating GH isoforms using immunoassays that differentiate between 22-kDa and other GH isoforms. Administration of 22-kDa GH results in a change in its abundance relative to other endogenous pituitary GH isoforms. The differential isoform method is, however, limited by its short time window of detection. A second approach that extends the time window of detection is based on detection of increased levels of circulating GH-responsive proteins, such as the insulin-like growth factor (IGF) axis and collagen peptides. As age and gender are the major determinants of variability for IGF-I and the collagen markers, a test based on these markers must take these factors into account. Extensive data now validate the GH-responsive marker approach, and implementation is largely dependent on establishing an assured supply of standardized assays. Conclusions: Robust tests are available to detect GH and enforce the ban on its abuse in sports. Novel approaches that include gene expression and proteomic profiling must continue to be pursued to expand the repertoire of testing approaches available and to maintain deterrence of GH doping.

Huang JH; Jacobs DF; Derevensky JL. DSM-based problem gambling: Increasing the odds of heavy drinking in a national sample of US college athletes? Journal of Psychiatric Research 45(3): 302-308, 2011. (37 refs.)

Despite previously found co-occurrence of youth gambling and alcohol use, their relationship has not been systematically explored in a national sample using DSM-based gambling measures and multivariate modeling, adjusted for potential confounders. This study aimed to empirically examine the prevalence patterns and odds of at-least-weekly alcohol use and heavy episodic drinking (HED) in relation to various levels of gambling severity in college athletes. Multivariate logistic regression analyses were performed on data from a national sample of 20,739 U.S. college athletes from the first National Collegiate Athletic Association national survey of gambling and health-risk behaviors. Prevalence of at-least-weekly alcohol use significantly increased as DSM-IV-based gambling severity increased, from non-gambling (24.5%) to non-problem gambling (43.7%) to sub-clinical gambling (58.5%) to problem gambling (67.6%). Multivariate results indicated that all levels of gambling were associated with significantly elevated risk of at-least-weekly HED, from non-problem (OR = 1.25) to sub-clinical (OR = 1.75) to problem gambling (OR = 3.22); the steep increase in the relative risk also suggested a possible quadratic relationship between gambling level and HED risk. Notably, adjusted odds ratios showed problem gambling had the strongest association with at-least-weekly HED, followed by marijuana (OR = 3.08) and cigarette use (OR = 2.64). Gender interactions and differences were also identified and assessed. In conclusion, attention should be paid to college athletes exhibiting gambling problems, especially considering their empirical multivariate associations with high-risk drinking; accordingly, screening for problem gambling is recommended. More research is warranted to elucidate the etiologic mechanisms of these associations.

Huang JH; Jacobs DF; Derevensky JL. Sexual risk-taking behaviors, gambling, and heavy drinking among US college athletes. Archives of Sexual Behavior 39(3): 706-713, 2010. (36 refs.)

The purpose of this study was to empirically examine the prevalence patterns of sexual risk-taking behaviors (i.e., unprotected sex and having multiple sex partners) in relation to levels of gambling problems and heavy episodic drinking (HED) status among U.S. college athletes. Data from a representative national sample of 20,739 U.S. college athletes were derived from the first National Collegiate Athletic Association national survey of problem gambling and health-risk behaviors. Among college athletes who were sexually active during the past year, males reported significantly higher prevalence of unprotected sex (10.2%) and multiple sex partners (14.6%) than females (7.9% and 9.3%, respectively). Using the DSM-IV Gambling Screen classification, as the level of gambling severity increased, the prevalence of sexual risk-taking behaviors also increased among female athletes, but decreased among male athletes. As regards the effect of heavy drinking, while both male and female HED athletes reported elevated sexual risk-taking, the effect of HED was twice as large in females as in males. It is important to note that the definitions of sexual risk behaviors in this study took into account committed sexual relationship status; hence, the results of this study need to be interpreted with the refined sexual risk measures in mind. Further investigations are warranted to help us better understand and explicate the interrelationships of sexual risk-taking behaviors, gambling, and heavy drinking among these college athletes. Findings from this exploratory study suggest new directions for future research and practice and also highlight the importance of a more inclusive multi-component approach to address these co-occurring youth risk behaviors.

Ip EJ; Barnett MJ; Tenerowicz MJ; Kim JA; Wei H; Perry PJ. Women and anabolic steroids: An analysis of a dozen users. Clinical Journal of Sport Medicine 20(6): 475-481, 2010. (38 refs.)

Objective: To provide an in-depth analysis of 12 female self-reported anabolic-androgenic steroid (AAS) users. Design: Web-based survey. Setting: A Web-based survey was posted on 38 discussion boards of various fitness, bodybuilding, weightlifting, and steroid Web sites between February and June 2009. Interventions: Participants completed a survey regarding demographics and use of AAS and other performance-enhancing agents (PEAs). Participants: A cohort of 1519 strength-trained subjects fully completed and submitted a valid survey. Five hundred eighteen subjects were self-reported AAS users consisting of 12 women and 506 men. One thousand one subjects were non-AAS users consisting of 230 women and 771 men. Main Outcome Measures: Demographic data and use of AAS and other PEAs. Results: The female AAS users reported using an average of 8.8 PEAs in their routine. Compared with male AAS users and female non-AAS users, respectively, female AAS users were more likely to have met criteria for substance-dependence disorder (58.3% vs 23.4%; P = 0.01; 58.3% vs 9.1%; P < 0.001), have been diagnosed with a psychiatric illness (50.0% vs 17.4%; P = 0.01; 50.0% vs 22.2%; P = 0.04), and have reported a history of sexual abuse (41.7% vs 6.1%; P < 0.001; 41.7% vs 15.3%; P = 0.03). Conclusions: Female AAS users practice polypharmacy. Female AAS users are more likely to have qualified for substance-dependence disorder, have been diagnosed with a psychiatric illness, and have a history of sexual abuse than both male AAS users and female non-AAS users.

Irwin C; Desbrow B; Ellis A; O'Keeffe B; Grant G; Leveritt M. Caffeine withdrawal and high-intensity endurance cycling performance. Journal of Sports Sciences 29(5): 509-515, 2011. (19 refs.)

In this study, we investigated the impact of a controlled 4-day caffeine withdrawal period on the effect of an acute caffeine dose on endurance exercise performance. Twelve well-trained and familiarized male cyclists, who were caffeine consumers (from coffee and a range of other sources), were recruited for the study. A double-blind placebo-controlled cross-over design was employed, involving four experimental trials. Participants abstained from dietary caffeine sources for 4 days before the trials and ingested caspulses (one in the morning and one in the afternoon) containing either placebo or caffeine (1.5mg center dot kg-1 body weight center dot day-1). On day 5, capsules containing placebo or caffeine (3mg center dot kg-1 body weight) were ingested 90min before completing a time trial, equivalent to one hour of cycling at 75% peak sustainable power output. Hence the study was designed to incorporate placebo-placebo, placebo-caffeine, caffeine-placebo, and caffeine-caffeine conditions. Performance time was significantly improved after acute caffeine ingestion by 1:49 +/- 1:41min (3.0%, P=0.021) following a withdrawal period (placebo-placebo vs. placebo-caffeine), and by 2:07 +/- 1:28min (3.6%, P=0.002) following the non-withdrawal period (caffeine-placebo vs. caffeine-caffeine). No significant difference was detetcted between the two acute caffeine trials (placebo-caffeine vs. caffeine-caffeine). Average heart rate throughout exercise was significantly higher following acute caffeine administration compared with placebo. No differences were observed in ratings of perceived exertion between trials. A 3mg center dot kg-1 dose of caffeine significantly improves exercise performance irrespective of whether a 4-day withdrawal period is imposed on habitual caffeine users.

Judkins CMG; Teale P; Hall DJ. The role of banned substance residue analysis in the control of dietary supplement contamination. Drug Testing and Analysis 2(9-10): 417-420, 2010. (19 refs.)

The potential for contaminated dietary supplements to result in a failed doping test remains a concern for athletes, trainers, and sporting authorities despite improvements to regulatory guidelines. Previous surveys of readily available supplements confirm that many are contaminated with steroids and stimulants prohibited for use in elite sport. Suggested responses to this issue include the complete avoidance of all supplements. Many athletes, however, use nutritional supplements to achieve effective training and also to ensure that daily nutritional requirements are met (e.g. recommended levels of vitamins and minerals). This ensures that the use of supplements is and will remain the norm for a range of sports. As a result, an alternative approach of rigorous testing of materials destined for use by elite athletes has been introduced in several countries. While the testing of final product for banned substances may help mitigate the problem, it will not help to remove the underlying issue of contamination. In this article we describe an alternative approach that uses appropriate quality assurance procedures backed up by testing to remove sources of contamination. The decrease in the incidence of contamination amongst supplement companies adopting such a system is explained, and contrasted with the relatively high incidences of contamination found in products that are not part of a quality system. These findings are of key importance to both supplement manufacturers and those involved in advising athletes about supplement use.

Kerwin J. The asterisk chronicles: A short history of steroid use and analysis. Drug Testing and Analysis 2(9-10): 456-459, 2010. (41 refs.)

