1. Mary Wilfert NCAA Sport Science Institute
The Latest Substance Use Data and Tool Kit for College Student-Athletes ACHA June 1 3:15-4: Session 27
Mary Wilfert
NCAA Sport Science Institute

2. No presenter has an actual or potential conflict of interest in relation to this presentation.

3. Learning Objectives
Identify the most recent data on substance use among college student-athletes.
Compare student-athlete data with the general student population.
Access tools to effectively address substance use issues among college student-athletes.

4. NCAA Student-Athlete Substance Use Study
Double check and its called study

5. Methodology Survey Administration:
All active member institutions of the NCAA were asked to participate.
teams surveyed were determined by a stratified random sampling procedure.
Detailed materials and instructions for administration provided to the FAR to ensure anonymity of the data and protection of student-athlete participants.
Data Collection:
survey data entered into a database by a third-party vendor.
data forwarded to the NCAA.
vendor destroyed the paper surveys

6. Demographics 23,028 student-athletes included in the analysis:
DII – 6331
DIII – 8135
Male – 13,112
Female – 9916
Native American-262
Asian-574
AfricanAmerican-4,089
Hispanic-1,527
Pacific Islander-230
White-16,664
Multiracial-708
Other-325

7. Reported Illicit Drug Use
Illicit Drug Use by Sex

9. Substance Use Trends by Sex
Women
Men
Year
2009
2013
2017
Alcohol
 83.1%
81.3%
78.5%
79.9%
76.2%
Amphetamines
 3.3%
3.5%
0.7%
 4.0%
5.3%
2.1%
Anabolic steroids
 0.2%
0.1%
 0.5%
0.6%
Cigarettes
13.5%
6.3%
16.8%
12.7%
14.0%
Cocaine
1.0%
1.7%
2.3%
2.6%
5.2%
Spit tobacco
2.4%
1.5%
27.2%
24.2%
21.8%
Synthetic “marijuana” - 
0.5%  -
0.8%

10. Used, but not in the last year
Reported Alcohol Use
Year
Never used
Used in the last year
Used, but not in the last year
2009
12.2%
83.2%
4.7%
2013
 14.9%
80.4%
2017
 19.8%
77.1% 
3.1%
Nearly 2% of student-athletes reported drinking on a daily basis and 36% on a weekly basis.
Over one quarter of students-athletes reported having experienced the following as a consequence of drinking alcohol within the last year:
Had a hangover (52%)
Forgot where you were or what you did (28%)
Done something you later regretted (25%)

11. Excessive Drinking Trends
All Divisions
2005
2009
2013
2017
4+/5+ drinks
67.2%
55.4%
51.1%
41.9%
10+ drinks
18.4%
14.7%
11.8%
8.4%

12. Reported Tobacco/Nicotine Use

13. Reported Marijuana Use Used, but not in the last year
Never used
Daily
Weekly
Monthly
In the last year
Used, but not in the last year
Inhale
65.7%
2.5%
2.9%
3.9%
14.5%
10.5%
Ingest
82.2%
0.3%
0.5%
1.9%
8.4%
6.8%
Skin application
97.9%
0.2%
0.1%
0.7%
1.0%
Synthetic “marijuana”
97.5%
0.0%
1.8%

14. Reported Marijuana Use
by NCAA Division

15. Prescription Medication Use Narcotic Pain Medication
Within the Last Year
Narcotic Pain Medication
2009
2013
2017
WITH a prescription
13.7%
18.0%
10.5%
WITHOUT a prescription
5.1%
5.8%
2.9%
ADHD Stimulants
4.5%
5.7%
6.6%
6.7%
8.7%
7.5%

16. Medication Misuse Within the Last Year Medication 2017
Ibuprofen, naproxen, aspirin or other NSAIDS
23.6%
Tylenol and acetaminophen
12.0%
Adderall, Ritalin, Concerta, Vyvanse
5.5%
Vicodin, Oxycontin, Percocet, Dilaudid, Morphine or Tylenol with Codeine
2.1%
Ultracet, Ultram or Tramadol
0.2%
Injectable Toradol or Ketorolac
0.1%

17. Substance Use by Sport Men’s Sports
Highest reported alcohol users are ice hockey players, followed by lacrosse and golf student-athletes.
Ice hockey (46%) and baseball (44%) players are the most common users of spit tobacco.
48% of men’s lacrosse players reported smoking marijuana.
Women’s Sports
Alcohol use is highest among lacrosse and ice hockey players
Marijuana and cocaine use is also highest among lacrosse players.
Women’s gymnastics student-athletes (18%) were the highest users of narcotic pain medication.

