The drive to enhance performance and “play through the pain” starts soon after that but at what cost? Studies have revealed that the prevalence of drugs, injury-induced surgeries and brain injuries are seriously impacting the quality of life for this and future generations with a “win at all costs” mindset. No one is making the argument  that college sports are a menace to society, or that every game should be the “perfect game,” but institutions of higher education should guard against blowing any chance to save their athletes from life-destroying injuries and choices. There’s no doubt about that.

History Of Drugs In Sports

Drugs in sports are nothing new. A generation before, the use of steroids prompted a national debate on the dangers of juicing—which was shown to even exist at the high school athletic team level—some professional and amateur athletes used central nervous system stimulant drugs (amphetamines or “uppers”) that artificially increased alertness, self-confidence and concentration while creating a feeling of increased energy, as well as decreasing appetite. Before the dangers and addictive nature of these substances were fully understood, they were used as if they were medical supplements.

But doping by athletes goes back to the early days of civilization. According to Dr. Larry D. Bowers, in an article entitled, “Athletic Drug Testing,” for Clinics in Sports Medicine, “The use of drugs to enhance performance in sports has certainly occurred since the time of the original Olympic Games [from 776 to 393 BC]. The origin of the word ‘doping’ is attributed to the Dutch word ‘doop,’ which is a viscous opium juice, the drug of choice of the ancient Greeks.”  Moreover, “Roman gladiators used stimulants and hallucinogens to prevent fatigue and injury. Gladiator competitions and chariot races became so popular in ancient Roman culture, that the Coliseum was expanded to hold 60,000 spectators in 100 AD,” according to the “History of Doping,” by Dr. Ramian Abdul Aziz.

So, when commentators expressed shock at the “unprecedented” use of doping in professional sports when the steroids crisis or the Adderall abuse dominated the national dialog, they simply didn’t know their history. Originally, the argument for any form of doping was that it was simply another form of skill enhancement like targeted exercise or nutritional supplements. We know better than that. We are better than that.

Steroids History In College Sports

In 1987, a scandal swept the University of Oklahoma when its star linebacker Brian Bosworth tested positive for steroids just days before the team played in the 1987 Orange Bowl. The National Collegiate Athletic Association (N.C.A.A.) had just instituted a new drug testing policy with much fanfare and legal battles. In fact, the UPI reported that the 6th District Appeal Court ruled that “The N.C.A.A.-mandated drug tests for student athletes at Stanford University violate the right of privacy,” in upholding a lower court decision. This ruling had far-reaching repercussions. UPI further reported at the time that, “The N.C.A.A. testing program was held unconstitutional at Stanford in 1988 by Superior Court Judge Conrad Rushing, who barred its use for the school’s athletes when they compete anywhere in the United States.”

To be clear, some members of the N.C.A.A. were privately concerned that drug use was more widespread in higher education sports than colleges were prepared to acknowledge. According to a New York Times article January 11, 1990, entitled, “N.C.A.A. Stiffens Drug Penalties and Expands Testing in Football” by William C. Rhoden, The National Collegiate Athletic Association had voted overwhelmingly to require random, year-round testing of players in major football programs for performance-enhancing drugs, and to impose stiffer penalties for violators, in any sport, of the N.C.A.A.’s drug policies. “The association has been trying to send a message that drug use is not a permissible part of competition in the N.C.A.A.,’’ said Jim O’Fallen, the faculty representative at Oregon and a professor of law.

Richard Schultz, the N.C.A.A.’s executive director, was also quoted in the article saying that the measure to expand testing of football players was needed because ‘‘we are only catching the dumb ones.” The pushback, particularly from Ivy League schools, was predictable. In fact, the eight members of the Ivy League opposed the proposal on the ground that it distinguished the athlete, in this case the football player, from the regular student.

The New York Times article quoted John Reardon, Harvard’s athletic director. ‘‘Basically, from a philosophic standpoint, we’ve felt all along that our students are representative of the rest of our student body, and we don’t drug-test the rest of our student body,’’ said Reardon. ‘‘There is no study that shows that athletes use drugs at a higher rate than regular students. None of the Ivy schools drug-test. Our students agree to be tested at the various championships.’’