Self-injection of extracts from dog and guinea pig testicles by C.-E. Brown-Sequard in 1889 initiated widespread use of organotherapy following (apparently unsubstantiated) claims of increased physical strength and mental acuity. While there were previous experiments on humans and animals using similar extracts, this report launched worldwide use of these potent "Elixirs of Life." In 1927, a crude but potent form of testosterone was isolated; however, it wasn't until 1935 that testosterone was crystallized, and a facile synthesis of testosterone developed using cholesterol as a starting material. There is some question about the provenance of the discovery, but the pertinent issue is that subsequent rapid progress in research on this compound and structurally related anabolic androgenic steroids (AAS) led to their widespread use in diagnosis and treatment of human and other animal maladies-among other things. The quest for magic elixirs dates at least back to the ancient Greeks, calling into question the protestations of Pierre de Coubertin and others, who exploited the myth of athletic purity while promoting the development of modern Olympic competitions. Paul de Kruif (circa 1945) experimented with testosterone injections, leading him to extol the ability of steroids to not only add weight and muscle mass, but to prolong sexual prowess and increase productivity. A pivotal period in the explosion of steroid use can be traced to the 1952 Olympics in Helsinki, specifically the performance of weight lifters from the former Soviet Union, and the Vienna1954 World Weightlifting Championships. Following exceptional performances by the Soviet team, Dr John Ziegler and Bob Hoffman, team physician and coach, respectively, of the United States weightlifting team, suspected the Soviet team of using "the hormone stuff", a conjecture subsequently confirmed by a Soviet team physician after an extended evening at a Vienna tavern. Upon returning to the USA, Ziegler experimented with testosterone injections on himself, Hoffman, and selected members of the weightlifting team, with impressive results. Claiming the results were due to a revolutionary training technique, the steroid supplements were not mentioned. Ziegler is recognized as one of, if not the most, pivotal figures in promoting early steroid use for athletic performance enhancement.The impact of "Pumping Iron "on the bodybuilding community (and other athletes) worldwide was immense and immediate, putting Venice Beach-and steroid use-on the map. Dan Duchaine further rattled both the habitu�s of Gold's Gym and the Venice Beach law enforcement community with the 1981 publication of The Underground Steroid Handbook for Men and Women (USH)." the use of laboratory tests to identify steroid use, emerged in the 1970s and early 1980s. The growth of testing and current status are described.

Kious BM. Dispelling a few false-positives: A reply to MacGregor and McNamee on Doping. (commentary). Theoretical Medicine and Bioethics 32(3): 195-200, 2011. (2 refs.)

McGregor and MacNamee recently, in this journal, offered several criticisms of an earlier article in which I attempted to refute a number of arguments for the claim that doping in sports is morally wrong. Their criticisms are numerous, but focus on four domains. First, they sketch a view on which the risk profiles of different sports may make doping permissible in some and impermissible in others. Second, they suggest that my criticisms of safety-based arguments assume that doping opponents are bent on harm elimination, rather than harm management. Finally, they offer two methodological criticisms, the first pertaining to my use of analogical arguments, and the second pertaining to the general difficulties of making revisionist arguments in ethics. I defend my criticisms of safety-based arguments by showing that these do not rest on the assumptions McGregor and MacNamee attribute to me and by noting that their own view about the variable relevance of safety considerations is underdeveloped. As for their methodological arguments, I endeavor to show that these are misplaced, in that they either rest on misinterpretations of my earlier article or on an excessively high standard for ethical argumentation.

Kondric M; Sekulic D; Mandic GF. Substance use and misuse among Slovenian table tennis players. Substance Use & Misuse 45(4): 543-553, 2010. (21 refs.)

Substance use and misuse (SU&M) is regularly studied in sports, but we have found no such data for table tennis. We have studied SU&M in athletes competing at the Slovenian Nationals 2008-2009 (responding rate was 100%; 50 males and 29 females; aged 18 years or older). The anonymous questionnaire for studying SU&M and corresponding educational, socio-demographic, and sport factors was used. More than 90% of all the athletes included in our study do not rely on coaches' and/or physicians' opinion regarding nutritional supplements and doping. Chi-square test revealed higher prevalence of binge drinking, cigarette smoking, and potential doping behavior in males. In both genders, with the advancement of the sport status, the probability for potential doping behavior increases. In conclusion, we strongly suggest permanent SU&M educational programs for table tennis athletes as well as for their coaches and physicians.

Kristjansson AL; James JE; Allegrante JP; Sigfusdottir ID; Helgason AR. Adolescent substance use, parental monitoring, and leisure-time activities: 12-year outcomes of primary prevention in Iceland. Preventive Medicine 51(2): 168-171, 2010. (13 refs.)

Objective. To examine 12-year changes in alcohol use and cigarette smoking in response to community-based prevention activities among Icelandic adolescents. Methods. This study used a quasi-experimental, non-randomized control group design to compare outcomes in 4 Icelandic communities (n=3117) that participated in community-based substance use prevention activities designed to increase levels of parental monitoring and adolescent engagement in healthy leisure-time activities and a matched group of 7 comparison communities (n = 1,907). Annual, nationwide, population-based cross-sectional surveys of the prevalence of adolescent substance use were conducted among cohorts of Icelandic adolescents, aged 14-15 years (N = 5,024), in all communities from 1997 to 2009. Results. Parental monitoring and adolescent participation in organized sports increased in communities that adopted the intervention program compared to communities that did not, whereas unmonitored idle hours and attendance at unsupervised parties decreased. Over time, alcohol use (OR = 0.89,95% CI 0.82, 0.98, p = 0.012) and being intoxicated during the last 30 days (OR = 0.86, 95% CI 0.78, 0.96, p = 0.004) decreased more in the intervention than control communities. Conclusion. Community-based prevention designed to strengthen parental monitoring and participation in organized sports may confer some protection against adolescent substance use.

Lazuras L; Barkoukis V; Rodafinos A; Tzorbatzoudis H. Predictors of doping intentions in elite-level athletes: A social cognition approach. Journal of Sport & Exercise Psychology 32(5): 694-710, 2010. (38 refs.)

Doping use is an ongoing problem in contemporary sports. Despite efforts to detect and control doping, research on its etiology is limited, especially among elite-level athletes. The present study used an integrated social cognition model to examine the predictors of doping intentions. Structured anonymous questionnaires were completed by 1075 Greek adult elite-level athletes (M age = 25 years, SD = 5.89, 36.1% females) from both team and individual sports. Multiple regression and mediation analyses showed that attitudes, normative beliefs, situational temptation, and behavioral control significantly predicted doping intentions. A normative process was identified whereby situational temptation mediated the effects of normative beliefs on intentions. The findings provide the basis for future social cognition research in doping use, and set the framework for the development of evidence-based preventive interventions.

Lee P; Kwan A; Nokes L. Actovegin (R) - Cutting-edge sports medicine or "voodoo" remedy? (review). Current Sports Medicine Reports 10(4): 186-190, 2011. (34 refs.)

Actovegin (R) is a deproteinized serum extract of bovine origin, and in recent years it has been used widely in treating sport injuries with many anecdotal reports of success. However, the use of Actovegin (R) in sport medicine has caused a substantial amount of controversy, especially concerning its supposed oxygen-enhancing capacity and an anecdotal belief that its use can increase an athlete's performance. In 2009, a sports physician was arrested with this "performance-enhancing drug," while an editorial in a sports medicine journal strongly questioned the evidence base for using this drug for acute muscle injury. There is also a report that suggested that Actovegin (R) might have induced anaphylactic shock in a cyclist. In this review, we have systematically examined the current evidence on Actovegin (R). Its mechanism of action, clinical evidence, legal status with sports governing bodies, and its potential role in sport injuries will be discussed.

Leifman H; Rehnman C; Sjoblom E; Holgersson S. Anabolic androgenic steroids: Use and correlates among gym users-an assessment study using questionnaires and observations at gyms in the Stockholm region. International Journal of Environmental Research and Public Health 8(7): 2656-2674, 2011. (21 refs.)

The purpose of this study was to estimate the prevalence of anabolic androgenic steroid (AAS) use and offers to use among gym users in Stockholm County (Sweden), and to conduct a comparison of concordance in estimates of AAS and supplements at gyms between two data collection methods. A questionnaire was distributed to members at 36 training facilities and 1,752 gym users participated in the study. An observation study was conducted as covert participant observations at 64 gyms. According to the questionnaire, 3.9% of men reported life time use of AAS, 1.4% use during the past 12 months and 0.4% AAS use during past 30 days. Not only were there similar patterns found in the two methods, i.e., similar age and gender distributions for AAS use, but analyses of concordance showed that gyms with a higher prevalence of self-reported AAS-use and supplement use (questionnaire) showed a significantly higher proportion of observer-assessed AAS users. Analyses of individual predictors showed that AAS users were almost always young men, regular weight trainers and more often users of drugs and nutritional supplements. The higher prevalence of AAS use among gym users than in the general population makes the former an appropriate target group for AAS prevention. The connection between supplements, drugs and AAS use suggests that effective AAS prevention need to focus on several risk factors for AAS use. The clear resemblance in estimates between the observation and questionnaire data strengthen the credibility of the two methods.

Lisha NE; Sussman S. Relationship of high school and college sports participation with alcohol, tobacco, and illicit drug use: A review. (review). Addictive Behaviors 35(5): 399-407, 2010. (59 refs.)

This study provides an exhaustive review of 34 peer-reviewed quantitative data-based studies completed on high school and college sports involvement and drug use. The studies reviewed suggest that participation in sport is related to higher levels of alcohol consumption, but lower levels of both cigarette smoking and illegal drug use. Additional research is needed in this domain to further elucidate the relationship between these variables.

MacGregor O; McNamee M. Harm, risk, and doping analogies: A counter-response to Kious. (editorial). Theoretical Medicine and Bioethics 32(3): 201- 207, 2011. (7 refs.)

Brent Kious has objected to our previous criticism of his views on doping, maintaining that we, by and large, misrepresented his position. In this response, we strengthen our original misgivings, arguing that (1) his views on risk of harm in sport are either uncontroversially true (not inconsistent with the views of many doping opponents) or demonstrably false (attribute to doping opponents an overly simplistic view), (2) his use of analogies (still) indicates an oversimplification of many issues surrounding the question of doping in sports, and (3) his doping analogies are insufficiently precise to support his conclusions.