18. Data from American College Health Association National College Health Assessment
Semi-annual survey of college students, about 10% identified as varsity athletes.
Survey covers several mental and physical health topics, including:
Alcohol, tobacco, and other drug use
Sexual health
Weight, nutrition, and exercise
Mental health
Personal safety and violence
Institutions have authority over sampling, survey method and time of administration.

19. Comparative Data- use within last 30 days
NCAA
[2017]
ACHA
Alcohol
61.1%
58.9%
Cigarettes
3.2%
9.4%
Marijuana*
9.3%
18.2%
Amphetamines*
0.8% -
Anabolic Steroids*
0.2%
0.3%
Cocaine*
1.4%
Ecstasy*
0.6%
Heroin*
0.1%
LSD
*Substance banned for use by the NCAA.

20. Comparative Data – use within the last year
NCAA
[2017]
CORE
[2013]
MTF
[2016]
Alcohol
77.1%
81.3%
78.9%
Cigarettes
10.5% -
18.7%
Marijuana*
24.7%
32.5%
39.3%
Amphetamines*
1.5%
5.4%
9.8%
Anabolic Steroids*
0.4%
0.6%
Cocaine*
3.8%
4.1%
4.0%
Ecstasy*
1.9%
4.7%
Heroin*
0.2%
LSD
1.7%
3.1%
*Substance banned for use by the NCAA.

21. NCAA Drug Testing To deter cheating To protect health and safety
To maintain the integrity of the game
Testing is part of a comprehensive approach to drug deterrence:
Written policy
Education
Testing

22. NCAA Banned Drugs Stimulants Anabolic agents
Alcohol and Beta Blockers (banned for rifle only)
Diuretics and other masking agents
Peptide hormones and analogues
Anti-estrogens
Beta 2 Agonists
Illicit Drugs

23. Medical Exceptions Not for marijuana/illicit class
Pre-approval required for anabolic agents (testosterone) and peptide hormones and analogues (EPO, hGH)
Stimulants, diuretics, anti-estrogens, and beta blockers reviewed following a positive drug test
Documentation must be in place prior to test

24. NCAA Drug Testing Timeline
1986: Championship Drug Testing Program Begins (PED And marijuana)
1990: Year Round Testing Begins (PED, masking agents, football and track & field)
2004-’05: All Sport Expansion
2015: Perceptual Deterrence Model Begins
In 1986 the NCAA drug-testing program was established with testing only at championship events. This included PED and marijuana testing.
: All Sport expansion in Division I and Division II YRT
2010: Targeted testing plan
2012: More targeted
2015: Perceptual Deterrence Model Begins in YRT

25. Markie just created this based off of research’s data.
11/22/2018

26. Institutional Testing Correlated with Reported Marijuana Use
Schools Conducting Institutional Testing
NCAA 2015 Survey
Reported Student-Athlete Marijuana Use
NCAA 2017 Survey
Division I
86%
17.7%
Division II
72%
21.6%
Division III
29%
32.6%
Slide demonstrates percentage of schools in each division that conduct institutional testing for marijuana, compared to those student-athletes in each division that report marijuana use. Note inverse relationship.

27. Emerging Performance Enhancing Drugs
Significant increases in NCAA positive tests for:
Turinabol – anabolic agent from old German doping scheme.
Selective Androgen Receptor Modulators (SARMS)--such as ostarine, an investigative drug not yet approved for human consumption, used as an anabolic agent similar to anabolic steroids with fewer undesired side effects.
Selective Estrogen Receptor Modulators (SERMS)--such as clomiphene, an FDA approved drug for various estrogen related conditions, used in steroid cycling to minimize

28. Selective Androgen Receptor Modulators (SARMS) Trends
Prior to positives
positives (2 ostarine
positives (14 ostarine)
positives (19 ostarine, 3 ligandrol)
positives (20 ostarine, 4 ligandrol (LGD 4033), 3 RAD140, 1 andarine)
Mar positives (21 Ostarine , 5 LGD4033, 4  RAD140)
Clomiphene (SERM) Trends
Oral Turanibol
Mar – 16 positives
positives
positives
positive
positives
positives
positives
positives
Mar positives  

29. Dietary Supplement Concerns

30. Dietary Supplement Health and Education Act (DSHEA) 1994
Puts burden onto FDA to prove that a nutritional supplement is harmful before it can regulate its sale.
11/22/2018

31. Dietary Supplements*…
* These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
Do not need to be proven effective
Do not need to be proven safe
Lack standards on potency and PURITY

32. NCAA Drug-Testing Consent Form Advisory
Before consuming any nutritional/dietary supplement product, review the product with your athletics department staff!
Dietary supplements are not well regulated and may cause a positive drug test result.
Student-athletes have tested positive and lost their eligibility using dietary supplements.
Many dietary supplements are contaminated with banned drugs not listed on the label.
Any product containing a dietary supplement ingredient is taken at your own risk.
It is your responsibility to check with the appropriate athletics staff
before using any substance.