Now The Good News

While it seemed for a time that schools would be able to be independent of outside standards, eventually, drug-testing became accepted by both courts and colleges as applied to football. By the 1990s, history was repeating itself in baseball. There was denial of the problem, resistance to change, public and official outcry, and then testing, as well as regulation.

The encouraging news for sports is that athletes traveling this grueling metaphorical marathon and running the gauntlet of unrelenting scrutiny have broken through to the other side. The reputation of professional sports is better than ever now. The blood-letting to rid sports of everything from blood-doping to performance enhancing drugs has restored faith and enthusiasm to the games. Ripping the scab off a festering wound is painful, but it’s the only way to make way for healing. And the even better news is that this has trickled down to collegiate sports, raising awareness, publicizing the long-term effects of drug abuse and maintaining an attitude of zero tolerance has produced happier and healthier athletes. Colleges are paying attention and becoming proactive in part because of raised public awareness. It’s far from perfect, but it’s better.

No Pain, No Gain

Much has been said about the opioid crisis in America. According to research cited by RiverMend Health in “High School Sports Pose High Risk for Injury—And Opioid Painkiller Addiction,” the pressure to excel, sports injury and treatment with opioids provides the perfect storm for drug abuse and sometimes death. The evidence included, “Recent research from the University of Michigan that found 11 percent of high school athletes have used a narcotic pain reliever or an opioid such as OxyContin or Vicodin for ‘nonmedical purposes.’ That translates in about one in nine school athletes having abused a prescription drug.”

The picture the research paints is that just as in the general population, “athletes get opioids from their doctors, who prescribe them to athletes at twice the rate of other adolescents. The stakes associated with high school sports—college scholarships, professional careers, as well as issues of community pride and team expectations—many athletes request pain relievers so they can continue to play with an injury and many physicians provide prescriptions that enable them to do that.”

And just as the case with steroids, opioids have been unmasked and thrust into the spotlight as a looming danger to society, as well as student athletes. Help is already available. According to the article “Why College Athletes Are at Greater Risk for Addiction,” presented by The Recovery Village, The N.C.A.A., realizing that student athletes are more vulnerable to drug dependency than non-athletes, has become “heavily involved in addiction education and prevention through a variety of programs.” Through its Sport Science Institute, the N.C.A.A. “now provides each of its schools with a ‘Substance Abuse Prevention and Intervention Tool Kit’ aimed at educating student athletes about the risks associated with substance abuse and providing campus administrators with guidelines for helping students who are exhibiting high-risk behaviors.” There are signs that schools are finally approaching the head of the learning curve on this ongoing sports health issue.

Concussive Injury: A Ticking Timebomb

Although college student Sports Related Concussions (SRC) can be traced to at the least the 1960s, very little was done throughout the college athletic community to address and mitigate the dangers of concussive injuries. According to the Sports Business Journal article, “Collegiate Concussion Cases with Implications for the Sports Industry,” a landmark and ongoing case filed by Notre Dame running back, Steve Schmitz against N.C.A.A. and Notre Dame University in 2014 shortly after doctors diagnosed Schmitz with chronic traumatic encephalopathy or CTE. The suit claims that the CTE diagnosis was related to concussions he suffered when he played football at Notre Dame in the 1970s.

The N.C.A.A. pushed back on the claim, saying the case was beyond the two-year statute of limitations, but the court ruled otherwise. Even though Schmitz died in 2015, the Ohio Supreme Court ruled that his widow can proceed with a lawsuit against the University of Notre Dame and the N.C.A.A. can proceed.

Raised public awareness and the weight of medical evidence prompted colleges and the N.C.A.A. to address this health crisis on campus. A second bellwether case, Ploetz v. N.C.A.A., was the first case to clear all legal hurdles and go to trial. In that case, the widow of the University of Texas’ Greg Ploetz, received an undisclosed settlement from the N.C.A.A. interrupting a public trial for the stage 4 CTE and premature death (at the age of 66) that the suit claims was caused by his years as linebacker in 1968, 1969 and 1971.

Further attention was brought to the subject in 2015 when a movie was released based on “Game Brain” by Jeanne Marie Laskas, published in 2009 by GQ magazine. “Concussion” starred Will Smith as Dr. Bennet Omalu, a forensic pathologist who takes on the NFL accusing the league of trying to suppress his research on chronic traumatic encephalopathy (CTE) brain degeneration suffered by professional football players. In the months and years that have followed these developments, hundreds of cases have been filed against schools, and the N.C.A.A. for not having done enough to protect student athletes and educate them about the dangers of CTE injuries.