Machado M; Koch AJ; Willardson JM; dos Santos FC; Curty VM; Pereira LN. Caffeine does not augment markers of muscle damage or leukocytosis following resistance exercise. International Journal of Sports Physiology and Performance 5(1): 18-26, 2010. (30 refs.)

Purpose: The purpose of this study was to evaluate the effects of caffeine ingestion before a resistance exercise session on markers of muscle damage (CK, LDH. ALT, AST) and leukocyte levels. Methods: Fifteen soccer athletes completed two resistance exercise sessions that differed only in the ingestion of caffeine or a placebo preworkout. Results: CK concentration increased significantly following the caffeine session (415.8 +/- 62.8 to 542.0 +/- 73.5) and the placebo session (411.5 +/- 43.3 to 545.8 +/- 59.9), with no significant differences between sessions. Similarly. LDH concentration increased significantly following the caffeine session (377.5 +/- 18.0 to 580.5 +/- 36.1) and the placebo session (384.8 +/- 13.9 to 570.4 +/- 36.1), with no significant differences between sessions. Both sessions resulted in significant increases in the total leukocyte count (caffeine = 6.24 +/- 2.08 to 8.84 +/- 3.41; placebo = 6.36 +/- 2.34 to 8.77 +/- 3.20). neutrophils (caffeine = 3.37 +/- 0.13 to 5.15 +/- 0.28; placebo = 3.46 +/- 0.17 to 5.12 +/- 0.24), lymphocytes (caffeine = 2.19 +/- 0.091 to 2.78 +/- 0.10; placebo = 2.17 +/- 0.100 to 2.75 +/- 0.11), and monocytes (caffeine = 0.53 +/- 0.02 to 0.72 +/- 0.06; placebo = 0.56 +/- 0.03 to 0.69 +/- 0.04), with no significant differences between sessions. Conclusion: Ingestion of caffeine at 4.5 mg.kg(-1) did not augment markers of muscle damage or leukocyte levels above that which occurs through resistance exercise alone.

Martens MP; Martin JL. College athletes' drinking motives and competitive seasonal status: Additional examination of the Athlete Drinking Scale. Addiction Research & Theory 18(1): 23-32, 2010. (37 refs.)

The Athlete Drinking Scale (ADS) was designed to assess a set of drinking motives unique to intercollegiate athletes. Although results from initial validation studies were promising (Martens, M. P., Watson, J. C., Royland, E. M., Beck, N. C. 2005. Development of the athlete drinking scale. Psychology of Addictive Behaviors 19:158-164; Martens, M. P., Labrie, J. W., Hummer, J. F., Pedersen, E. R. 2008. Understanding sport-related drinking motives in college athletes: Psychometric analyses of the athlete drinking scale. Addictive Behaviors 33:974-977), to date only cross-sectional studies on the measure have been published. The purposes of this longitudinal study were to determine whether the factor structure of the ADS remains consistent across a group of athletes' competitive season and off-season, determine whether scores on the ADS increased during athletes' competitive seasons, and assess the relationships among athlete-specific drinking motives and drinking behaviors across these two time points. Complete data were obtained from 153 athletes representing 11 varsity sports teams competing at the NationalCollegiate Athletic Association Division I level. Longitudinal confirmatory factor analysis at the subscale level indicated that fit indices for the hypothesized three-factor model of the ADS were excellent. Repeated measures ANOVA indicated that athlete-specific drinking motives increased during the athletes' competitive seasons, and scores on the ADS subscales were associated with alcohol use and alcohol-related problems at both time points. Results provide support for the validity of the ADS and have implications for researchers and clinicians working in the area of alcohol prevention among collegiate athletes.

Martens MP; Pedersen ER; Smith AE; Stewart SH; O'Brien K. Predictors of alcohol-related outcomes in college athletes: The roles of trait urgency and drinking motives. Addictive Behaviors 36(5): 456-464, 2011. (51 refs.)

Research has shown that college students participating in athletics drink more than other students, yet relatively few studies have examined variables that are associated with alcohol-related outcomes among this population. The purpose of this study was to examine the relationships among trait urgency, general drinking motives and sport-related drinking motives, and both alcohol use and alcohol-related problems. Data were collected from 198 college students participating in either intercollegiate or recreational athletics at three U.S. universities. Structural equation modeling was used to examine a series of theoretically derived explanatory models. All variables included in the model were directly associated with alcohol use and/or alcohol-related problems. The specific patterns of relationships differed across the motives and trait urgency variables. Sport-related coping motives, sport-related positive reinforcement motives, and general enhancement motives had direct relationships with alcohol use, while trait urgency, general coping motives, and sport-related positive reinforcement motives had direct relationships with alcohol-related problems. Several indirect effects on alcohol use and alcohol-related problems were also found. This study suggests that general drinking motives, sport-related drinking motives, and trait urgency all serve as important predictors of alcohol-related outcomes in college athletes.

Mays D; Thompson N; Kushner HI; Mays DF; Farmer D; Windle M. Sports-specific factors, perceived peer drinking, and alcohol-related behaviors among adolescents participating in school-based sports in Southwest Georgia. Addictive Behaviors 35(3): 235-241, 2010. (57 refs.)

This study investigated the relationships among sports-specific factors, perceived peer drinking, and alcohol-related behaviors among adolescents, examining sex differences in the relationship between perceived peer drinking and alcohol-related behaviors. A questionnaire assessing demographics, sports-specific factors, perceived peer drinking, and alcohol-related behaviors was administered among 378 adolescents who were mostly male (76.3%) and non-Hispanic black (70.0%). Varsity sports participants reported higher levels of perceived peer drinking compared to those who participated in sports at other levels (B 0.64, 95% CI 0.28, 0.99. p<0.001). Participants in both sports offering team- and individual-level competition reported greater perceived peer drinking (B 0.71, 95% CI 0.05, 1.38, p=0.04), compared to those who only participated in individual sports. Perceived peer drinking was associated with alcohol-related behaviors (B 0.39, 95% CI 0.31, 0.47, p < 0.001) and there were no significant differences between males and females in this relationship. Suggestions for future research include examining factors contributing to the low prevalence of drinking behaviors, and investigating factors related to sports that impact perceived peer drinking and alcohol-related behaviors.

Melrose D; Ocker L; Bonnette R; Spaniol F. The internet and steroids: A less than honest relationship. Strength and Conditioning Journal 33(2): 95-99, 2011. (14 refs.)

The purpose of this article is to inform strength and conditioning professionals about potentially dishonest tactics used on the internet to sell and distribute anabolic steroids. Products purchased through this medium may have broad, diverse, and unforeseen consequences for users. By dissemination of this information, strength and conditioning professionals can use their influence to educate those individuals mostly at risk for obtaining steroids through this medium.

Merlo LJ; Ahmedani BK; Barondess DA; Bohnert KM; Gold MS. Alcohol consumption associated with collegiate American football pre-game festivities. Drug and Alcohol Dependence 116(1-3): 242-245, 2011. (17 refs.)

Internationally, sporting events represent a specific context in which heavy episodic drinking is common. The current study assessed determinants of heavy episodic drinking among tailgaters (i.e., individuals engaging in pre-game social festivities) prior to American football games at two large universities. A total of 466 individuals at two universities completed a short interview and provided a breathalyzer sample to estimate breath alcohol content (BrAC) during the tailgating window (150 min prior to and 10 min after the start of the game). The plurality of participants, 48.5% at the southeastern university (School1) and 58.8% at the midwestern university (School2), engaged in heavy episodic drinking. Only 54 individuals (11.6%) from the combined sample at both universities abstained from alcohol (confirmed via BrAC). In total, 40.2% of participants at School1 and 31.9% at School2 produced breath samples over the legal limit for driving (i.e., BrAC = 0.08 or higher). In site-specific regression analyses, younger ages, males, and non-students at SchooL1, and younger ages and non-game attendance at School2 were associated with self-reported heavy episodic drinking and higher levels of estimated BrAC (p <0.05). Given the widespread participation in heavy episodic drinking among both students and non-students in this sample, public health interventions should be implemented both on- and off-campus to promote safety and to discourage heavy episodic drinking at American football games and other high-profile sporting events.

Mesko M; Stihec J; Sisko PK; Karpljuk D; Videmsek M. Relation between participation in sport activities and drug-taking among 14 year-old primary school pupils in Slovenia. Slovenian Medical Journal 79(11): 769-773, 2010. (19 refs.)

Purpose/Objective: The aim of this research was to establish whether there is a correlation between sport activity and drug-taking among 680 14-year-old pupils, and to establish whether the drug-sports link depends on the type of sports. Methods: We used a questionnaire with 38 variables on sports activities and drugs. The probability relations among the variables were tested by chi-square. Results: The analysis has shown that 74.6 % male and 79.3 % female pupils practise sports in their leisure time. On average, they practise sports 2 to 3 times a week. The majority of male pupils practise sports competitively, while female pupils primarily practise unorganized recreational sports. 7.3 % male and 16.6 % female pupils smoke; the majority of male pupils had the first cigarette at the age of 13, female pupils at the age of 12. 87-4 % male and 85.5 % female pupils had tried an alcohol beverage. 21.6 % male and 29.3 % female pupils had tried drugs. We have ascertained that there is some statistically significant correlation between sports activities and taking licit and illicit drugs. A statistically characteristic correlation has been established for alcohol drinking with male pupils and for smoking with female pupils. We also observed a significant correlation between organized sports as the type of sports and drug use. Conclusion: We can conclude that persistent sports inactivity in adolescence may increase the risk of alcohol use among male, and smoking among female pupils. Participation in organized sports, as opposed to unorganized and competitive sports, may reduce illicit drug use.