33. Herbs/Dietary Supplements Fail Ingredient Tests
Consumer Lab.com tested over 4,500 products Nov 1999-July 2015
20% of the vitamins and minerals, 43% of herbals, 24% of nutritional powders and drinks, 21%of other failed their evaluation
most common problem was too little or no main ingredient.
other problems included
too much active ingredient;
the wrong ingredient;
potentially dangerous or illegal ingredients;
contamination with heavy metals;
"spiking" with unexpected ingredients;
poor disintegration (which affects absorption);
and misleading or incomplete product information.
Bottom line – supplements are risky business!

34. Dietary Supplement Concerns for Student-Athletes Health and Eligibility
The U.S. Food and Drug Administration (FDA) does not have the authority to review dietary supplement products for safety and effectiveness before they are marketed. FDA Website.
“Determining whether specific products contain AAS [anabolic androgenic steroids] is difficult without chemical analysis (Geyer et al., 2008), especially as there is no guarantee of label accuracy and the chemical names listed on product labels often do not follow modern conventional nomenclature. Owing to such a high prevalence of intentional and accidental contamination of bodybuilding and sports supplements reaching the consumer the question arises if the legality of labeled ingredients even matters.” 2015 American Society of Andrology and European Academy of Andrology

35. Presence of Banned Drugs in Dietary Supplements Following FDA Recalls-JAMA 2014
Supplements remained adulterated in:
85%(11/ 13) of those for sports enhancement,
67%(6/9) for weight loss,
Of the subset of supplements produced by US manufacturers, 65%(13/20) remained adulterated with banned ingredients.

36. Drug Test Appeals: Reported Supplement Contamination
15 appeals for positive drug tests conducted in the fall of 2017.
4 clomiphene,
4 ostarine,
3 turinabol, 2 other anabolic agents
13 appeals for PEDs,
12 included unsubstantiated claims that the source of the banned substance from named supplements they were taking, with no label ingredient reflecting the banned substance.
One student-athlete had his supplement tested by BSCG , which found trace amounts of turinabol (no documented chain of custody).

37. Deterrence Strategies
Policy
Drug Testing/Screening
Education

38. Perceptual Deterrence Principles
Increase ambiguity/uncertainty/unpredictability of being tested
increase perceived risk by more short-no-notice repeat testing
increase perceived risk by more contemporary reporting of results in aggregate (eg. quarterly YER results from football)
Increase “intelligent” testing by targeting high risk sport or responding to suspicious circumstances

39. Substance Abuse Prevention: A Comprehensive Approach
Tool Kit Checklists and Implementation Resources:
Student needs assessment
Department resource inventory
Policy review and dissemination
Collaboration with campus prevention experts
Student, coach and faculty education and engagement
Screening and intervention
Treatment and recovery resources

40. Supported by: American College Health Association
American Council on Education
Association for Student Conduct Administration
Association of College and University Housing Officers — International
ACPA - College Student Educators International
FARA
IACLEA – International Association of Campus Law Enforcement Admin.
N4A
NASPA - Student Affairs Administrators in Higher Education
National Athletic Trainers’ Association
National Panhellenic Conference
NIRSA - Leaders in Collegiate Recreation
Order of Omega

41. Who’s Who in Athletics Director of Athletics
Senior Woman Administrator
Compliance Coordinator
Faculty Athletics Representatives
Coaches
Life Skills Coordinators; Academic Advisors
Sports Psychologists
Sports Dietitians
Athletic Trainers and Team Physicians
SAAC/SAM Peer Educators

42. Promoting a culture of prevention through the socio-ecological model of behavior
APPLE Training Institute – departmental and team strategic planning
CHOICES Alcohol Education Grants – cross campus collaborations
Marijuana PPT for Team Discussion
myPlaybook online curriculum – individual learning modules
Step UP! Prosocial-bystander intervention guided facilitator training

43. True or False
Student-athletes use drugs at higher rates than other college students.
FALSE
Alcohol abuse is decreasing among collegiate student-athletes.
TRUE
Perceptual deterrence refers to the perceived risk of being drug tested.
Purchasing dietary supplements from a legal retails outlet is a best practice for NCAA student-athletes.
NCAA policy allows for a medical exception for prescribed medical marijuana.