Substance Misuse in Elite Athletes: Early Detection, Brief Intervention and Referral to Treatment

David R McDuff; Michelle Garvin; Joy Chang; Donald Thompson

doi:10.1016/j.csm.2023.06.008

Substance Misuse in Elite Athletes: Early Detection, Brief Intervention and Referral to Treatment

Clin Sports Med. 2024 Jan;43(1):127-144. doi: 10.1016/j.csm.2023.06.008. Epub 2023 Jul 18.

Authors

David R McDuff¹, Michelle Garvin², Joy Chang³, Donald Thompson⁴

Affiliations

¹ Department of Psychiatry, University of Maryland School of Medicine, 110 South Paca Street - 4th Floor, Baltimore, MD 21201, USA; Baltimore Orioles, Major League Baseball, 333 West Camden Street, Oriole Park at Camden Yards, Baltimore, MD 21201, USA; Maryland Centers for Psychiatry, 3290 North Ridge Road, Suite 320, Ellicott City, MD 21043, USA. Electronic address: dmcduff52@gmail.com.
² Detroit Lions, National Football League, 222 Republic Drive, Allen Park, MI 48101, USA; Elite Performance Psychology, LLC, 205 Warrenton Drive, Silver Spring, MD 20904, USA.
³ Department of Psychiatry, University of Maryland School of Medicine, 110 South Paca Street - 4th Floor, Baltimore, MD 21201, USA; University of Maryland, College Park, 8500 Paint Branch Drive, XFINITY Center, Room 2707, College Park, MD 20742, USA.
⁴ Department of Psychiatry, University of Maryland School of Medicine, 110 South Paca Street - 4th Floor, Baltimore, MD 21201, USA; Baltimore Orioles, Major League Baseball, 333 West Camden Street, Oriole Park at Camden Yards, Baltimore, MD 21201, USA.

PMID: 37949506
DOI: 10.1016/j.csm.2023.06.008

Abstract

Sports medicine physicians and athletic trainers regularly encounter athletes who misuse substances that put them at risk for adverse health, social, interpersonal, academic, psychological, and performance effects. The three most encountered substances are alcohol (binge drinking), cannabis (marijuana), and tobacco/nicotine vaping. Early detection using self-report screening instruments, adverse consequences questionnaires, and urine testing are reviewed. Brief interventions that involve personalized feedback, goal setting, support system involvement, psychoeducation, contingency management, and/or motivational interviewing are highlighted. Lack of response to brief intervention or progression to a substance use disorder should prompt the consideration of referral to a substance specialty level of care.

Keywords: Alcohol; Cannabis; Early detection; Elite athletes; Nicotine; Substance misuse; Tobacco.

Publication types

Review

MeSH terms

Athletes / psychology
Crisis Intervention
Humans
Referral and Consultation
Sports*
Substance-Related Disorders* / diagnosis
Substance-Related Disorders* / therapy