Minett G; Duffield R; Bird SP. Effects of acute multinutrient supplementation on rugby union game performance and recovery. International Journal of Sports Physiology and Performance 5(1): 27-41, 2010. (30 refs.)

Purpose: To investigate the effects of an acute multinutrient supplement on game-based running performance, peak power output, anaerobic by-products, hormonal profiles, markers of muscle damage, and perceived muscular soreness before, immediately after, and 24 h following competitive rugby union games. Methods: Twelve male rugby union players ingested either a comprehensive multinutrient supplement (SUIT), [RE-ACTIVATE:01], or a placebo (PL) for 5 d. Participants then performed a competitive rugby union game (with global positioning system tracking), with associated blood draws and vertical jump assessments pre, immediately post and 24 h following competition. Results: SUPP ingestion resulted in moderate to large effects for augmented 1st half very high intensity running (VHIR) mean speed (5.9 +/- 0.4 vs 4.8 +/- 2.3 m.min(-1) d = 0.93). Further, moderate increases in 2nd half VHIR distance (137 +/- 119 vs 83 +/- 89 m; d = 0.73) and VHIR mean speed (5.9 +/- 0.6 v 5.3 +/- 1.7 m.min(-1); d = 0.56) in SUPP condition were also apparent. Postgame aspartate aminotransferase (AST; 44.1 +/- 11.8 vs 37.0 +/- 3.2 UL; d = 1.16) and creatine kinase (CK; 882 +/- 472 vs. 645 +/- 123 UL; d = 0.97) measures demonstrated increased values in the SUPP condition, while AST and CK values correlated with 2nd half VHIR distance (r = 0.71 and r = -0.76 respectively). Elevated C-reactive protein (CRP) was observed postgame in both conditions; however, it was significantly blunted with SUPP (P = .05). Conclusions: These findings suggest SUPP may assist in the maintenance of VHIR during rugby union games, possibly via the buffering qualities of SUPP ingredients. However, correlations between increased work completed at very high intensities and muscular degradation in SUPP conditions, may mask any anticatabolic properties of the supplement.

Mulcahey MK; Schiller JR; Hulstyn MJ. Anabolic steroid use in adolescents: Identification of those at risk and strategies for prevention. Physician and Sportsmedicine 38(3): 105- 113, 2010. (80 refs.)

Success in sports is oft en defined by winning, which drives athletes to use performance-enhancing drugs (PEDs) to gain an advantage over opponents. Over the past 20 years, use of PEDs by Olympic and professional athletes has led to public discussion regarding potential negative health effects and ethical implications of their use. Unfortunately, PEDs are not isolated to professional athletes, as PED use in adolescents has increased dramatically. Many professional organizations, including the American Academy of Orthopaedic Surgeons (AAOS), have taken a stance against PED use in sports. The AAOS believes neither anabolic steroids nor their precursors should be used to enhance performance or appearance, and that these substances should be banned in all sports programs. Pediatricians and orthopedists are often the first physicians to see these young athletes. It is critical for these physicians to recognize the significance of the problem, have the knowledge to inform adolescents, dissuade them from future use, and provide viable alternatives for meeting performance goals.

Nakhostin-Roohi B; Valizadeh S. Worrisome prevalence of waterpipe smoking among athletes. Medicina Dello Sport 64(1): 63-69, 2011. (15 refs.)

Aim. The aim of this study was to evaluate the prevalence of waterpipe smoking in athletes of Ardabil, a city in the Northwest of Iran. Methods. The members of 16 sport associations (N.=1647) were randomized from 49 sport associations. A cluster sampling technique was used. The sampling unit was sport association. Results. Of the 1647 participants, 14.7% and 10.5% of athletes were habitual and recreational users respectively; 24.4% of non-smokers stated they were in the exposure of waterpipe smoke. The most habitual smokers were wrestlers (42%), whereas the most recreational users were swimmers (26.1%). Prevalence of waterpipe smoking among football players was lower than among other athletes (non-smokers: 91.3% and habitual smokers: 0.0%). Just 36.8% of athletes believed waterpipe use affect their performance. Conclusion. According to the knowledge of athletes about risks connected with waterpipe smoking data are not sufficient and most of the athletes would suffer from misunderstanding about risks of the waterpipe use. Knowledge promotion about waterpipe risks among athletes and the increase of recreational facilities may be a suitable manner to prevent this increasing phenomenon among athletes.

Nicolich RS; Padilha MC; Neto FRD. Study of the endogenous steroid profile of male athletes from the Brazilian National Soccer Championship 2009. Drug Testing and Analysis 2(11-12, special issue): 599-602, 2010. (19 refs.)

Changes in the endogenous profile of androgenic anabolic steroids (AAS) may be interpreted as markers of doping. The objective of this study was to evaluate the endogenous profile of AAS in male athletes of the 2009 Brazilian National Soccer Championship, in normal conditions, particularly in the light of the revision of World Anti-Doping Agency's (WADA) Technical Document on the Interpretation of Endogenous AAS in athletes for doping control drafted in that year, as well as comparing these results to profiles already published in the literature. The upper limit of the 95% central reference interval of the following parameters for the studied population were estimated to be significantly higher than WADA's criteria, with a confidence of 90%: DHEA (about 2.3 times higher), Adiol (1.2 times higher), Bdiol (2.7 times higher), and Adiol/E (6 times higher). These findings seem to imply that WADA's criteria proposed in 2009 for DHEA, Adiol, Bdiol, and Adiol/E may not have been applicable to the studied population. Moreover, their comparison to previously published studies pointed to the need to evaluate in detail the appropriateness of adopting these criteria as universal, since there seems to be variations among different populations of athletes.

Nikolopoulos DD; Spiliopoulou C; Theocharis SE. Doping and musculoskeletal system: Short-term and long-lasting effects of doping agents. (review). Fundamental & Clinical Pharmacology 25(5): 535-563, 2011. (268 refs.)

Doping is a problem that has plagued the world of competition and sports for ages. Even before the dawn of Olympic history in ancient Greece, competitors have looked for artificial means to improve athletic performance. Since ancient times, athletes have attempted to gain an unfair competitive advantage through the use of doping substances. A Prohibited List of doping substances and methods banned in sports is published yearly by the World Anti-Doping Agency. Among the substances included are steroidal and peptide hormones and their modulators, stimulants, glucocorticosteroids, beta(2)-agonists, diuretics and masking agents, narcotics, and cannabinoids. Blood doping, tampering, infusions, and gene doping are examples of prohibited methods indicated on the List. Apart from the unethical aspect of doping, as it abrogates fair-play's principle, it is extremely important to consider the hazards it presents to the health and well-being of athletes. The referred negative effects for the athlete's health have to do, on the one hand, by the high doses of the performance-enhancing agents and on the other hand, by the relentless, superhuman strict training that the elite or amateur athletes put their muscles, bones, and joints. The purpose of this article is to highlight the early and the long-lasting consequences of the doping abuse on bone and muscle metabolism.

O'Brien KS. Commentary on Terry-McElrath & O'Malley (2011): Bad sport: Exorcizing harmful substances and other problems. (editorial). Addiction 106(10): 1866-1867, 2011. (18 refs.)

O'Brien KS; Kolt GS; Webber A; Hunter JA. Alcohol consumption in sport: The influence of sporting idols, friends and normative drinking practices. Drug and Alcohol Review 29(6): 676-683, 2010. (29 refs.)

Introduction and Aims. High-profile sportspeople are posited as role models for others. We examine whether university sports people and non-sports people's perceptions of high-profile sportspeople's (sports stars) and friends perceived drinking behaviours are related to their own drinking behaviours. Further, we examine the importance of drinking with competitors after sports events. Design and Methods. A convenience sample of 1028 participants (58% females, n = 652 sportspeople) from two Australian universities were approached at sporting and university venues. Participants completed a survey booklet containing demographic questions, the Alcohol Use Disorders Identification Test (AUDIT, alcohol measure), perceived drinking of high-profile sportspeople and friends (social norms), and for sportspeople only, items assessing the importance of drinking with competitors. Bivariate and multivariate analyses were used to assess relationships. Results. Both sporting and non-sporting participants perceived high-profile sportspeople to drink less than themselves and their friends. Small significant bivariate relationships were found between high-profile sportspeople's perceived drinking and self-reported drinking for sportspeople (r = 0.20, P < 0.0005). However, in multivariate regression models the perceived drinking behaviours of high-profile sportspeople were not significant predictors of sportspeople's drinking, and were negatively related to non-sportspeople's drinking. The practice of drinking with competitors after sports and games accounted for an additional 6.1% of the unique variance in AUDIT-scores (P < 0.0005). Discussion and Conclusions. Sports stars are touted as negative role models when it comes to drinking. Contrary to expectations high-profile sportspeople were not perceived to be heavy drinkers and their perceived drinking was not predictive of others drinking. Friends' and normative drinking practices were predictors of drinking.

Palmer C. Everyday risks and professional dilemmas: Fieldwork with alcohol-based (sporting) subcultures. Qualitative Research 10(4): 421-440, 2010. (76 refs.)

This article discusses some of the everyday risks and professional dilemmas encountered when conducting participant-observation based research into the use and meaning of alcohol among fans of Australian Rules football. The key risks and dilemmas were those that emerged from female researchers entering into a predominantly male football subculture in which alcohol is routinely (and often excessively) consumed, the negotiation of key gatekeepers, the potential dangers of conducting research with participants who are inebriated and the duty of care to research participants. The article draws on an eighteen-month period of ethnographic fieldwork to highlight the risks and dilemmas negotiated and re-negotiated throughout the research process. The article argues that a failure to attend to these and other risks and dilemmas can threaten the viability of research among drinking-based communities and subcultures.

