Drug doping in senior Australian rules football: a survey for frequency

Analgesic Management of Pain in Elite Athletes: A Systematic Review

OBJECTIVE

To identify the prevalence, frequency of use, and effects of analgesic pain management strategies used in elite athletes.

DESIGN

Systematic literature review.

DATA SOURCES

Six databases: Ovid/Medline, SPORTDiscus, CINAHL, Embase, Cochrane Library, and Scopus.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Empirical studies involving elite athletes and focused on the use or effects of medications used for pain or painful injury. Studies involving recreational sportspeople or those that undertake general exercise were excluded.

MAIN RESULTS

Of 70 articles found, the majority examined the frequency with which elite athletes use pain medications, including nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, anesthetics, and opioids. A smaller set of studies assessed the effect of medications on outcomes such as pain, function, and adverse effects. Oral NSAIDs are reported to be the most common medication, being used in some international sporting events by over 50% of athletes. Studies examining the effects of pain medications on elite athletes typically involved small samples and lacked control groups against which treated athletes were compared.

CONCLUSIONS

Existing empirical research does not provide a sufficient body of evidence to guide athletes and healthcare professionals in making analgesic medication treatment decisions. Based on the relatively robust evidence regarding the widespread use of NSAIDs, clinicians and policymakers should carefully assess their current recommendations for NSAID use and adhere to a more unified consensus-based strategy for multidisciplinary pain management in elite athletes. In the future, we hope to see more rigorous, prospective studies of various pain management strategies in elite athletes, thus enabling a shift from consensus-based recommendations to evidence-based recommendations.

A risk profile of elite Australian athletes who use illicit drugs

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.

Football and doping: study of African amateur footballers

OBJECTIVE

To investigate use and awareness of lawful and unlawful substances by amateur footballers in Yaounde, Cameroon.

METHODS

A total of 1116 amateur footballers (1037 male and 79 female) out of 1500 contacted participated in this study. They were divided into three groups: elite players (n = 314); local players (n = 723); female players (n = 79). They answered a questionnaire of 30 items grouped under six main topics: identification of players; use of lawful substances subject to certain restrictions on the International Olympic Committee (IOC) list; use of IOC banned substances; doping behaviour; awareness of doping; food supplements. The results of the questionnaire were scrutinised using Microstat software, and the level of significance was p<0.05.

RESULTS

(a) Use by our footballers of a banned substance (cocaine) and substances subject to certain restrictions (alcoholic drinks, methylated spirits, and banga (marijuana)). (b) Doping behaviour: use by our footballers of substances with similar effects to some IOC banned substances but not listed as such: tobacco, liboga, wie-wie (narcotic), bilibili (locally made alcohol drink). (c) A large intake of vitamin C (food supplements) in all three groups. In contrast, the footballers' knowledge of doping was vague.

CONCLUSION

Preventive actions and an epidemiological study of doping among footballers are urgently required.

Nutrition for the Australian Rules football player

This review summarises past and present nutritional practices of Australian Rules Football players, noting changes that have occurred as the footballers have become more receptive to scientific input. Australian Rules Football is a unique sport, with matches involving intermittent high intensity sprints between periods of jogging and walking and repeated physical contact. Endurance, speed, strength, power and agility are essential physical characteristics. Australian Rules footballers exhibit a wide range of anthropometrical attributes due to the positional requirements of the game. Dietary surveys indicate that footballers of the 1980's consumed a diet similar to that of the general Australian population consisting of 44%, 37.5%, 15% and 3.5% of carbohydrate (CHO), fat, protein and alcohol, respectively. However, as dietitians are becoming an integral part of the support staff of teams there is evidence that nutritional practices conducive to optimal sporting performance are now being followed. Due to the prolonged duration and intermittent high intensity activity pattern of Australian Rules, nutritional supplementation such as fluid and CHO intake during training and competition and creatine intake may be beneficial; however, further research needs to be conducted in the field to determine its importance in Australian Rules Football.

Steroids and steroid-like compounds

Athletes have been searching for an "edge" in competition as long as there has been a reward for success. Anabolic-androgenic steroids have been the most popular of these ergogenic aids when winning is the only goal. The authors present a concise review of these substances, their prevalence, efficacy, adverse effects, and legality. This article also presents a steroid user profile and discusses physician perception and management of a patient who uses these drugs. The popular precursors of testosterone, dehydroepiandrosterone, and androstenedione are discussed with a review of the limited available data on these substances.