{"id":114,"date":"2008-02-14T14:47:50","date_gmt":"2008-02-14T14:47:50","guid":{"rendered":""},"modified":"2013-11-26T21:45:07","modified_gmt":"2013-11-26T21:45:07","slug":"drug-use-by-college-athletes-is-random-testing-an-effective-deterrent","status":"publish","type":"post","link":"https:\/\/thesportjournal.org\/article\/drug-use-by-college-athletes-is-random-testing-an-effective-deterrent\/","title":{"rendered":"Drug Use by College Athletes: Is Random Testing an Effective Deterrent?"},"content":{"rendered":"
Submitted by: Russell Meldrum, MD, and Judy R. Feinberg, PhD<\/div>\n

Abstract<\/strong><\/p>\n

Incidence
\nof anabolic steroid use among college athletes is about 1%,
\nwith another 12% considered at-risk in that they would use
\nsuch drugs under the right circumstances. This study aimed
\nto determine if volunteer drug testing, without fear of penalty,
\nwould result in positive identification of drug use, or if
\nthe testing alone is a deterrent. A group of 197 college athletes,
\nall of who denied drug use, voluntarily and anonymously supplied
\nurine samples. Average T\/E ratio was 1.33 \u00b1 0.86, with
\ntwo cases (1.1%) above the accepted ratio. We conclude that
\nT\/E ratio testing is effective in detecting use of performance-enhancing
\ndrugs and that testing itself, although an effective deterrent
\nto drug use, may not eliminate drug use among college athletes.<\/p>\n

<\/p>\n

Introduction<\/strong><\/p>\n

Athletes
\nhave used performance-enhancing drugs for decades. In 1968
\nthe International Olympic Committee (IOC) banned the use of
\nperformance-enhancing substances to promote fair play in competition.
\nAt that time the banned substances were primarily anabolic
\nsteroids and amphetamines. Other athletic associations and
\nsport governing bodies soon followed suit by adopting similar
\nbans, including the National Collegiate Athletic Association
\n(NCAA) which adopted a drug-testing program to promote fair
\nand equitable competition and to safeguard the health and
\nsafety of student-athletes. Since then the specified number
\nof banned substances has risen dramatically as athletes are
\ndriven to finding new ways to obtain a competitive edge and\/or
\nto avoid detection. Currently the NCAA promotes drug education
\nand mandates that each athletic department conduct a drug
\nand alcohol education program once a semester, presumably
\nto increase the athletes’ understanding of the drug-testing
\nprogram and to promote the avoidance of drug use.<\/p>\n

Despite
\nthese regulations, the incidence of anabolic steroid use among
\nathletes has not decreased, and, in some instances, has increased
\n(Catlin & Murray, 1996). In general, the decision to not
\nuse drugs is felt to be related more to the fear of reprisal
\nthan to health issues, and users continue to look for ways
\nto avoid detection rather than decide not to use these banned
\nsubstances. Tricker and Connolly (1997) reported an 8% rate
\nof anabolic steroid use in college athletes over a lifetime
\nand a 1% use within the past six months. In addition they
\nidentified about 12% at-risk athletes, i.e., they would use
\nsteroids under the right circumstances. Those circumstances
\nwere largely defined as the ability to achieve their athletic
\npotential without testing positive for use.<\/p>\n

The
\npurpose of this study was to examine T\/E ratios in a group
\nof college athletes who volunteered for testing under the
\nconditions of anonymity and therefore had no fear of reprisal.
\nThe T\/E ratio was chosen because of its low false-positive
\nrate (0.1%). We aimed to determine if the anticipated results
\nof no positive test results would occur, or if there might
\nbe any positive test results with the threat of reprisal removed.<\/p>\n

Method<\/strong><\/p>\n

Subjects<\/strong><\/p>\n

A
\ngroup of 206 male varsity or junior varsity NCAA Division
\nI college athletes identified themselves as not currently
\ntaking nutritional supplements or performance-enhancing drugs
\nand volunteered to provide a urine sample for testing. Because
\nthe testing was done anonymously, there was no fear of reprisal
\nfrom submitting to the testing. Nine samples were contaminated
\nduring processing and were eliminated, leaving a study group
\nof 197 college athletes, all of whom would presumably have
\nnegative test results.<\/p>\n