Papacosta E; Nassis GP. Saliva as a tool for monitoring steroid, peptide and immune markers in sport and exercise science. (review). Journal of Science and Medicine In Sport 14(5): 424-434, 2011. (128 refs.)

Objectives: This paper discusses the use of saliva analysis as a tool for monitoring steroid, peptide, and immune markers of sports training. Design: Salivary gland physiology, regarding the regulation and stimulation of saliva secretion, as well as methodological issues including saliva collection, storage and analysis are addressed in this paper. The effects of exercise on saliva composition are then considered. Method: Exercise elicits changes in salivary levels of steroid hormones, immunoglobulins, antimicrobial proteins and enzymes. Cortisol, testosterone and dehydroepiandrosterone can be assessed in saliva, providing a non-invasive option to assess the catabolic and anabolic effects of exercise. Validation studies using blood and salivary measures of steroid hormones are addressed in this paper. Effects of acute exercise and training on salivary immunoglobulins (SIgA, SIgM, SIgG) and salivary antimicrobial proteins, including a-amylase, lysozyme and lactoferrin, are also discussed. Results: Analysis of cortisol and testosterone in saliva may help detect the onset of non-functional overreaching and subsequently may help to prevent the development of overtraining syndrome. Assessment of salivary immunoglobulins and antimicrobial proteins has been shown to successfully represent the effects of exercise on mucosal immunity. Increases in SIgA and antimicrobial proteins concentration and/or secretion rate are associated with acute exercise whereas conversely, decreases have been reported in athletes over a training season leaving the athlete susceptible for upper respiratory tract infections. Conclusions: The measurement of physiological biomarkers in whole saliva can provide a significant tool for assessing the immunological and endocrinological status associated with exercise and training.

Paul RJ; Weinbach AP. The determinants of betting volume for sports in North America: Evidence of sports betting as consumption in the NBA and NHL. International Journal of Sport Finance 5(2): 128-140, 2010. (19 refs.)

The National Basketball Association (NBA) and National Hockey League (NHL) are studied to ascertain the determinants of betting volume on an individual game-to-game basis. Actual betting volume was obtained and aggregated across three on-line sportsbooks for the 2008-09 season. Independent variables such as the quality of teams, television coverage by network, day of the week, time of day, month of the season, etc. are included in a regression model to determine the factors that influence betting volume. The results reveal betting behavior is much like fan behavior as key fan-attributes, such as the quality of teams and the availability of television coverage, are shown to have a positive and significant effect on betting volume. The results imply that consumption plays a major role in the decision to gamble on sports. Pure investment-based gambling appears to be the exception, rather than the norm. The implication of this result as it relates to models of sportsbook behavior is explored.

Picu RM; Lamor M; Radu GL. Evaluation of urinary steroid profile after administration of pharmaceutical preparations. Romanian Biotechnological Letters 16(2): 6008- 6016, 2011. (19 refs.)

On World Anti-Doping Agency (WADA) initiative, in the near future, a passport will be developed for the athletes, comprising the main parameters of the steroid profile. The most characteristic endogenous steroids that define the steroid profile, one of the most versatile and informative screening tools for the detection of steroid abuse in sports drug testing, are testosterone, epitestosterone. androsterone. etiocholanolone. dehydroepiandrosterone. 5 alpha-androstane-3 alpha, 17 beta-diol and 5 beta-androstane-3 alpha.17 beta-diol. Knowledge of factors that influence the steroid profile pattern is of central importance. In addition to parameters such as specific gravity, pH-value, gender, sport discipline and time of sampling, other factors such as pharmaceutical, technical and biological issues need consideration when interpreting steroid profile. The purpose of this study was to monitor the values of steroid profile for two male volunteers after the administration of pharmaceutical preparations that contained human chorionic gonadotropin hormone. The analysis was performed by a selective, specific and sensitive gas chromatography/mass spectrometry method in selective ion monitoring (SIM) mode. The study showed that the concentrations of the main parameters of steroid profile increased, but the testosterone/epitestosterone ratio has not exceeded the WADA action limit for human doping control (ratio 4) after the intramuscular administration of one single dose (5000UI) of Pregnyl injection.

Piper T; Geyer H; Schanzer W. Degradation of urine samples and its influence on the C-13/C-12 ratios of excreted steroids. Drug Testing and Analysis 2(11-12, special issue): 620-629, 2010. (29 refs.)

The degradation processes in deficiently stored urine samples are well investigated regarding steroid concentrations and diagnostic ratios, such as the quotient of testosterone divided by epitestosterone. In contrast, nothing is known about the influence on carbon isotope ratios (CIR) by inappropriate storage conditions. In general, it is assumed that degradation, i.e. deconjugation or dehydrogenation, does not change CIR and thus CIR can be used in cases where the steroid profile turns out to be invalid. Therefore, the CIR of urinary steroids was investigated in different urine samples during the course of degradation over a time period of six months. Several steroids excreted as glucuronides (androsterone (A), etiocholanolone (E), testosterone, pregnanediol (PD) and 5 alpha- and 5 beta-androstane-3 alpha,17 beta-diol) or sulfo-conjugated (A, E and androst-5-ene-3 beta,17 beta-diol (5EN17b)) were investigated together with their unconjugated correspondents (A, E, PD and 5EN17b) and the main dehydrogenation products (5a- and 5 beta-androstane-3,17-diol and androst-4-ene-3,17-diol). For this purpose, the exiting methods for CIR determination were extended and validated. In addition, the urinary concentrations of all investigated steroids were monitored. Particular attention was paid to dehydroepiandrosterone conjugated and unconjugated together with its degradation product 3 alpha,5-cyclo-5 alpha-androstan-6 beta-ol-17-one as here the strongest influence on CIR was expected.

Pokrywka A; Kwiatkowska D; Kaliszewski P; Grucza R. Some aspects concerning modifications of the list of prohibited substances and methods in sport. Biology of Sport 27(4): 307-314, 2010. (36 refs.)

In 1967 the International Olympic Committee (IOC) founded Medical Commission to organize and supervise fight against doping. At that time, the Commission published the first list of substances prohibited for use in sport to meet the need of anti-doping testing at the 1968 Olympic Games. The Prohibited List included stimulants, sympathomimetic amines, narcotics (narcotic analgesics), antidepressants and tranquilizers. For years the list was expanding and underwent modifications, mainly prior to successive Olympic Games. Starting from 1 January 2004, the World Anti-Doping Agency (WADA) has assumed the role of the main coordinator in fight against doping. WADA significantly modified the list of prohibited substances and methods (the Prohibited List). These modifications initiated changes, whose effects can be observed in three main areas of sport and anti-doping i.e. in: athletes, doping control laboratories, and sport entourage. In Poland, the removal some substances from the List or the addition other compounds to the basic List caused an increase of usage of pseudoephedrine and caffeine by athletes and a decrease of number of positive doping cases with cannabinoids and glucocorticosteroids. The annual modification of the Prohibited List by WADA and subsequent introduction of new examples of prohibited substances strengthened the world anti-doping system. Considering the open character of the list a regular update would be expected, especially indicating prohibited or permitted status of new substances and drugs. It would be advisable to publish, on the WADA website, some additional information regarding those substances which cause the most interpretation problems.

Primack BA; Fertman CI; Rice KR; Adachi-Mejia AM; Fine MJ. Waterpipe and cigarette smoking among college athletes in the United States. Journal of Adolescent Health 46(1): 45-51, 2010. (30 refs.)

Purpose: Tobacco use using a waterpipe is an emerging trend among college students. Although cigarette smoking is low among college athletes, waterpipe tobacco smoking may appeal to this population. The purpose of this study was to compare cigarette and waterpipe tobacco smoking in terms of their associations with organized sport participation. Methods: In the spring of 2008, we conducted an online survey of 8,745 college students at eight institutions as part of the revised National College Health Assessment. We used multivariable regression models to assess the associations between tobacco use (cigarette and waterpipe) and organized sports participation. Results: Participants reported participation in varsity (5.2%), club (11.9%), and intramural (24.9%) athletics. Varsity athletes and individuals who were not varsity athletes had similar rates of waterpipe tobacco smoking (27.6% vs. 29.5%, p = .41). However, other types of athletes were more likely than their counterparts to have smoked waterpipe tobacco (35.1% vs. 28.7%, p < .001 for club sports and 34.8% vs. 27.7%, p < .001 for intramural sports). In fully-adjusted multivariable models, sports participants of any type had lower odds of having smoked cigarettes, whereas participants who played intramural sports (odds ratio = 1.15, 95% confidence interval = 1.03, 1.29) or club sports (odds ratio = 1.15, 95% confidence interval = 1.001, 1.33) had significantly higher odds of having smoked waterpipe tobacco. Conclusions: College athletes are susceptible to waterpipe tobacco use. In fact, compared with their nonathletic counterparts, club sports participants and intramural sports participants generally had higher odds of waterpipe tobacco smoking. Allure for waterpipe tobacco smoking may exist even for individuals who are traditionally considered at low risk for tobacco use.

Rossi SS; Botre F. Prevalence of illicit drug use among the Italian athlete population with special attention on drugs of abuse: A 10-year review. Journal of Sports Sciences 29(5): 471-476, 2011. (21 refs.)

