With the Olympics touched by drug scandal and the continued investigations into BALCO (the alleged San Francisco Bay Area doping ring for elite athletes), the image of athlete-as-drug-abuser is reappearing across the nation’s front sports pages. The focus of such negative attention to world-class athletes trivializes a complex relationship between athletes and addiction that extends down to the most basic recreational forms of sport. As a treatment population, athletes, professional or amateur, have surprisingly not been subjected to more comprehensive research into patterns of substance use and abuse. While there are potentially many reasons for this oversight, one fact remains: in spite of limited clinical findings to apply in treatment, addiction professionals may at one time or another have to manage the recovery of an athlete, whether a professional or recreational player. In light of such gaps in knowledge, how do we successfully treat athletes?

Addicted athletes in counseling
When an athlete, be it a recreational player, a high schooler or a professional athlete, enters the counseling room, where does the counselor begin? Athletic clients may be particularly identified with their physical bodies and social status — and out of touch with their minds. Addiction counseling can increase the athlete’s cognitive awareness and treatment success. This article presents counselors, mentors, coaches, and addiction and recovery professionals with a psychosocial model for screening addiction risk, the first step of the treatment process.

Athletes as “everyday heroes”
In a culture built around the pursuit of excellence and the cult of the hero, athletes tend to be idolized. This sort of admiration, whether experienced by a national sports hero or the local high school basketball star, may not feel all that different. Furthermore, depending on our own interest in athletics, our judgment may be influenced when managing athletes through the treatment continuum. An effective treatment approach involves increasing our awareness of the stressors that come to bear on athletes, and understanding and promoting prevention and outreach strategies.

Understanding an athlete’s stress
Athletics is a subculture with its own written and unwritten rules. While professional athletes may garner more money, media attention, and fame, athletes of lesser stature and profile also often experience the trappings of privilege. These conditions not only “come with the territory,” they also come with price, which some athletes pay by succumbing to addictive behavior. The pressure of being a competitive athlete often leads to the complex processes of defining one’s identity while managing the social pressure of performing in a fish bowl. Many athletes, particularly those who “go professional,” have a difficult time defining who their real friends are, what they have gotten themselves into, how to cope with the stress to perform, and how to deal with the public 24/7. Some may experience the sensation of “anomie,” a state of uncertainty due to a lack having a clear sense of their future direction, values, or identity.

Privacy and boundary issues are potentially challenging matters for athletes at all levels. Take Lawrence Taylor, NFL Hall of Famer who was a linebacker for the New York Giants, as one example. Without question, “L.T.” projected as a player with one of the strongest personalities on and off the field in the history of sports. In a 2003 20/20 interview, Taylor discussed how he was manipulated by temptations of sex and drugs — all of which altered his perception of himself, setting him on the wrong track. With all his toughness, he still fell to addictions. It might surprise some people to think that an athlete does not know “who they really are,” as is commonly the case.

While pressures to perform, ego, and confidence are not unique to the athlete, they are manifest in unique ways in athletes’ lives. Successes and failures are measured on a public stage. High levels of expectation, which hold potential for increased criticism, impede steps to recovery. In some respects, they may be “pampered” for their prowess, jeopardizing their feelings of self-worth and influencing their decisions to engage in addictive behavior.

How do athletes’ addictions evolve?
In presenting four clinical theories, the following two-axis Athlete Addiction Risk Matrix (see Table 1 below) provides a map for how addiction can evolve in athletes. The first axis comprises two continuums, individual and group. The farther the person moves out on the risk matrix from the centerline (between Julian Rotter and Albert Bandura) in either direction, the greater the risk may be for developing an addiction. The centerline represents work-life balance. The risk categories provide psychosocial examples of the athlete’s cognitions and behaviors as risk level escalates.

This awareness matrix is designed to help counselors cut through rules of the athletics subculture. It can be used to both gauge a client’s motivation and open a dialogue with the client to set an intention for developing cognitive self-awareness at the outset of treatment planning. The theoretical foundations in this chart reflect a range of treatment modalities. Depending on one’s core competencies, orientation and experiences, counselors will design a treatment plan populated by different theoretical positions and recovery tools.

Prevention and outreach strategies
Due to the prevalence of recreational and performance drug use in the world of athletics, helping addicted athletes requires more than a “sit-back-and-wait” approach. Prevention work is essential, especially given that the unique demands and pressures experienced by athletes may mitigate its impact. Furthermore, counselors know that developing a counseling practice involves integration into a community’s culture — and sports is an integral component of communities. Implementing prevention and outreach for athletes can be an excellent way to serve a community and a culture at large that is in need of your services.

Addiction and substance abuse prevention professionals have an important role to play in the culture of athletics, whether on the professional, school, or community level. While most sports teams already have a coach or coaches (and may have massage therapist, physical therapist, etc.), there is an obvious spot for addiction professionals, including counselors, prevention specialists, and life and recovery coaches, on the team. Potential roles include teaching young athletes the written and unwritten “rules of the game” regarding the impact of substance abuse on their health; assisting athletes with family and relationship issues that interfere with both their training and their self esteem; and keeping athletes on work-life balance plans and so forth — all with the goal of identifying or preventing at risk behaviors.