Testing
\nProcedure<\/strong><\/p>\n

Urinary
\nspecimens were examined for the ratio of testosterone (T)
\nto epitestosterone (E). The accepted standard for identifying
\nanabolic steroid use was used with a T\/E ratio above 6:1 as
\na positive indication of doping (Catlin et al.,1996; International
\nOlympic Committee, 1982). All urine specimens were run on
\nHP 599SC gas chromatography – mass spectrometry (Hewlett Packard
\nCompany, Avondale, Pennsylvania) using standard testing procedures
\n(Borts & Bowers, 2000; Dehennin, 1994; Ismail & Harkness,
\n1966; van de Kerkhof, De Boer, Thijssen, & Maes, 2000).
\nBecause there is a small incidence of false positive results,
\nit is recommended that additional testing be done on those
\nwhose T\/E ratios exceed 6:1 before legal action is considered
\n(Dehennin & Scholler, 1990). However, in this study, no
\nadditional testing was done as the athlete could not be identified
\nand there would be no punitive action. It is also known that
\nthere are athletes who use exogenous testosterone, yet their
\nT\/E ratio never exceeds 6:1 (Garle, Ocka, Palonek, & Bjorkhem,
\n1996).<\/p>\n

Results<\/strong><\/p>\n

The
\naverage testosterone\/epitestosterone (T\/E) ratio was 1.33:1
\n\u00b1 0.86 (mean \u00b1 standard deviation). Two of the
\n197 (1.1%) athletes tested had T\/E ratios greater than the
\naccepted international standard (12:1 and 9:1) and, thus,
\nhad positive test results. Thus, the specificity of the T\/E
\ntesting in this study group was 195\/197 (98%) as all subjects
\nwere presumably drug-free.<\/p>\n

Discussion<\/strong><\/p>\n

Our
\ndata confirms that the T\/E ratio testing is at least 98% accurate,
\ndepending upon the true drug status of the two individuals
\nwho had abnormal T\/E ratios in this study. The two specimens
\nwith ratios higher than the accepted norm were not verified
\nwith further testing, and, therefore, it is not know whether
\nthese two cases represented true or false positives. If we
\nassume that those two athletes were, in fact, taking performance
\nenhancing drugs, the accuracy, sensitivity, specificity, of
\nthe T\/E ratio testing becomes 100%.<\/p>\n

The
\nfact that two athletes tested positive under the study conditions
\nis interesting. Although only those who professed that they
\ndid not use any performance-enhancing drugs were recruited
\nfor the study, perhaps those two athletes thought they might
\ndraw attention by their lack of participation and possibly
\nbe singled out for sanctioned testing in the future if they
\nchose not to participate. Since there was no fear of personal
\nidentification or of reprisal for positive test results, they
\nmay have felt participation was risk-free regardless, or they
\nsimply may have felt that they could beat the system or wanted
\nto test the system to see if they might go undetected.<\/p>\n

Confirmation
\nor refutation in the two positive cases was not pursued. However
\nit is felt that most likely these were true positives. The
\nreasons for this assumption are based on known percentages
\nof drug use among college athletes and previous reports of
\nthe incidence of false positive results on initial testing.
\nTricker and Connolly (1997) reported a 1% use of anabolic
\nsteroids within the past six months in their survey of 563
\ncollege athletes. Catlin and Murray (1996) reported a similar
\npercentage in Olympic athletes over a nine-year period and,
\nover a three-year period in NCAA football players, the average
\nwas also approximately 1%. On the other hand, Dehennin and
\nScholler (1990) reported the incidence of false positives
\nat 15 per 10,000 (0.15%). The two positive results in this
\ngroup of 197 college athletes represented 1.1% of the study
\ngroup, and this percentage would be consistent with the anticipated
\nnumber of positive results in a random sample of male college
\nathletes.<\/p>\n