The objective of this study was to assess the prevalence of illicit drugs use among young adults, in particular elite athletes. This study considers the data obtained from anti-doping analyses performed on nearly 100,000 urine samples from 2000 to 2009 by the World Anti-Doping Agency accredited Italian Anti-Doping Laboratory. The percentage of adverse analytical findings varies on a yearly basis, but it is in the range 1.0-1.8% (not considering atypical findings, such as an altered endogenous steroid profile). Among positive results, there is a high prevalence of stimulants and drugs of abuse. The drug of abuse found most frequently is the tetrahydrocannabinol (cannabis) metabolite, accounting for 0.2-0.4% of the total samples analysed (18% of the positive results). The second most frequently encountered drug is cocaine, as detected from cocaine metabolites, accounting for 0.1% of the total samples analysed (7% of positive results). Other stimulants found included amphetamines, ephedrines, carphedon, modafinil, and anorexic compounds. No amphetamine-like designer drugs were detected. These data are indicative of the widespread prevalence of cocaine and cannabis use among the young adult population. However, due to the particular population studied, it must be considered an underestimation of the phenomenon among elite athletes with respect to the general population.

Schneider MB; Benjamin HJ; Bhatia JJS; Abrams SA; De Ferranti SD; Schneider MB et al. Clinical report. Sports drinks and energy drinks for children and adolescents: Are they appropriate? Pediatrics 127(6): 1182-1189, 2011. (45 refs.)

Sports and energy drinks are being marketed to children and adolescents for a wide variety of inappropriate uses. Sports drinks and energy drinks are significantly different products, and the terms should not be used interchangeably. The primary objectives of this clinical report are to define the ingredients of sports and energy drinks, categorize the similarities and differences between the products, and discuss misuses and abuses. Secondary objectives are to encourage screening during annual physical examinations for sports and energy drink use, to understand the reasons why youth consumption is widespread, and to improve education aimed at decreasing or eliminating the inappropriate use of these beverages by children and adolescents. Rigorous review and analysis of the literature reveal that caffeine and other stimulant substances contained in energy drinks have no place in the diet of children and adolescents. Furthermore, frequent or excessive intake of caloric sports drinks can substantially increase the risk for overweight or obesity in children and adolescents. Discussion regarding the appropriate use of sports drinks in the youth athlete who participates regularly in endurance or high-intensity sports and vigorous physical activity is beyond the scope of this report.

Seear K; Fraser S. The 'sorry addict': Ben Cousins and the construction of drug use and addiction in elite sport. Health Sociology Review 19(2): 176-191, 2010. (53 refs.)

Australian Football League (AFL) player Ben Cousins is one of the most highly acclaimed and recognised athletes in Australia. Followed closely in the media, his off-field activities are subject to as much attention and speculation as those on the field. In 2007, Cousins and his family confirmed long-standing rumours that he was an illicit (non-performance enhancing) drug user. Following a series of incidents, his football contract was terminated and Cousin's publicly entered drug rehabilitation. In this article we explore the multiple extant accounts of Cousins' drug use. We examine media representations of his drug use, including accounts from a range of key stakeholders, and we also look at Cousins' public accounts of his own drug use. What emerges is paradoxical picture both of Cousins himself and of drug users more broadly. Cousins is simultaneously positioned as in control and out of control, as manipulative and as subject to the manipulations of his 'addiction', as criminal and victim, as culpable and innocent. In the process, he acts as a figure through which contemporary understandings of the nature and implications of addiction are produced and reproduced. What is addiction? If as many now take for granted, it is a disease requiring a medical response, what can be said about the agency and responsibility of the 'addict' in the context of elite sport? How do mainstream understandings of elite sportsmen as intrinsically masterful, commanding and physically exemplary mesh with assumptions about drug addicts as passive and physically compromised? In considering this intersection of discourses of elite sports and of addiction, we also explore some of the unique dimensions of the Cousins case including the challenge his embodied athleticism poses to understandings of his drug use, and the significance attributed to his rehabilitation and 'comeback' in 2009. We conclude with some reflections on the ways in which Cousins' case troubles certainties about drug use, and on the strategic efficacy of disease models of addiction in Australia.

Shaw I; Shaw BS; Brown GA. Concurrent training and pulmonary function in smokers. International Journal of Sports Medicine 32(10): 776-780, 2011. (39 refs.)

This study compared the effects of aerobic, resistance and concurrent aerobic and resistance training on pulmonary function and cardiorespiratory endurance in at-risk smokers. 50 sedentary, male smokers with pulmonary function impairments at risk for developing chronic lung diseases were randomly assigned to an aerobic (AerG; n = 12), resistance (ResG; n = 13), concurrent (ConG; n = 13) or non-exercising control (NexG; n = 12) group for 16 weeks. AerG subjects performed 45 min of aerobic exercise at 60% HR max, ResG subjects performed 8 resistance exercises at 60 % 1-RM for 3 sets, 15 repetitions while ConG subjects performed both aerobic and resistance exercises. ANOVA revealed no significant difference between the groups in their pre-/post-test changes for FEV(1)/FVC ratio (AerG: -4.13 %; ResG: -2.13%; ConG: -0.56%); FEF-50 (AerG: -4.59%; ResG: -7.62%; ConG: 5.76%), FEF-75 (AerG: -2.36%; ResG: -7.62%; ConG: 10.71%) and FEF 25 -75 (AerG: -3.53%; ResG: -6.43%; ConG: 7.63%). Significant differences were found between the groups in their pre-/post-test changes for FVC (AerG: 8.05%; ResG: 7.22%; ConG: 11.55%), FEV(1) (Aer: 9.60%; ResG: 5.13%; ConG: 12.10%), PEF (AerG: 11.29%; ResG: 7.49%; ConG: 20.18%), PIF (AerG: 24.80%; ResG: 19.41%; ConG: 28.15%), IVC (AerG: 9.04%; ResG: 6.21%; ConG: 16.35%), FEF-25 (AerG: 5.88%; ResG: 5.37%; ConG: 11.88%) and cardiorespiratory fitness (AerG: 25.44%; ResG: 11.59%; ConG: 22.83%). Post-hoc analysis revealed concurrent and aerobic training were equally effective at improving PIF and cardiorespiratory fitness with concurrent training most effective at improving FVC, FEV(1), PEF, IVC and FEF-25. This suggests synergy between aerobic and resistance exercise in preventing or reducing the detrimental effects of smoking while gaining the unique benefits of each mode of exercise.

Smith AE; Fukuda DH; Kendall KL; Stout JR. The effects of a pre-workout supplement containing caffeine, creatine, and amino acids during three weeks of high-intensity exercise on aerobic and anaerobic performance. Journal of the International Society of Sports Nutrition 7: article 10, 2010. (90 refs.)

Background: A randomized, single-blinded, placebo-controlled, parallel design study was used to examine the effects of a pre-workout supplement combined with three weeks of high-intensity interval training (HIIT) on aerobic and anaerobic running performance, training volume, and body composition. Methods: Twenty-four moderately-trained recreational athletes (mean +/- SD age = 21.1 +/- 1.9 yrs; stature = 172.2 +/- 8.7 cm; body mass = 66.2 +/- 11.8 kg, VO(2)max = 3.21 +/- 0.85 l.min(-1), percent body fat = 19.0 +/- 7.1%) were assigned to either the active supplement (GT, n = 13) or placebo (PL, n = 11) group. The active supplement (Game Time (R), Corr-Jensen Laboratories Inc., Aurora, CO) was 18 g of powder, 40 kcals, and consisted of a proprietary blend including whey protein, cordyceps sinensis, creatine, citrulline, ginseng, and caffeine. The PL was also 18 g of powder, 40 kcals, and consisted of only maltodextrin, natural and artificial flavors and colors. Thirty minutes prior to all testing and training sessions, participants consumed their respective supplements mixed with 8-10 oz of water. Both groups participated in a three-week HIIT program three days per week, and testing was conducted before and after the training. Cardiovascular fitness (VO(2)max) was assessed using open circuit spirometry (Parvo-Medics TrueOne (R) 2400 Metabolic Measurement System, Sandy, UT) during graded exercise tests on a treadmill (Woodway, Pro Series, Waukesha, WI). Also, four high-speed runs to exhaustion were conducted at 110, 105, 100, and 90% of the treadmill velocity recorded during VO(2)max, and the distances achieved were plotted over the times-to-exhaustion. Linear regression was used to determine the slopes (critical velocity, CV) and y-intercepts (anaerobic running capacity, ARC) of these relationships to assess aerobic and anaerobic performances, respectively. Training volumes were tracked by summing the distances achieved during each training session for each subject. Percent body fat (%BF) and lean body mass (LBM) were assessed with air-displacement plethysmography (BOD POD (R), Life Measurement, Inc., Concord, CA). Results: Both GT and PL groups demonstrated a significant (p = 0.028) increase in VO(2)max from pre- to post-training resulting in a 10.3% and 2.9% improvement, respectively. CV increased (p = 0.036) for the GT group by 2.9%, while the PL group did not change (p = 0.256; 1.7% increase). ARC increased for the PL group by 22.9% and for the GT group by 10.6%. Training volume was 11.6% higher for the GT versus PL group (p = 0.041). %BF decreased from 19.3% to 16.1% for the GT group and decreased from 18.0% to 16.8% in the PL group (p = 0.178). LBM increased from 54.2 kg to 55.4 kg (p = 0.035) for the GT group and decreased from 52.9 kg to 52.4 kg in the PL group (p = 0.694). Conclusion: These results demonstrated improvements in VO(2)max, CV, and LBM when GT is combined with HIIT. Three weeks of HIIT alone also augmented anaerobic running performance, VO(2)max and body composition.

Sobolevsky T; Rodchenkov G. Sulbutiamine in sports. Drug Testing and Analysis 2(11-12, special issue): 643-646, 2010. (9 refs.)

