July 13, 2004

The Abuse of Anabolic Steroids and Their Precursors by Adolescent and Amateur Athletes


Bill Martin
Athletic Director
University of Michigan


Mr. Chairman, Mr. Co-Chairman, Members of the Caucus, good morning and thank you for the opportunity to speak with you about a subject I take very seriously. My name is Bill Martin. I am the Athletic Director at the University of Michigan and I recently stepped down after one year as acting President of the United States Olympic Committee, where I was actively involved in these same issues. I am pleased to be here this morning to discuss the importance of drug education and compliance programs at the University and in the collegiate setting.

We at the University care foremost about educating young people to be successful students and athletes. To that end, we believe that student-athletes should only use drugs when medically necessary and ones deemed permissible by the National Collegiate Athletic Association (NCAA). At a time in sport when "bigger is better," when athletes hear about and often seek that magical drug to help them get bigger, faster, and stronger (in addition to, or sometimes in place of, hard work and sport-specific training), it is now more important than ever for universities to help lead the charge against inappropriate drug use in sport.

This morning, I would like to first highlight the importance of including drug education in university athletic programs to help in this difficult challenge, and help illustrate this by our university's response when the performance enhancing supplement creatine was introduced. Second, I will discuss the NCAA's commitment, and the expansion of these concepts at our university, including information about our internal drug testing program. And finally, I will briefly discuss some of the challenges we face in the future and the importance of unifying standards and promoting educational efforts for our future student-athletes.

The Importance of Education

The difficult challenge facing institutional committees asked to address drug use in sport has never been greater. Surveys continue to report an increasing use of drugs and related performance-enhancing substances by athletes of all ages and skill levels irrespective of potential risks. Stellar individual performances are more often than not immediately followed by rumors of use of performance-enhancers. Suspensions of high-profile athletes are not uncommon, and terms like "andro" and "ephedra" seem to dominate sports page headlines as frequently as "goals scored" and "win/loss records." The integrity of sport is threatened as is the health and well-being of our athletes; young and old, male and female, recreational and elite.

Our athletic department's stance on performance-enhancing substances was best reflected in our approach with creatine. Promoted as a performance-enhancing "dietary supplement" that can be purchased "over the counter" with virtually no risk, the use of creatine accelerated like a tidal wave through athletic campuses across the country, with the majority of institutions supporting its use and many providing it for their student-athletes. The pressures to jump on board and promote creatine use magnified, despite little reputable data to support the claims of performance enhancement and no studies proving it was safe long-term.

In accordance with both our institution's and athletic department's mission statements, it was felt that our most important role was to educate: to provide our student-athletes not only with the highest quality medical care, but also with the highest quality programs in preventative medicine and health care education. Based on a thorough and ongoing review of the available literature and consultation with experts both at our institution and others throughout the country, we educate each student-athlete at his or her initial pre-participation evaluation of our view of performance enhancing drugs, emphasizing our stance and how those conclusions were reached. We strongly discourage the use of creatine, and emphasize good nutrition, hydration, and training programs as the critical components to helping our student-athletes reach their goals.

After the creatine surge, the explosion of other dietary supplements marketed as performance enhancers has further increased confusion and controversy among student-athletes. As a result of the Dietary Supplement and Health Education Act of 1994, the U.S. Food and Drug Administration (FDA) does not tightly regulate the supplement industry, and thus, the purity and safety of nutritional supplements are a real concern. To help our student-athletes, we have continually re-evaluated and when warranted, slightly modified our nutritional supplement policy, but the conclusion has not changed: the University of Michigan's Athletic Medicine staff strongly discourages the use of creatine and other "performance enhancing" dietary supplements as an adjunct to a student-athlete's training regimen. In addition, our sports nutritionist is now on-site full time during the academic year to help answer questions and provide accurate information on nutritional supplements.

