Coaches: How to Identify if your Athlete is Abusing Prescription Drugs

Contributor: Crystal Karges, MS, RDN, IBCLC Special Projects Coordinator at Eating Disorder Hope/Addiction Hope

NCAA BASKETBALL 2011 - FEB 13 - Miami Hurricanes at Duke Blue DevilsCoaches are often the gateway for many athletes, seeing aspects of their lives that may go unnoticed by others.  Regardless of what athletic level an individual is participating in, be it high school, collegiate, or professional, athletes face unique challenges and obstacles as they strive to excel and thrive in their sport of choice.  Under the pressure to succeed and rise above these challenges, athletes may find themselves facing choices and decisions that they may not have been aware of prior to becoming an athlete.


Many athletes encounter the decision to engage in substance use or not.  Whether the substance is intended for enhancing performance or not, athletes are likely to be confronted with the choice of whether or not to use outside substances, including alcohol, recreational drugs, prescription medications, hallucinogens, depressants, narcotics, stimulants and more.   Other reasons that athletes may use substances include the self-treatment of physical pain, coping with stressors, or for dealing with untreated mental illness, such as depression or anxiety.

There are a variety of classes of substances that may be used and misused among athletes.  These include doping agents, selective androgen receptor modulators, aromatase inhibitors, antiestrogens, androgens, growth hormones and growth factors, stimulants (including caffeine, cocaine, ephedrine), nutritional supplements, recreational drugs, beta blockers, beta agonists, and other prescription drugs.  Types of prescription drugs that might be abused among athletes include stimulants, painkillers, antiasthmatic medications, tranquilizers, muscle relaxers, and more.

volleyball-520093_640Athletes may be more likely to misuse a prescription medication for several reasons, including easier access, particularly if a athlete already has a script for a certain medication.  Athletes may also feel that a drug is “safer” if it prescribed by doctor rather than street or illicit drugs, which may also make them more inclined to misuse prescription drugs.  In reality, prescription medications have side effects and can result in dangerous consequences if abused or misused.  Prescription drug misuse includes taking a medication without authorization or recommendation from a doctor, using a prescription medication that is not yours, not following the dosage recommended or mixing prescription medication with other substances/alcohol.

As a coach that oversees athletes, you may observe behaviors that may bring substance abuse into question.  Signs and symptoms of prescription drug abuse may vary based on the type of medication that is being used, however any abnormal behaviors should not be taken lightly.  If you are concerned that your athlete may be abusing prescription medications, be aware of the following signs and symptoms:

  • Drowsiness and confusion
  • Complaints of gastrointestinal distress, such as nausea, constipation, diarrhea, and vomiting
  • Visible restlessness, anxiety, or difficulty maintaining focus
  • Slurred speech
  • Dizziness or complaint of frequent headaches
  • Lack of coordination
  • Changes in mood, such as agitation, paranoia, depression, or anxiety
  • Expression of suicidal ideations or suicide attempts
  • Flushed skin, dilated pupils
  • Complaints of heart pain, heart palpitations or chest pains

Men working out in gymAny changes in habits, eating behaviors, mood and personality changes may also indicate a problem with prescription drug abuse.  This might include increased isolation among peers and other athletes, poor hygiene, lack of interest in activites and hobbies that were previously enjoyed, drastic changes in weight, reoccurring injuries, poor performance in school and sports, and more.

If you have observed any of these abnormal behaviors or changes in an athlete that you interact with, it is important to approach this individual in a caring and concerning way.  As a coach, you likely have a positive influence in your athlete’s life, and your guidance and direction can make all the difference.  As a coach, you may be one of the first individuals to observe these changes in an athlete, and addressing these signs and symptoms as early as possible can help propel intervention and treatment.  Be ready to share some resources with your athlete that may help them connect to the treatment they need to overcome an addiction to prescription medication.

Community Discussion – Share your thoughts here!

Are you a coach that frequently interacts with athletes?  How prevalent is prescription drug abuse among athletes, and what are some resources that have been helpful for directing athletes towards help and treatment?