Sulbutiamine (isobutyryl thiamine disulfide) is a lipophilic derivative of thiamine used for the treatment of asthenia and other related pathological conditions. It is available over-the-counter in several countries either as a component of nutritional supplements or as a pharmaceutical preparation. The presence of sulbutiamine in urinary doping control samples was monitored to evaluate the relevance of its use in sports. As one of the sulbutiamine metabolites has very close retention time and the same characteristic ion (m/z 194) as the main boldenone metabolite, the raw data files generated from the screening for anabolic steroids were automatically reprocessed to identify the samples containing sulbutiamine. It was found that of ca. 16000 samples analyzed in the Russian laboratory during 2009, about 100 samples contained sulbutiamine. It is important to note that most of these samples were collected in-competition, and sulbutiamine concentration was estimated to be greater than 500 ng/ml. This may indicate that sulbutiamine was intentionally administered for its ergogenic and mild stimulating properties.

Solberg J; Ringer R. Performance-enhancing drug use in baseball: The impact of culture. Ethics & Behavior 21(2): 91-102, 2011. (21 refs.)

Few sports-related events have generated as much controversy as the steroid crisis in baseball. Both ardent fans and casual observers wonder why professional baseball players would choose to use such substances when their use was viewed as outside the bounds of fair play. This article attempts to answer that question by applying concepts from the area of organizational culture. Understanding the culture of baseball and the ways leaders embedded and strengthened that culture adds insight into the decisions by athletes to engage in steroid use. In general, such use was consistent with the already-existing culture. In addition, key decisions and events likely created the conditions in which steroid use was more likely.

Strain EC. Drug use and sport: A commentary on: Injury, pain and prescription opioid use among former National Football League football players by Cottler et al. (editorial). Drug and Alcohol Dependence 116(1-3): 8-10, 2011. (3 refs.)

The accompanying paper by Cottler et al. reports on findings from a telephone survey study that examined opioid analgesic use and misuse by U.S. professional football players. The study shows high rates of misuse of these medications, and provides an opportunity to consider the intersection between sports and drug use. While in recent years there has been increasing focus upon the use of performance enhancing drugs (e.g., steroids) in athletes, the present report provides valuable information about a relatively unexplored but important topic: opioid analgesic misuse by athletes. The data provided show that misuse of opioids in this population is cause for concern, suggest that study of other groups of athletes should be undertaken, and that further assessment of opioid use in football players is also needed. The study also provides an opportunity to conceptualize drug (and non-drug) use in athletes, as a means to either return athletic functioning to a previous level of performance, or to enhance functioning. Discussions of drug use in sports need to appreciate the complexity of such use, which can be indicated and appropriate under certain circumstances, but which can also be inappropriate and problematic under others for example, for drugs such as opioid analgesics.

Terry-McElrath YM; O'Malley PM. Substance use and exercise participation among young adults: Parallel trajectories in a national cohort-sequential study. Addiction 106(10): 1855-1865, 2011. (60 refs.)

Aims This study examined the extent to which the trajectory of participation in sports, athletics or exercising (PSAE) covaried with substance use in early adulthood controlling for team sports participation using parallel process latent growth curve modeling. Design, setting and participants: Analysis of data collected from a series of panel studies using a cohort-sequential design. Specifically, the analyses used longitudinal data from 11 741 individuals from the graduating classes of 1986-2001, first surveyed as seniors in American high schools. Up to four additional follow-up surveys were administered to age 26 years. Data were collected using in-school and mailed self-administered questionnaires. Measurements: Level of PSAE, past-30-day alcohol, cigarette and marijuana use frequency and any past-30-day use of illicit drugs other than marijuana (IOTM) were the main processes of interest. Self-reported race/ethnicity, college status at age 19/20 years, parental education, gender and team sports participation during high school were included as covariates. Findings: Results indicate that higher initial levels of PSAE related to lower initial substance use prevalence rates other than alcohol, and lower initial prevalence rates of substance use then corresponded with lower substance use rates throughout early adulthood. Further, as individuals increased PSAE levels throughout early adulthood, the frequency of their use of cigarettes, marijuana and IOTM correspondingly decreased. Conclusions: Increased participation in sports, athletics or exercising (PSAE) is related to significantly lower substance use frequency at modal age 18 and through significantly and negatively correlated growth trajectories through early adulthood. Encouraging PSAE among adolescents and early adults may relate to lower substance use levels throughout early adulthood.

Thevis M; Kuuranne T; Geyer H; Schanzer W. Annual banned-substance review: Analytical approaches in human sports drug testing. (review). Drug Testing and Analysis 3(1): 1-14, 2011. (122 refs.)

The timely update of the list of prohibited substances and methods of doping (as issued by the World Anti-Doping Agency) is an essential aspect of international anti-doping efforts and represents consensual agreement by expert panels regarding substances and the methods of performance manipulation in sports. The annual banned-substance review for human doping controls critically summarizes recent innovations in analytical approaches; its purpose is to improve the quality of doping controls by reporting emerging and advancing methods that focus on detecting known and recently outlawed substances. This review surveys new and/or enhanced procedures and techniques of doping analysis together with information relevant to doping control that has been published in the literature between October 2009 and September 2010.

Thevis M; Sigmund G; Geyer H; Schanzer W. Stimulants and doping in sport. Endocrinology and Metabolism Clinics of North America 39(1): 89+, 2010. (68 refs.)

Stimulants have been frequently detected in doping control samples and represent a structurally diverse class of compounds. Comprehensive sports drug-testing procedures have been developed using gas or liquid chromatography combined with mass spectrometric detection, and they have revealed various adverse analytical findings, as demonstrated with 2 examples, 4-methylhexan-2-amine and methoxyphenamine. Moreover, the necessity of controlling the use or misuse of stimulating agents is outlined by means of pseudoephedrine, a compound that was prohibited in sports until the end of 2003. Since the ban was lifted, monitoring programs proved a significant increase in pseudoephedrine applications as determined from urine samples collected in competition. As a consequence, a reimplementation of this drug in future doping controls was decided.

Thomas JO; Dunn M; Swift W; Burns L. Illicit drug knowledge and information-seeking behaviours among elite athletes. Journal of Science and Medicine In Sport 14(4): 278-282, 2011. (23 refs.)

Objective: : Many sporting organisations in Australia conduct drug information seminars for their athletes; however, it is uncertain whether these programs provide athletes with pertinent drug information in formats that are conducive to information retention. The aims of the current study were to investigate self-reported confidence in knowledge of illicit drugs and information seeking behaviours among elite athletes. Methods: Data were collected from two sources: (1) quantitative surveys with elite Australian athletes; and (2) qualitative interviews with key experts who conic into contact with elite athletes. Results: Athletes were confident in their knowledge of the effects of illicit drugs such as cannabis and meth/amphetamine, but less confident in their knowledge of the effects of illicit drugs such as GHB and ketamine. A substantial proportion felt that athletes in their sport would benefit from more information concerning illicit drugs. Conclusions: Both athletes and key expert believed that information on illicit drugs should be delivered to athletes in a specific and relevant manner. There may be stigma attached to information seeking within a sports club or organisation. Accordingly, improving the accessibility to creditable information via the Internet may prove to be an effective means by which to educate athletes on the effects of illicit drugs.

Thorlindsson T; Halldorsson V. Sport, and use of anabolic androgenic steroids among Icelandic high school students: a critical test of three perspectives. Substance Abuse Treatment, Prevention and Policy 5: e-article 32, 2010. (37 refs.)

Background: This study investigates the use of anabolic androgenic steroids (AAS) among a national representative sample of high school students in Iceland. We test several hypotheses drawn from three perspectives. The first perspective focuses on the use of AAS as an individual phenomenon motivated by the desire to succeed in sport. The second perspective views the use of AAS as shaped by norms and values embedded in social relationships of formally organized sport. The third perspective suggests that factors outside sport, which have been shown to correlate with the use of other substances, predict the use of AAS. Method: We use logistic regression and predicted probabilities to analyze data from a national representative survey of 11031 Icelandic high school students. Results: Our results indicated that the use of AAS is not significantly related to participation in formally organized sports. However, it positively relates to fitness and physical training in informal contexts. We found a relatively strong relationship between the use of AAS and the use of illicit substances and a moderate relationship between AAS use and alcohol and tobacco consumption. We also found a significant negative relationship between AAS use and school integration and school achievement, and a significant positive relationship between AAS use and school anomie. The relation between AAS use and family-related variables was weaker. Finally, we found that the relationship between sport participation, physical exercise, and AAS use varies across levels of anomie and integration. Conclusion: Our findings suggest that the use of AAS and especially illegal substances should be considered more as a social and a health problem rather than a sport specific issue. We found that high school students participating in fitness and informal training outside of formally organized sport clubs are the main risk group and should be the target of prevention efforts. However, this should not be done at the expense of general risk factors that affect AAS and other substances used by the general population. Finally, we suggest that prevention efforts should target both groups and individuals.

Tomon JE; Ting SR. Effects of team climate on substance use behaviors, perceptions, and attitudes of student-athletes at a large, public University. Journal of College Student Development 51(2): 162-179, 2010. (56 refs.)

A study of the relationship between team norms, team cohesion, and performance by Patterson, Carr�n, and Loughead (2005) demonstrated that, on teams with high levels of cohesiveness, there was more pressure for teammates to conform to group norms.\n Future research could focus on the validity of the SATCSUS as well as the administration of the survey to other studentathlete populations throughout the country. Because of the limitations associated with the generalizability of the data, future research could include a sample of student-athletes from a variety of institution types, sizes, and locations.

Turp JC; Lunsch H; Radlanski RJ. Interdental spacing and orthodontic treatment in competitive athletes: Clues to doping with growth hormones? Journal of Orofacial Orthopedics 71(5): 373-382, 2010. (24 refs.)