Now those responsible for the administration of college sports are collaborating with scientists, physicians and inventors to proactively address this issue. Equipment innovations, closer medical monitoring and changes to the rules of engagement are beginning to place more emphasis on safety, to ensure student athletes can go on to live healthy lives long after their amateur and possibly professional careers on the field come to an end.

Surgically Enhanced Performances

Sports injuries are an occupational hazard. Much can be done to make sports injuries as rare as possible. Sports injuries are treated with physical therapy and surgery, as well as pharmaceuticals. And when the athlete recovers, he’s welcomed back on the playing field. But what about having surgery to improve performance? Can that be acceptable both on an ethical level and in the best medical interest of the student athlete? One can argue that the slippery slope college athletics finds itself on began in 1974, when a 31-year old baseball player had landmark ulnar collateral ligament elbow surgery that added years to his pitching career. The surgery, which was subsequently named after the player, Tommy John, has arguably and slowly become quasi-elective surgery because the prevailing consensus is that Tommy John surgery not only repairs damage, it actually makes the arm better than it was even before the injury and improves performance.

What’s worse, the prevalence of this surgery is trending among student athletes. The article, “Tommy John Surgeries High Among Teens” by Delia O’Hara for Rush University Medical Center, cites a study published in the American Journal of Sports Medicine, which found that, “athletes aged 15 to 19 presently account for 56.8 percent of…Tommy John surgery. The overall average incidence of Tommy Johns during the period studied, 2007 to 2011, was just under four per 100,000 patients in the database the analysis used. However, the incidence for patients aged 15-19 was 22 per 100,000 patients, which the study’s authors call ‘a staggering statistic.’”

One of the leading opponents of overusing this surgery, ironically, is Tommy John, himself, and his son, Tommy III, a chiropractor with a sports medicine background. According to Stan Grossfield, who penned “Now Campaigning Against Tommy John Surgery: Tommy John” for the Boston Globe, both father and son, “appear together at speaking engagements. Two Tommy Johns trying to stop kids from having Tommy John surgery. Kids, they say, are being pressured into overperforming, causing degenerative joint problems. They are overstimulated, less aware, overcoached, and underdeveloped. They shouldn’t be playing just one sport.”

Tommy John surgery is, in some instances, becoming a rite of passage for pitching prospects. Some opine that sooner or later pitchers blow out their arms and need surgery, why not sooner? Beyond the medical issues raised, the ethical question must be asked: to what extent should young athletes be encouraged to surgically alter themselves in an obsession for sports perfection. There is hope that with such a high-profile athlete such as Tommy John speaking out and bringing attention to this issue, attitudes will change.    

Bottom line: The desire for fame and fortune in the “bigs” isn’t justification for any students or their guardians to go down this road. •

The Case For College Sports

5 Reasons To Say, “Game On!”

The University of Missouri Health Care makes the case that “Organized, well-structured youth sports and on-going physical activities can provide many benefits for children and adolescents. Physical exercise is good for the mind, body and spirit. Team sports help teach adolescents accountability, dedication, leadership and other skills.”

On their website, UM lays out five important reasons that the right to engage in organized sports should be encouraged on college campuses and its athletes protected from harm.

1. Athletes Have Better Academic Achievement—Contrary to the popular stereotype of the football player skipping classes to practice, the skills athletes learn about memorizing plays and repeating drills can be transferred to their academic classes.

2. Athletes Are Better at Working in a Team Environment and Problem-Solving—the very nature of being on a team teaches athletes how to work with others to resolve conflicts and overcome obstacles.

3. Athletes Are Healthier—Student Athletes have to maintain healthy weight goals and abstain from unhealthy practices such as smoking and drinking.

4. Sports Are Good for a Healthy Ego—Meeting team goals or fitness milestones is great for self-esteem, especially for young athletes who might be more vulnerable to depression and self-doubt.

5. Sports Are a Pressure Release Valve for Athletes—We all know that exercise relieves stress and tension. Imagine the benefits of working out with teammates that student athletes can relate to and share their stress and pressure concerns.