The small size of this community and its regular participation in drugs tests would lead many to believe that it should be easier to obtain relatively accurate prevalence data. However, despite these preconceptions it may in fact be more difficult to assess the prevalence of AS use in this community than in other populations. Severe penalties are imposed by the International Olympic Committee (IOC) and many other sporting bodies if the use of AS is detected. The penalties of a positive drugs test may also have serious repercussions for the public image and financial situation of the athletes and their sport. For these reasons it may be difficult to get AS-using athletes to admit to their drug use, and to give honest responses to questions about the drug use within their area of sport. It is also difficult to rely on the number of positive drugs tests to determine prevalence of AS use. A variety of methods have been used by athletes to avoid detection in drugs tests. The use of masking agents, catheterization of urine, sample substitution and sample manipulation are just a few of the methods previously used (Voy, 1991; Mottram, 1996).
An additional difficulty encountered when relying upon positive drug test results to indicate prevalence rates for AS use is related to the way in which these substances are used. Anabolic steroids may be used during pre-competition training periods, and if the athlete ceases to use these substances in enough time before a competition drug test detection they may avoid the detection of illicit substances (Goldman and Klatz, 1992). Thus, the positive drug test data do not provide an overall view of the use of AS among the athletic community (Dubin, 1990). It has been suggested that out-of-competition drug testing may combat this type of behaviour. However, the success of out-of-competition testing in reducing the international spread of AS use in sport depends upon international co-operation. If certain countries are proceeding with out-of-competition testing when others are not, there could be difficulties in maintaining fair competition at international sporting events. Other difficulties in the implementation of such a strategy are related to the diligence with which each country implements this type of testing regime. The financial burdens that may be created by such a scheme could present difficulties for Third-World or developing countries. This problem was highlighted as early as 1990 when the Dubin Report (1990) suggested that perhaps Canada should not compete against countries where out-of-competition testing did not occur. It also suggested that the International Amateur Athletic Federation (IAAF) should provide financial support to countries in which out-of-competition testing may be difficult to conduct because of technical difficulties and financial costs.
A study of the prevalence of doping in sports in Norway from 1977 to 1995 (Bahr and Tjornhom, 1998) showed that an increase in the frequency of doping tests was associated with a decrease in the percentage of positive samples in targeted sports. This study involved a total of 15,208 athletes, most of whom belonged to national federations under the jurisdiction of the Norwegian Confederation of Sport (NCS), and it is interesting to note that 90% of the tests performed were unannounced.
In the past, AS have been frequently associated with strength-dependent sports such as weightlifting and wrestling. It has been suggested that certain athletes may use AS in the belief that this is the only way in which they can compete with drug-using competitors (Heikkala, 1993; Black and Pape, 1997). It would be logical to assume that this type of drug use may be selfperpetuating in that participants in sports previously associated with a high prevalence of AS use are more likely to use AS for this reason. However, the use of AS is not exclusive to these types of sports, and reports of AS use by swimmers, cyclists and sprinters have been frequent (George, 1996a; Verroken, 1996). Some of the potential effects of AS use are clearly more beneficial to certain sports than others. Thus it would be expected that the prevalence rates for AS use in sports such as figure skating, where high muscle mass, or ‘bulk’, is not a crucial factor for success, might be less than in the more conventional strength sports such as weightlifting (Yen and Jaffe, 1978; Francis, 1990).
The actual prevalence rates of AS use among elite athletes are believed to be high (Dubin, 1990). In a testimony about the use of AS by US athletes between the 1984 and 1988 Olympics, Pat Connolly declared that at least 40% of the women’s team in Seoul had probably used steroids at some time in their preparations for the games. This again highlights the issue of out-of-competition use of AS.
A prevalence study of powerlifters in the USA (Curry and Wagman, 1999) reviewed the use of AS among 28 members of teams of US powerlifters. Of the 15 members that returned the postal questionnaires, 10 admitted using AS, and five admitted they had evaded the IOC’s doping control procedures while using AS.
Scarpino et al. (1990) carried out research about the prevalence of doping among Italian athletes. Their work involved 1015 Italian athletes and 216 coaches, doctors and managers. Results showed that over 10% of the athletes admitted to frequent use of AS at national- and international-level sport. It is interesting that 62% of the athletes that acknowledged doping stated that there was pressure from coaches and managers to use doping methods to improve performance. The research also stated that 70% of the athletes felt that access to illegal substances was easy.
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