The aim of this report is to examine clues of a suspected link between the artificial ingestion of human growth hormone (rhGH) and resulting interdental spaces in adult athletes. We conducted an electronic search in the German-language versions of the search engines Google and Google Scholar as well as in the database PubMed. While no explicit articles could be identified in PubMed, the search in Google and Google Scholar produced 1370 and 6 hits, respectively. Original quotes from 20 sources show that in the media the wearing of orthodontic multibracket appliances among athletes is largely attributed to changes in tooth position as a consequence of the illegal ingestion of rhGH. On the other hand, there are few references to the possibility that orthodontic treatments with fixed appliances might be carried out for reasons unrelated to doping. Conclusion: A definitive assessment of this issue is not possible at present. In view of its major importance of the subject, the relationships depicted here should be investigated in greater depth.

Uvacsek M; Nepusz T; Naughton DP; Mazanov J; Ranky MZ; Petroczi A. Self-admitted behavior and perceived use of performance-enhancing vs psychoactive drugs among competitive athletes. Scandinavian Journal of Medicine & Science in Sports 21(2): 224-234, 2011. (47 refs.)

The relationships between projected use, self-reported behavior and attitudes to performance-enhancing (PED) and recreational (RD) drugs were investigated among 82 competitive Hungarian athletes, with 14.6% admitting using PED and 31.7% using RD. Both the observed doping estimations (even those made by non-users) and self-admitted use were considerably higher than the average rate of positive doping tests (2% of all tests). The notable overestimation by PED users (34.6% vs 16.9%) was in keeping with the false consensus effect. A prediction model with attitude and projection to the likelihood of PED use suggested at least a 70% chance of self-involvement of athletes, with responses at or above the median scores (Performance Enhancement Attitude Scale >= 60 and estimation >= 50%) on the two independent measures. Users overestimated the prevalence of doping in their sport (P=0.007) but not RD use, with the converse holding for RD users' views of doping (P=0.029). PED users also showed a significantly more lenient attitude toward doping (P < 0.001). This domain-specific characteristic adds new information to the ongoing research effort in understanding drug-doping co-morbidity. The reasons for elevated in-group projection are discussed, along with the potential application of this phenomenon in doping epidemiology studies.

Van Renterghem P; Van Eenoo P; Sottas PE; Saugy M; Delbeke F. Subject-based steroid profiling and the determination of novel biomarkers for DHT and DHEA misuse in sports. Drug Testing and Analysis 2(11-12, special issue): 582-588, 2010. (39 refs.)

Doping with natural steroids can be detected by evaluating the urinary concentrations and ratios of several endogenous steroids. Since these biomarkers of steroid doping are known to present large inter-individual variations, monitoring of individual steroid profiles over time allows switching from population-based towards subject-based reference ranges for improved detection. In an Athlete Biological Passport (ABP), biomarkers data are collated throughout the athlete's sporting career and individual thresholds defined adaptively. For now, this approach has been validated on a limited number of markers of steroid doping, such as the testosterone (T) over epitestosterone (E) ratio to detect T misuse in athletes. Additional markers are required for other endogenous steroids like dihydrotestosterone (DHT) and dehydroepiandrosterone (DHEA). By combining comprehensive steroid profiles composed of 24 steroid concentrations with Bayesian inference techniques for longitudinal profiling, a selection was made for the detection of DHT and DHEA misuse. The biomarkers found were rated according to relative response, parameter stability, discriminative power, and maximal detection time. This analysis revealed DHT/E, DHT/5 beta-androstane-3 alpha,17 beta-diol and 5 alpha-androstane-3 alpha,17 beta-diol/5 beta-androstane-3 alpha,17 beta-diol as best biomarkers for DHT administration and DHEA/E, 16 alpha-hydroxydehydroepiandrosterone/E, 7 beta-hydroxydehydroepiandrosterone/E and 5 beta-androstane-3 alpha,17 beta-diol/5 alpha-androstane-3 alpha,17 beta-diol for DHEA. The selected biomarkers were found suitable for individual referencing. A drastic overall increase in sensitivity was obtained. The use of multiple markers as formalized in an Athlete Steroidal Passport (ASP) can provide firm evidence of doping with endogenous steroids.

Vangrunderbeek H; Tolleneer J. Student attitudes towards doping in sport: Shifting from repression to tolerance? International Review for the Sociology of Sport 46(3): 346-357, 2011. (23 refs.)

In the debate on the use of illegal substances for performance enhancing aims, commonly referred to as doping, perceptions and interpretations of doping by significant outsiders has received little attention compared to media attention for doping in elite sports. Therefore, this study focuses on opinions on doping in elite sports by students in human movement studies covering a period from 1998-1999 to 2005-2006 (N = 555). Three research questions were examined: 1) how much attention do students pay to the issue of doping in elite sports; 2) what are the students' opinions; and 3) which arguments do students use to substantiate these opinions? A four-level model was developed to categorize the ethical arguments according to who or what is at stake: the individual athlete (the self), the athlete's opponents and social environment (the other), the sport and its fair play essence (the play) and the spectator sport and its social role (the display). Over the years studied students seem to have developed a more diffuse ethical attitude on the doping issue. A shift from the zero tolerance principle towards a more lenient attitude towards doping in elite sports is observed and discussed.

Velasquez JR. The use of ammonia inhalants among athletes. Strength and Conditioning Journal 33(2): 33-35, 2011. (7 refs.)

Ammonia inhalants (AI) are commonly used by athletes as possible ergogenic aids during training or competition. Virtually, no research exists that has examined ai effectiveness, safety, or prevalence among athletes. Anecdotally, ai use is widespread, with some adverse reactions having been reported. The present article serves as an introduction to the use of AIs and examines the anecdotal use of AIs among the athletic population, as well as their effectiveness, practices, and safety. Strength and conditioning professionals, coaches, and sports medicine personnel should be familiar with their use and contraindications because adverse reactions have been reported.

Weiss S. Cross-addiction on campus: More problems for student-athletes. Substance Use & Misuse 45(10): 1525-1541, 2010. (61 refs.)

Data on 503 students from rural and urban areas were collected from January 2009 to October 2009 to test for cross-addiction of alcohol dependency with disordered gambling among college athletes and nonathletes. To test for alcohol dependency, the Michigan Alcohol Screening Test (MAST) was employed, while the South Oaks Gambling Screen (SOGS) was utilized to assess gambling behaviors. Athletes had higher frequencies of cross-addiction. For athletes there was a correlation between scores on the MAST and SOGS. Limitations related to data collection are discussed. Recommendations for further research directed toward the development of programs geared to assist students are given.

Weiss SM; Loubier SL. Gambling habits of athletes and nonathletes classified as disordered gamblers. Journal of Psychology 144(6): 507-521, 2010. (37 refs.)

The objective of the present study was to determine the forms of gambling that were the most prevalent in those having problems with their gambling. High-risk individuals who were experiencing difficulties with their gambling were examined. Specifically, the gambling behaviors of current athletes, former athletes, and nonathletes were investigated. Only members of these 3 groups with elevated scores on the South Oaks Gambling Screen (SOGS) were tested. Specifically, only those classified as disordered gamblers (SOGS score >= 3) were recruited. Among these individuals with high SOGS scores, former athletes were more likely to participate in skill-based forms of gambling such as sports gambling and poker card playing, whereas nonathletes were more likely to partake in gambling games that were based predominately on chance factors. Also, former athletes were more likely to wager on the sport they had once played. Findings suggest that a competitive spirit may lead athletes to involvement in skill-based forms of gambling. While other explanations were considered, preliminary indicators support this view.

Woolsey C; Waigandt A; Beck NC. Athletes and energy drinks: Reported risk-taking and consequences from the combined use of alcohol and energy drinks. Journal of Applied Sport Psychology 22(1): 65-71, 2010. (22 refs.)

This study measured athletes' alcohol, energy drink, and combined-use. It also compared athletes' reported risk-taking and consequences while using alcohol-only and in combination with energy drinks. From the total sample of 401 intercollegiate student-athletes, 315 (78%) used alcohol, 150 (37%) combined alcohol with energy drinks, and 194 (48%) used energy drinks (EDs) without alcohol. Ninety-two percent of drinkers participated in binge drinking. Sixty-one percent of combined users participated in high risk "energy binge" drinking episodes (using 3+ EDs on one occasion). Results indicated combined users (n = 150) consumed significantly more alcohol and had riskier drinking habits (e.g., heavy binge drinking) than athletes who used alcohol only (n = 165). The combined use of alcohol and energy drinks could potentially contribute to increased risk-taking and negative consequences. Results suggest a possible need to include information about energy drinks in existing athlete alcohol education and prevention programs.

Zacny JP; Jun JM. Lack of sex differences to the subjective effects of nitrous oxide in healthy volunteers. Drug and Alcohol Dependence 112(3): 251-254, 2010. (30 refs.)

Background: Although numerous studies have assessed subjective effects of nitrous oxide few studies have analyzed for sex differences. Since sex differences have been reported in subjective effects of several drugs such as opioids nicotine and alcohol we sought to determine if sex modulates the subjective effects of the inhalant nitrous oxide in healthy volunteers Methods: Thirty-eight females and seventy-two males from nine studies that were conducted in our laboratory were included in this retrospective analysis. All experimental studies utilized randomized placebo-controlled repeated measures designs in which subjects Inhaled 30% nitrous oxide in oxygen and 100% oxygen (placebo) Dependent measures in this analysis were subjective effects measured at baseline and 15 min into the inhalation period. Results: Nitrous oxide produced a number of subjective effects including those that could be considered abuse liability-related ( elated having pleasant thoughts drug liking) but sex did not modulate these effects. Conclusions: Females and males showed similar subjective responses to 30% nitrous oxide. Future prospective studies might assess other concentrations other measures (choice analgesic response) and other inhaled general anesthetics to more comprehensively characterize the role of sex in response to inhalants.artmouth e-journal