If an athlete is at-risk for addiction, it is advised that counselors consider the same treatment strategies and interventions as they would for clients who are not athletes. The addiction counselor must remember: the athlete is human being first, no matter how much “celebrity status” they experience relative to their playing levels. But implementing any treatment plan requires an awareness of the challenges athletes may be facing in treatment and recovery, depending on their particular profile. For example, when a high-profile athlete enters a detox center, the “news” (if leaked) breaks fast and compromises treatment and recovery. Ask yourself if your clients might find the local or national media at their doorstep? How many are at risk of losing college scholarships, million dollar contracts and media endorsements? How many young people are at risk of permanent physiological damage from drug use such as steroids?

Our commitment to the game
Athletes and athletics are integral components of all of our communities. They have the opportunity to be positive role models to a society that yearns for more heroes to cheer for. What athletes — and your communities — need from you is YOUR professional commitment to not give credence to the illusion that athletes are really any different than you and me. The image that a greater part of our society projects on this population may make it appear that the stakes are higher. We cannot fall for this façade.

William A. Howatt, PhD, EdD, ICADC, a postdoc at the UCLA School of Medicine, serves on the faculty of Nova Scotia Community College and is co-editor (with Robert H. Coombs) of the Wiley Book Series on Treating Addictions. He can be reached at This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Resources
Bodley, H. (2003). Game moving in right direction. USA Today. Retrieved February 24, 2004 from the World
Wide Web at http://www.usatoday.com/sports/baseball/columnist/bodley/2003-11-14-bodley_x.htm.
Bohannan, L. (1999). John Daly: Expert says fame makes fighting addiction harder. The Desert Sun. Retrieved February 24, 2004 from the World Wide Web at http://www.thedesertsun.com/news/stories/sports/940120137.shtml.
Canepa, N. (2002, September 4). Drug-test policies prescribe disaster. San Diego Union-Tribune. Retrieved February 24, 2004 from the World Wide Web at http://www.signonsandiego.com/sports/canepa/200209049999_1s4canepa.html.
Carmouche, M. (1999). Marijuana, steroid testing around corner for NBA! Cannibis News. Retrieved February 24, 2004 from the World Wide Web at: http://www.cannabisnews.com/news/thread2113.shtml.
Carr, C., Kennedy, S. & and Dimick, K. (n.d). Alcohol use among high school athletes. The Prevention Researcher 3(2). Retrieved February 24, 2004 from the World Wide Web at: http://www.tpronline.org/read.cfm?ID=48.
Delaney, B. (1998). Alcohol still top health risk to college students. CNN. Retrieved February 24, 2004 from the World Wide Web at: http://www.cnn.com/HEALTH/9811/23/binge.drinking/.
Green, G. A., Uryasz, F. D., Petr, T. A., & Bray, C. D. (2001). NCAA study of substance use and abuse habits of college student-athletes. Clinical Journal of Sport Medicine, 11, 51-56.
Hans, D. (2000). McCaffrey on ‘Weed’: Drug Czar’s 1998 Washington Post Op Ed Implied — On No Apparent Evidence — Several NBA Players Had Pot ‘Addiction’. Common Dreams News Center. Retrieved February 24, 2004 from the World Wide Web at http://www.commondreams.org/views/051700-105.htm.
Higher Education Center for Alcohol and Other Drug Prevention (1997). College athletes and alcohol and other drug use. Infofacts. Retrieved February 24, 2004 from the World Wide Web at http://www.edc.org/hec/pubs/fact
sheets/fact_sheet2.html.
International Encyclopedia of Justice Studies (n.d). Anomie and strain theory. Retrieved February 24, 2004 from the World Wide Web at http://www.iejs.com/Survey_of_CJ/CH03.htm.
Kahn, M. (1998). For athletes, names have changed, but drug problems remain. CBS Sportsline. Retrieved February 24, 2004 from the World Wide Web at http://www.mapinc.org/drugnews/v98/n609/a01.html.
King, P. (1996, May 27). Bitter pill. Sports Illustrated, 24-31.
Leshanski, J. ( 2003). Major league baseball’s drug problem. AtHomePlate.com. Retrieved February 24, 2004 from the World Wide Web at http://www.athomeplate.com/drug.shtml.
Millson, L. (2004, February 23). Steroid issue will explode, Godfrey says. Globe and Mail, Toronto, CA.
Mitchell, M. (2002). Study examines ‘other’ leisure pursuits, such as drug use, gambling. News Bureau, University of Illinois at Urbana-Champaign. Retrieved February 24, 2004 from the World Wide Web at: http://www.news.
uiuc.edu/gentips/02/10leisure.html.
(November 14, 2003). MLB strikes out with policy: Steroids will continue to be part of game until penalties get tougher. WFAA.com, Dallas/Fort Worth, Channel 8. Retrieved February 24, 2004 from the World Wide Web at http://www.wfaa.com/sharedcontent/dallas/sports/baseball/mlb/stories/111503dnspofraley.18c50.html.
National Center on Addiction and Substance Abuse at Columbia University (CASA) & White House Office of National Drug Control Policy (ONDCP). (2000).

This article is published in Counselor,The Magazine for Addiction Professionals, December 2004, v.5, n.6, pp.34-37

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