The
\nmore important issue is that the use of anabolic steroids
\namong athletes, although not increasing, has not diminished
\nunder the current testing programs. Even in this study, where
\nvolunteer athletes were recruited to participate only if they
\nwere non-users, positive test results occurred. This is not
\nto say that the testing programs are ineffective, but they
\nare not entirely effective in acting as a deterrent to drug
\nuse. The fear of testing positive and risking disqualification
\nor sanction clearly deters a certain percentage of athletes
\nconsidered at risk for drug use, but others continue to use
\ndrugs and either hope to or try to beat the system. Testing
\nprograms vary among sports governing agencies. At the 1996
\nOlympics Games in Atlanta, approximately 18% of athletes were
\ntested after their events including all medallists and one
\nor two others at random (Catlin and Murray, 1996). Random
\ntesting leaves a chance for an athlete to avoid detection,
\nyet testing of all athletes one or more times during a season
\nis cost-prohibitive. In addition, those motivated to gain
\na competitive edge, legal or otherwise, will seek novel ways
\nto avoid detection, including taking masking substances.<\/p>\n

Drug
\nuse is a serious concern, not only for the concepts of integrity
\nand fair play in competitive sports, but because of the health
\nthreats to the athletes. Certainly drug testing programs should
\ncontinue with increasing numbers of athletes being tested
\nand increasing penalties for detection, since these are most
\nlikely means of deterrence. Drug education programs must also
\ncontinue in a further attempt to curtail the use of illegal
\nperformance-enhancing drugs by empowering the young athlete
\nwith the information and skills to make responsible and healthy
\ndecisions.<\/p>\n

Conclusion<\/strong><\/p>\n

Drug
\ntesting programs are designed to promote fair play and deter
\ndrug use among athletes. Under conditions of anonymity a group
\nof professed non-user athletes volunteered for drug testing.
\nTwo positive results were identified indicating the importance
\nof continued testing and need for further testing and education,
\nas testing alone is not a sufficient deterrent to eliminate
\ndrug use among college athletes.<\/p>\n

Acknowledgement<\/strong><\/p>\n

This
\nstudy was supported by a student institutional grant by and
\nperformed at Brigham Young University in Provo, Utah.
\nReferences<\/strong><\/p>\n

    \n
  1. Borts, D. J., & Bowers, L. D. (2000). Direct measurement
    \nof urinary testosterone and epitestosterone conjugates using
    \nhigh-performance liquid chromatography\/tandem mass spectrometry.
    \nJournal of Mass Spectrometry, 35, 50-61.<\/li>\n
  2. Catlin, D. H., Cowan. D.A., De la Torre. R., Donike, M.,
    \nFraisse, D., Oftebro H., Hatton, C.K., Starcevic, B., Becchi,
    \nM., de la Torre, X., Norli, H., Geyer, H., & Walker,
    \nC.J. (1996). Urinary testosterone (T) to epitestosterone
    \n(E) ratios by GC\/MS. I. Initial comparison of uncorrected
    \nT\/E in six international laboratories. Journal of Mass Spectrometry,
    \n31, 297-402.<\/li>\n
  3. Catlin, D. H., & Murray, T. H. (1996). Performance-enhancing
    \ndrugs, fair competition, and Olympic sport. Journal of the
    \nAmerican Medical Association, 276, 231-237.<\/li>\n
  4. Dehennin, L. (1994). On the origin of physiologically high
    \nratios of urinary testosterone to epitestosterone: consequences
    \nfor reliable detection of testosterone administration by
    \nmale athletes. Journal of Endocrinology, 142, 353-360.<\/li>\n
  5. Dehennin, L., & Scholler, R. (1990) Detection of self-administration
    \nof testosterone as an anabolic by determination of the ratio
    \nof urinary testosterone to urinary epitestosterone in adolescents.
    \nPathologie Biologie (Paris), 38, 920-922.<\/li>\n
  6. Garle, M., Ocka, R., Palonek, E., & Bjorkhem, I. (1996).
    \nIncreased urinary testosterone\/epitestosterone ratios found
    \nin Swedish athletes in connection with a national control
    \nprogram. Evaluation of 28 cases. Journal of Chromatography
    \nB Biomedical Applications, 687, 55-59.<\/li>\n
  7. International Olympic Committee. (1982). International Olympic
    \nCommittee Definition of Doping and List of Doping Classes
    \nand Methods. Lausanne, Switzerland.<\/li>\n
  8. Ismail, A. A., & Harkness, R.A. (1966). A method for
    \nthe estimation of urinary testosterone. Biochemistry Journal,
    \n99, 717-725.<\/li>\n
  9. Tricker, R., & Connolly, D. (1997). Drugs and the college
    \nathlete: An analysis of the attitudes of student athletes
    \nat risk. Journal of Drug Education, 27,105-119.<\/li>\n
  10. van de Kerkhof, D.H., de Boer, D., Thijssen, J. H., &
    \nMaes, R. (2000). Evaluation of testosterone\/epitestosterone
    \nratio influential factors as determined in doping analysis.
    \nJournal of Analytical Toxicology, 24,102-115.<\/li>\n<\/ol>\n