The NCAA is also strongly committed to education about drug use by student athletes, including drugs used in an attempt to enhance athletic performance (such as anabolic steroids including androstenedione and THG, amphetamines, ephedrine to name a few) as well as those used "recreationally" (i.e. alcohol, marijuana, cocaine, PCP, and many others). Use of such drugs compromises the rules and ethics that govern athletic competition.

University and NCAA Working Together on Testing and Enforcement

It is a guiding general principle of the NCAA that each member institution work to protect the health of and provide a save environment for each of its participating student-athletes. To that end, the NCAA maintains a banned-substance list of performance enhancing drugs and substances that are detrimental to a student-athletes health (see attached list). Categories of banned substances include stimulants, anabolic agents (namely steroids), diuretics/drug test manipulators, street drugs, peptide hormones (such as human growth hormone), and beta-blockers, which are banned for the specific sport of rifle. Drug testing is performed at championship events and also year-round on campuses as part of a random testing program for athletes in selected sports. A student-athlete who tests positive is suspended for a minimum of one competitive season. The NCAA also has student-athletes from all sports complete drug use surveys on a regular basis to help institutions develop appropriate and up-to-date educational and treatment programs.

The NCAA Committee on Competitive Safeguards and Medical Aspects of Sports recommends policies and procedures to the Executive Committee and hears drug testing appeals. The NCAA education services staff provides support to the NCAA drug-education and drug-testing subcommittee of the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports, which hears appeals to positive drug-testing cases. The Executive Committee, however, maintains final authority over the procedures and implementation of the NCAA drug-testing program. NCAA member institutions are dedicated to the ideal of fair and equitable competition as well as the protection of the health, safety and wellbeing of the student-athletes. The NCAA drug testing program was created so that no participant has an artificially induced advantage, that no participant might be pressured to use chemical substances to remain competitive and to safeguard the health and safety of participants.

Since 1999, NCAA drug-testing programs have been administered by The National Center for Drug Free Sport. The Center randomly selects football and track and field programs for short-notice testing (less than 48 hours notice to the schools). The Center also randomly selects athletes for testing based on the institutional squad lists. The Center provides collectors, supplies, on-site support and administrative services for the program along with results reporting and positive-case administration. The Center currently provides services to the NCAA, the National Football League, and the International All-Around Weightlifting Association.

At the University of Michigan, in addition to compliance with the NCAA programs, we have instituted our own internal drug education program. Although drug testing is a part of our program, it is only a small part, with the emphasis placed on drug education. Our program would perhaps be better termed a substance education program, as the program includes additional information regarding nutritional supplements, vitamins, and alcohol, substances not typically thought of as drugs by many in society.

A particular emphasis of our program is prevention. At the time of the student-athlete's first contact with our athletic medicine staff, direct questions about substance use are asked as part of the pre-participation evaluation. Also at that time, questions are answered and information is given discouraging the use of nutritional supplements (see attached Ephedra, Creatine, & Related Dietary Supplements). Teaching sessions led by our counselors and sports nutritionist, impromptu talks led by strength and conditioning staff, and informational pamphlets and posters made available and visible in our athletic training rooms continually help reinforce our message.

Our internal drug-testing program at the University of Michigan was implemented to augment all these efforts to create a drug-free environment for student-athletes, in addition to helping prepare our student-athletes for potential testing by the NCAA. All student-athletes encompassing every varsity sport at The University are subject to random, year-round testing. In addition, student-athletes are sometimes tested based on reasonable suspicion.

When a first positive test occurs, and it is confirmed a "true positive" upon meeting with our team physician (and not a positive test resulting from a prescribed medication such as a narcotic pain reliever or a stimulant for Attention Deficit Disorder (ADD), or a dietary ingestion such as a poppy seed bagel), the emphasis is on education. The extent and severity of the substance use is determined, and the student-athlete referred for education, counseling, and treatment, with a substanceľabuse professional involved if deemed necessary. The student-athlete is also informed he or she will be subject to more frequent follow-up drug testing.

