Doping Prevalence Among Elite U.S. Athletes

Abstract Background: Determining the prevalence of doping within an elite athlete population is challenging due to the extreme sensitivity of the topic, however understanding true doping prevalence is important when designing anti-doping programs and measuring their effectiveness. The objective of this study was to estimate the prevalence of doping among Olympic, Paralympic, World and National-level competitive athletes in the United States subject to the World Anti-Doping Agency (WADA) Prohibited List. This study used a web-delivered survey and direct questioning approach to collect data from athletes in the United States Anti-Doping Agency (USADA) Registered Testing Pool or Clean Athlete Program. For the first time, a prevalence survey of elite athletes used the WADA Prohibited List to assess prevalence in each specific category of banned substance / method. Results: Of 1,425 respondents, overall doping prevalence among U.S. elite athletes in the 12 months prior to survey administration ranged from an estimated 6.7-9.2% depending on the method of calculation. Specific doping prevalence rates for each individual substance category ranged from 0.1% (diuretics or masking agents) to 4.1% for cannabinoids (in-competition). Conclusion: By measuring doping prevalence down to specific performance enhancing substances and methods, as well as coupling with individual athlete personality characteristics such as attitudes, motivators and norms, a clearer picture of the use of specific prohibited substances in- and out of-competition, attitudes toward doping, beliefs about testing and most effective deterrents can be identified. By understanding doping prevalence, anti-doping programs can be tailored to increase deterrence and overall program effectiveness.