    Russell
    \nMeldrum, MD, and
    \nJudy R. Feinberg, PhD
    \nIndiana University
    \nSchool of Medicine
    \nDepartment of Orthopedic Surgery
    \n541 Clinical Drive
    \nSuite 600
    \nIndianapolis, IN 46202-5111
    \nPhone: 317-274-8318
    \nFax: 317-274-3702
    \nEmail: rmeldrum@iupui.edu<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

    Submitted by: Russell Meldrum, MD, and Judy R. Feinberg, PhD<\/div>\n

    Abstract<\/strong><\/p>\n

    Incidence
    \n of anabolic steroid use among college athletes is about 1%,
    \n with another 12% considered at-risk in that they would use
    \n such drugs under the right circumstances. This study aimed
    \n to determine if volunteer drug testing, without fear of penalty,
    \n would result in positive identification of drug use, or if
    \n the testing alone is a deterrent. A group of 197 college athletes,
    \n all of who denied drug use, voluntarily and anonymously supplied
    \n urine samples. Average T\/E ratio was 1.33 ± 0.86, with
    \n two cases (1.1%) above the accepted ratio. We conclude that
    \n T\/E ratio testing is effective in detecting use of performance-enhancing
    \n drugs and that testing itself, although an effective deterrent
    \n to drug use, may not eliminate drug use among college athletes.\n <\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"jetpack_publicize_message":"","jetpack_is_tweetstorm":false,"jetpack_publicize_feature_enabled":true,"jetpack_social_options":[]},"categories":[290,291,296],"tags":[38,8,31,39],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p4btio-1Q","jetpack-related-posts":[{"id":86,"url":"https:\/\/thesportjournal.org\/article\/its-time-to-work-together-to-stop-doping-in-sports\/","url_meta":{"origin":114,"position":0},"title":"It’s Time to Work Together to Stop Doping in Sports","date":"February 13, 2008","format":false,"excerpt":"Submitted by: Richard Bell, Ed.D. The greatest threat to international sport isn't the pay offs in Salt Lake City, but the use of dangerous performance-enhancing drugs. Their use threatens the very foundation of sport. The integrity, the image and even the existence of elite-level international competition is in jeopardy. Every\u2026","rel":"","context":"In "Contemporary Sports Issues"","img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":85,"url":"https:\/\/thesportjournal.org\/article\/model-student-athlete-drug-testing-policy\/","url_meta":{"origin":114,"position":1},"title":"Model Student Athlete Drug Testing Policy","date":"February 13, 2008","format":false,"excerpt":"Submitted by: Hoover City Schools- Hoover, AL STUDENT DRUG SCREENING The Board of Education values student athletes not only for their athletic talent but also for their leadership and scholastic abilities. Student athletes, as role models for other students, are a key to our goal of providing the best possible\u2026","rel":"","context":"In "Contemporary Sports Issues"","img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":82,"url":"https:\/\/thesportjournal.org\/article\/student-athlete-drug-testing\/","url_meta":{"origin":114,"position":2},"title":"Student Athlete Drug Testing","date":"February 13, 2008","format":false,"excerpt":"Submitted by: Joseph C. Franz, M.D. Since the June 1995 U. S. Supreme Court ruling in support of random interscholastic student athlete drug testing, more schools then ever before have begun either mandatory, reasonable suspicion or voluntary types of drug testing as they battle drug abuse by their students. By\u2026","rel":"","context":"In "Contemporary Sports