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According to the book Drugs and Sport, the rates for at least occasional heavy alcohol use in professional athletes are similar to the rates for college athletes across all sports. Binge drinking is also more common among athletes compared to the general population, and significant percentages of professional athletes admit to at least one binge drinking episode within the past six months.

Many high-profile professional athletes have been treated for alcohol abuse or alcohol use disorders.

  • Four-time World Series champion Darryl Strawberry has been treated for both alcohol abuse and cocaine abuse.
  • Pro golfer Jon Daly has struggled with alcohol abuse.
  • Professional football linebacker Thomas “Hollywood” Henderson has suffered from drug and alcohol abuse.
  • Professional basketball player Ron Tarpley was suspended permanently for alcohol abuse and had prior issues with cocaine abuse.

Treatment for Athletes

Athletes, like many of the individuals who develop alcohol use disorders, generally don’t seek out formal treatment on their own. Instead, athletes are often forced into treatment by an organizational body, or by family and friends.

The treatment for any substance use disorder is spurred by issues with control over one’s use of the substance, and resulting levels of distress and functional impairment that inevitably occur as a result of substance abuse. The development of an alcohol use disorder is particularly damaging to the functioning of an individual in all areas of life. The treatment protocol for an alcohol use disorder will follow the same overall approach, whether the individual is a high-profile professional athlete or just a “normal” everyday person. However, the overall blueprint used to address alcohol use disorders requires a personal adjustment for it to be effective for the needs of any single individual.

The overall treatment approach describes the general domains of treatment that are effective, but the actual application of the treatment is individualized to suit the needs and specific differences in the person being treated. For an alcohol use disorder, an overall treatment approach generally involves the following:

  • An initial overall assessment to determine the extent of the individual’s problem and any potential co-occurring disorders or conditions
  • Placement in a physician-assisted withdrawal management program (sometimes referred to as a medical detox program) if the individual displays withdrawal symptoms or is at risk for withdrawal upon discontinuation of alcohol
  • A comprehensive addiction treatment program, following the completion of the withdrawal management program,
  • Substance use disorder therapy, which is typically some type of cognitive-behavioral approach
  • Social support from teammates, family, close friends, and peers in addiction treatment
  • Psychoeducation
  • Objective monitoring to ensure abstinence from alcohol and drugs, often via random drug tests for athletes
  • Continued participation in a treatment program, which is particularly important for athletes who may be continually exposed to heavy drug and alcohol use among peers

Athletes can be held accountable for their behaviors via employers. The use of a Contingency Management program by the athlete’s supervising organization can be a key factor in helping the individual recover. Sanctions on the individual’s playing time, salary, scholarship, etc., can motivate the individual to stay involved in their treatment program.

Because athletes often travel extensively during the competitive season, the use of social support groups, such as Alcoholics Anonymous, online therapy, video therapy, etc., can act as additional enhancements to keep these individuals involved in recovery because they are available nearly everywhere. For most athletes, it is also essential that they be candid with their family, friends, coaches, and fellow players regarding their struggle with alcohol abuse. Most of these individuals will be sympathetic to the athlete’s struggle and needs, and can be very useful in helping them maintain their recovery program. The fear of appearing vulnerable or being ridiculed often results in individuals attempting to hide their alcohol abuse, and this situation simply exacerbates the cycle of abuse. Learning to be honest, vulnerable, and admitting one’s imperfections is often very difficult for athletes who often set unrealistic goals for themselves regarding personal integrity and the need to appear as if they are invulnerable.

For many athletes, injuries, retirement, or just getting older can result in additional issues with stress, disappointment, and inactivity that can be a trigger for alcohol abuse or other drug abuse. Athletes should be trained to expect these potential issues, learn how to deal with them, and be given resources they can access if needed. Education and training in relapse prevention should address these issues in professional athletes who are in recovery for an alcohol use disorder. The family and friends of retired or injured athletes who have a past history of alcohol abuse or other substance abuse should be aware of potential relapse and support the individual in seeking further treatment or support as needed.

