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Are Extreme Athletes at a Greater Risk for Drug and Alcohol Abuse?

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Extreme athletes are often referred to as “adrenaline junkies”. Until recently, though, it was not thought that a behavior like sports, however extreme, could be the basis for a true addiction. That is changing. With the adoption of the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), behavioral addictions have been codified within the same category as substance-based addictions: Substance-Related and Addictive Disorders.  

Behavioral Addictions and Substance Addictions

Research over the past few decades has indicated that behavioral addictions, such as pathological gambling, internet addiction, and sex addiction, share essential hallmarks with addictions based on substance abuse. Researchers increasingly believe that behavioral and substance addictions share a similar root cause, and this root cause is related to a characteristic pattern of intense and immediate reward.

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The Addictive Nature of Adrenaline

But how can a sports activity, which involves the healthy practice of exercise, be considered an addiction?  It turns out that many healthy behaviors can develop into addiction-like habits, including exercise and even time in nature. Extreme sports have an additional aspect—the adrenaline “rush” of engaging in a high-risk activity—that seems to be especially addictive.

Extreme athletes freely admit to feeling that these thrilling activities are akin to getting high on drugs. Doing something that makes you feel good does not equate to an addiction, but a subset of extreme athletes do suffer from negative hallmarks characteristic of other types of addictions. First, this subset continues to engage in the extreme sport when that engagement leads to negative consequences—not only injuries, but also strained relationships or diminished work/education activities. Second, they speak of withdrawal-like symptoms, such as restlessness and agitation, when not engaged in the sport. Finally, they also show a characteristic craving for the “high” they get from the activity, as well as a loss of interest in other activities.

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Are extreme athletes more likely to abuse drugs or alcohol?

So, if extreme sports can be an addictive activity, does this mean that extreme athletes are at greater risk for drug and alcohol abuse?  We know that people who have kicked one drug addiction are susceptible to developing an addiction to a different drug, and that people with behavioral addictions can exchange one behavioral addiction for another.  Also, professional athletes have been found to have higher rates of substance abuse—even when it interferes with their sports performance—than the general population.  However, at this point in time, there is no body of evidence indicating that extreme sports athletes are at greater risk for alcohol and drug abuse than other members of the population.  

Characteristics That Might Make Extreme Athletes More Prone to Addiction

That being said, there are reasons to suspect that extreme athletes might be more prone to other addictions. One is that extreme athletes tend to share certain personality traits with substance abusers, such as impulsivity and sensation-seeking.  Another is that, if they are forced to quit an extreme sport (for example, due to injury), a drug might be an easy replacement if they suffer from withdrawal-like symptoms such as lack of pleasure from ordinary activities. Finally, if an extreme athlete has engaged in the activity in an addictive way, to the point of negative consequences such as hurting their relationships, this suggests that similar negative consequences might not inhibit them from engaging in substance abuse.

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Are extreme athletes less likely to abuse drugs or alcohol?

On the other hand, there are reasons to speculate that extreme athletes may be less prone to substance abuse.  Because extreme athletes are able to get their “high” in a natural way, they may be less motivated to abuse alcohol or other drugs. Also, while it’s true that people are at risk for starting a second addiction after they kick the first one, if extreme athletes do not perceive any need to quit their extreme sports activities, they might never fall into this risk category. Indeed, UK and Cal-Tech researchers Clough, Mackenzie, Mallabon, and Brymer claim that the negative characterization of extreme sports belies their potential to enhance psychological health and well-being, both of which are associated with resistance against substance addiction.

 

References:

Heirene RM, Shearer D, Roderique-Davies G, Mellalieu SD. J Behav Addict. 2016;5(2):332-341.Addiction in Extreme Sports: An Exploration of Withdrawal States in Rock Climbers

Nature Fix: Addiction to Outdoor Activities – Commentary on: Addiction in extreme sports: An exploration of withdrawal states in rock climbers. Buckley RC. J Behav Addict. 2016 Dec;5(4):557-558.

Internet Addiction and Other Behavioral Addictions – Jorgenson AG, Hsiao RC, Yen CF. Child Adolesc Psychiatr Clin N Am. 2016 Jul;25(3):509-20.

Behavioral addictions – Robbins TW, Clark L. Curr Opin Neurobiol. 2015 Feb;30:66-72.

Discussing prevalence, impacts, and treatment of substance use disorders in athletes – Gil F, de Andrade AG, Castaldelli-Maia JM. Int Rev Psychiatry. 2016 Dec;28(6):572-578.

The Road to Recovery (part two of a two-part series on heroin) – Copeland CS. Healthcare Journal of Baton Rouge. 2014 Sep-Oct: 27-34.

Adventurous Physical Activity Environments: A Mainstream Intervention for Mental Health. – Clough P, Houge Mackenzie S, Mallabon L, Brymer E. Sports Med. 2016 Jul;46(7):963-8.

Review of the application of positive psychology to substance use, addiction, and recovery research. – Krentzman AR. Psychol Addict Behav. 2013 Mar;27(1):151-65.

Protective role of personal competence skills in adolescent substance use: psychological well-being as a mediating factor. – Griffin KW, Scheier LM, Botvin GJ, Diaz T. Psychol Addict Behav. 2001 Sep;15(3):194-203.

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