Issues"","img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":84,"url":"https:\/\/thesportjournal.org\/article\/a-journey-through-olympic-drug-testing-rules-a-practitioners-guide-to-understanding-drug-testing-within-the-olympic-movement\/","url_meta":{"origin":114,"position":3},"title":"A Journey Through Olympic Drug Testing Rules: A Practitioner’s Guide to Understanding Drug Testing Within the Olympic Movement","date":"February 13, 2008","format":false,"excerpt":"Submitted by: Jill Pilgrim and Kim Betz It's the spring of the year 2000, and you are looking forward to your first summer of the new Millennium. Baseball season has started, the NBA playoffs are on the horizon, Wimbledon, the French Open, and the US Open are all ahead of\u2026","rel":"","context":"In "Contemporary Sports Issues"","img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":79,"url":"https:\/\/thesportjournal.org\/article\/generic-alcoholism-are-college-athletes-at-risk\/","url_meta":{"origin":114,"position":4},"title":"Generic Alcoholism: Are College Athletes at Risk?","date":"February 13, 2008","format":false,"excerpt":"Submitted by: Michael Moulton, Ed.D Alcohol and other drug use by college athletes have received increased attention in recent years. The purpose of this study was to explore the relationship of collegiate athletes and non-athletes drinking patterns to those of generic alcoholism. The findings revealed a large portion of the\u2026","rel":"","context":"In "Contemporary Sports Issues"","img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":2342,"url":"https:\/\/thesportjournal.org\/article\/ratios-of-certified-athletic-trainers-to-athletic-teams-and-number-of-athletes-in-south-carolina-collegiate-settings\/","url_meta":{"origin":114,"position":5},"title":"Ratios of Certified Athletic Trainers\u2019 to Athletic Teams and Number of Athletes in South Carolina Collegiate Settings","date":"March 16, 2015","format":false,"excerpt":"Submitted by\u00a0Robert Bradley1, Ed.D, ATC, SCAT*. Fred Cromartie2, Ed.D*, Jeff Briggs3 PhD.*, Fred Battenfield4, Ph.D.*, Jon Boulet5 Ph.D*. 1*\u00a0Assistant Professor of Sport management\u00a0at North Greenville University,\u00a0Tigersville,\u00a0South Carolina,\u00a029680 2*\u00a0Director of Doctoral Studies at the United States Sports Academy, Daphne, Alabama, 36526 3* Professor of Sport Management\u00a0at North Greenville University, Tigersville, South\u2026","rel":"","context":"In "Contemporary Sports Issues"","img":{"alt_text":"Table 1","src":"https:\/\/i0.wp.com\/thesportjournal.org\/wp-content\/uploads\/2015\/03\/Table1.jpg?resize=350%2C200","width":350,"height":200},"classes":[]}],"_links":{"self":[{"href":"https:\/\/thesportjournal.org\/wp-json\/wp\/v2\/posts\/114"}],"collection":[{"href":"https:\/\/thesportjournal.org\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/thesportjournal.org\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/thesportjournal.org\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/thesportjournal.org\/wp-json\/wp\/v2\/comments?post=114"}],"version-history":[{"count":2,"href":"https:\/\/thesportjournal.org\/wp-json\/wp\/v2\/posts\/114\/revisions"}],"predecessor-version":[{"id":1215,"href":"https:\/\/thesportjournal.org\/wp-json\/wp\/v2\/posts\/114\/revisions\/1215"}],"wp:attachment":[{"href":"https:\/\/thesportjournal.org\/wp-json\/wp\/v2\/media?parent=114"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/thesportjournal.org\/wp-json\/wp\/v2\/categories?post=114"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/thesportjournal.org\/wp-json\/wp\/v2\/tags?post=114"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}