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Specific Contributions to Alcohol Use and Abuse in Sports

Typically, when there is a discussion of drug use in athletics, it is centered on the use of performance-enhancing drugs, such as steroids or stimulants, painkillers, and illicit drugs like cocaine. However, there is significant use and abuse of alcohol and tobacco products in both collegiate and professional sports as well.

For instance, a recent study found that 75%-93% of male collegiate athletes admitted to significant alcohol use and 71%-93% of female athletes admitted to significant alcohol use over the year prior to the study. The highest rates of alcohol use in collegiate athletics occurred among swimmers, divers, soccer players, and softball and baseball players.

There are general risk factors that increase the probability that an individual will develop any type of substance use disorder, including an alcohol use disorder. The American Psychiatric Association (APA) lists many of these risk factors, including family history of substance abuse, family history of any other mental disorder, the experience of stress and trauma, early exposure to drugs or alcohol, etc.

In addition to the general risk factors that apply over all sectors of the population, athletes (particularly professional athletes) may have several risk factors that can increase the probability that they will turn alcohol and other drugs. According to the book Drugs, Athletes, and Physical Performance, these specific types of risk factors include:

  • High levels of perceived stress: Athletes, particularly athletes who are very visible to fans or the public, often have to deal with high levels of perceived stress. The issue of stress often begins early for athletes, who are under stress to perform in childhood from coaches, their parents, and their peers. The stress continues throughout an athlete’s competitive career. High-profile athletes often experience additional levels of stress as their actions on and off the playing field are open to scrutiny from numerous sources, including the media, social media, coaches, friends, etc.Perceived stress refers to the subjective interpretation that an individual has about their level of stress. There is no way to formally and objectively measure stress across individuals; instead, it is the individual’s subjective interpretation of stress or pressure that is important. Because alcohol is a central nervous system depressant, and freely available and legal, it becomes a method for individuals to reduce stress, to relax, to distance themselves from others, etc.
  • Sports culture: There is a tradition of binge drinking in all sports that has been documented and routinely portrayed in the media. Winning a championship or playoff spot is often celebrated by drinking champagne, pouring champagne on one another, etc. Athletes often socialize in bars and lounges where alcohol is freely available. This acceptance of alcohol use within sports further increases the risk that certain individuals may abuse alcohol and go on to develop alcohol use disorders.
  • Lifestyle factors: Professional athletes often have quite a bit of free time. Even during the competitive season, athletes typically train in the morning or early afternoon, and have the rest of the day or evening to recover. College athletes generally have less free time, but there is downtime. In addition, professional athletes receive significant compensation and often do not have to worry about their financial situation. These lifestyle factors may result in boredom, significant idle time, etc., that may be filled by the use of drugs or alcohol.
  • Denial: Because having a substance use disorder, such as an alcohol use disorder, is potentially damaging to an individual’s image and reputation, athletes are very likely to rationalize their use of alcohol and to hide it if it becomes problematic for them. This actually results in an increased risk to continue to abuse alcohol, but to hide the use from others.
  • Sponsors: Sponsorship for amateur and professional athletics is one of the major revenue-producing sources for these endeavors. Many sponsors for athletic teams and individual athletes are companies involved in the alcohol beverage industry. Having a sponsorship that promotes the use of alcohol increases the risk that an individual will use alcohol. A significant risk factor for the development of an alcohol use disorder is repetitive use of alcohol.
  • Polysubstance abuse: The use of alcohol can counteract the effect of stimulants, the side effects associated with the use of pain medications, and the effects of using performing-enhancing drugs like steroids. Alcohol is the most commonly used drug in conjunction with other illicit drug use. Individuals in sports who use performance-enhancing drugs, painkillers, or illicit drugs are very likely to also abuse alcohol in conjunction with these substances.
  • Injuries: Most athletes despise having long periods of inactivity or feeling as if they are not productive. When athletes suffer injuries and are unable to compete, they may experience issues with boredom and stress that spur the use of alcohol and can lead to alcohol abuse.