Substance Use Among Collegiate Athletes Versus Non-athletes

Intercollegiate sport participation is an integral part of U.S. college life. Since the National Collegiate Athletic Association (NCAA) began keeping records in 1981–1982, the number of men's and women's championships sponsored by member institutions reached an all-time high of 19,506 in 2015–2016. Although college sports offer numerous benefits,¹ collegiate athletes are confronted with the challenge of maintaining the dual roles of academics and athletics. This challenge often produces stressful experiences that can increase the likelihood of substance use or abuse among some athletes.² In addition to this pressure, anxiety and depression are two factors highly prevalent in collegiate athletes² and are closely linked to sleep difficulties³ and substance use.⁴ Because of the sizable number of U.S. students involved in collegiate athletics, pressure to perform in a public forum, and the heightened risk for substance use or abuse, research on this population is essential.

A substantial body of literature exists that focuses on the use of marijuana, opioids, stimulants (eg, methylphenidate, amphetamines), anabolic androgenic steroids, other forms of forbidden substances commonly referred to as illicit, and legally regulated substances commonly referred to as licit (eg, alcohol) among collegiate athletes.⁵ These studies demonstrate that in addition to being more likely to binge drink than their non-collegiate athlete peers, current illicit substance use by collegiate athletes is associated with various forms of risky behaviors (eg, impaired driving, unsafe sexual practices, compulsive gambling and spending, binge eating, frequent alcohol intoxication, binge drinking and related problems, heavy tobacco use, and performance enhancing substance use).^6,7 Current prevalence rates (past year and month) of illicit substance use among collegiate athletes vary considerably by substance class,⁸ sport,⁹ sex,⁹ sexual orientation,¹⁰ injury status,¹¹ and in-season versus out-of-season periods.¹² In addition, the literature suggests lower rates of illicit substance use by collegiate athletes compared to their non-collegiate student athlete counterparts.¹³ According to a 2017 NCAA study,¹⁴ collegiate athlete past year self-reported illicit use rates were below those of the general population (0.4% overall; 0.6% for men and 0.1% for women).

Previous research suggests prescription stimulants (eg, methylphenidate and amphetamines) and opioid pain medications use rates may be higher for collegiate athletes than non-athletes.^9,15 Ford et al¹⁵ demonstrated...