To be effective, we believe any drug-testing program must have some punitive component, and for a second positive test, the student-athlete is suspended from competition for a minimum of 10% of his or her competitive season. The student-athlete is re-evaluated and further help provided. If the student-athlete successfully completes the treatment program prescribed, he or she is cleared to return to participation. A third positive test results in a minimum of one year suspension from all team related activities. In addition, the student-athlete's head coach or I, the Athletic Director, may impose more stringent disciplinary action after any positive test.

Our program's continued success is dependent on the commitment and support of the entire athletic department staff: from team physicians to administrators, athletic trainers to strength and conditioning coaches, nutritionists to counselors, academic support personnel to all coaches. Routine communication and collaboration amongst all these groups is essential to achieving the goal of a drug-free environment for our student-athletes. However, the responsibility to stay drug-free ultimately remains squarely on the shoulder of the student-athlete. And as athletic department staff at the University of Michigan, a University committed to higher education and learning, it is our obligation to provide the educational support and timely advice needed to help our student-athletes reach that goal and achieve success.

I find recent statistics showing increased steroid and other drug use among high school and junior high athletes extremely disturbing. In the future, efforts must focus on developing and implementing drug educational programs at these levels, well before the student-athletes compete at the university level. Time, energy, and dollars spent attacking this problem in high schools, junior highs, and even youth sport programs is a good investment: an investment to reaching the ultimate goal of drug-free sports.

The Need for Unified Standards

As technologies evolve, and terms like genetic engineering, bionic implants, and "designer" steroids further complicate the landscape for drug policy-making committees, reaching this goal is increasingly difficult -- especially difficult when one considers human nature. In addition, there are differing standards that exist for athletes at different levels in different sports. Professional athletes backed by strong player unions are not subjected to the same rigorous testing programs and sanctions as are amateur athletes participating in Olympic training programs. And there is no uniformity across sport as to what is permissible, as the banned substance list for Olympic athletes is different and more exhaustive than the NCAA banned substance list.

I believe the establishment of uniform rules and testing procedures across sports and across amateur and professional leagues would go a long way toward providing consistent messages to athletes and would greatly simplify enforcement. To that end, I would encourage my colleagues at all levels to work on developing guidelines.

In recent years, many universities across the country, like Michigan, have intensified and expanded their drug education programs. In the Big Ten Conference, each institution commits a large amount of resources and spends thousands of dollars yearly testing and educating their student-athletes, and this commitment can only increase. The national and international efforts are evolving rapidly, helped in large part by the establishment of the World Anti-doping Agency (WADA). This agency, supported by many governments and the International Olympic Committee, heads the difficult task of unifying a global effort to address drugs in sport and help develop, implement, and enforce appropriate drug use policies and programs. Although simply a small part of the increased global effort to eliminate inappropriate and unethical drug use in sport, the University of Michigan Athletic Department remains steadfastly committed to help preserve the quality and integrity of sport.

Conclusion

Mr. Chairman, the issue of steroids and other performance-enhancing drugs in sports requires all of us -- amateur and professional alike -- to re-double our efforts to make sure we are sending a consistent message. The NCAA and the University of Michigan fully support the efforts of this Caucus and Senator Biden's bill, The Anabolic Steroid Control Act of 2004, in shedding light on this important subject. NCAA President Myles Brand has expressed his strong support saying, "this legislation is vital to the student-athlete and public welfare because although steroid precursors are as dangerous as illegal anabolic steroids, they are not only legal, but free from federal regulation." I urge the members of this Caucus to continue to work to pass this legislation this year.

At the University of Michigan, I believe we are working harder than ever to educate and enforce our rules to both ensure the health of our athletes and also to protect the integrity of the sports these athletes play. To do any less is a disservice both to the athletes and to the nation. Thank you for the opportunity to appear here today, and I look forward to answering any questions.


Attachments:
1. NCAA Banned-Drug Classes:
http://www1.ncaa.org/membership/ed_outreach/health-safety/drug_testing/banned_drug_classes.pdf

2. Ephedra, Creatine, & Related Dietary Supplements, Prepared by The University of Michigan Athletic Medicine Staff.