News broke yesterday that Abby Wambach, whose memoir Forward was released today, had abused alcohol and prescription drugs for years, including during her time as a member of the US Women’s National Team. In an interview with the Associated Press, Wambach, arrested earlier this year on a DUI, came clean on her history of abusing vodka, Vicodin, Ambien, and Adderall. That arrest, during which she admitted to having used cocaine and marijuana in her twenties, was a welcome wake-up call for the ex-player and current ESPN analyst, who said that she had been “stubborn” and “in denial” up until that point. It was the public shame and humiliation that forced her to confront her addictions and offered her an avenue to sobriety, having entered into a diversion and treatment program for first offenders after entering a guilty plea in court.
Certainly, the memoir, a chapter of which is titled “Addict”, will offer more information into the troubled personal life behind one of soccer’s greatest players, but the admission from Wambach does raise several questions about international soccer and drug abuse. The biggest is how one of the best known names in soccer — men’s or women’s — was able to hide an addiction to alcohol and prescription drugs for years. As two-time Olympic Gold medalist (2004, 2012) and 2015 Women’s World Cup winner, Wambach should have been subjected to rigorous testing by a number of agencies, including the US Anti-Doping Agency (USADA) and World Anti-Doping Agency (WADA), the US and International Olympic Committees (USOC and IOC, respectively), and FIFA itself.
So why is this the first time we’re hearing of it?
The problem, or at least, the answer to that question, is that of the drugs mentioned, Adderall (amphetamine-dextroamphetamine) is only prohibited during competition while Vicodin (hydrocodone) and Ambien are on WADA’s list of permitted substances. Cocaine and marijuana, of course, are prohibited at all times. The drug testing that athletes undergo focuses on performance-enhancement or the use of illegal controlled substances. Prescription drugs that do not noticeably enhance an athlete’s performance and that might reasonably be provided by a physician, whether used legally or illegally, are not disavowed by the bodies responsible for keeping professional and elite athletes, and athletics, clean. Their focus is doping, not necessarily drug or medication usage.
The legal abuse of prescription drugs is not unknown to soccer, unfortunately. In 2012, FIFA’s Chief Medical Officer Jiri Dvorak announced that the use and abuse of painkillers was prevalent in the sport, after asking team doctors for the 2010 World Cup in South Africa to “provide a list of medications which players were taking prior to each game.” This study revealed that the use of such medications were being used by up to 39 percent of athletes participating in the 2010 World Cup; in the 2014 World Cup the number was up to 67 percent. In late 2015, a report which Dvorak co-authored that was published in the British Journal of Sports Medicine suggested that between 2002 and 2014, up to 69 percent of adult male players reported using prescribed medication prior to each match.
However, that same BJSM article indicated that the rates of prescription drug usage during the Women’s World Cups were even higher. While 69 percent of adult male players used prescription medication during World Cups between 2002 and 2014, 71.5 percent of female athletes reported using (non-contraceptive) medications during Women’s World Cups across the same period, 2003-2007. Also revealed in these reports is a trend that medication use increases with age, as youth teams surveyed had significantly lower reported usage of prescription medications. And while this seems to just be common sense, it does highlight the possibility that the roots of addiction by elite athletes to prescription drugs may extend all the way back to their use during youth; as the body acquires more and more damage over time, increased therapeutic usage may be required to continue performing at high levels.
None of this, of course excuses the misuse of prescription (and non-prescription) drugs by Wambach. However, it may help not only to explain it, but to highlight the use and abuse of legal medications in professional sports. These medications, while not enhancing performance according to the criteria laid out by WADA and the IOC generally, do enhance and prolong an athlete’s ability to perform on the field at all, extending an athlete’s professional life while also possibly increasing the long-term damage of existing injuries to their body, and masking — or even causing — more serious damage to their long-term health. As a 2009 study on the use of prescription drugs in female and youth athletes noted, “The use of substances that are not on the doping list — so-called legal drugs — also needs to be considered in relation to moral, ethical, and health aspects.”
The issue here is not that Abby Wambach has admitted to using legal drugs such as Vicodin, Adderall, and Ambien, in addition to alcohol, during her US Women’s National Team career.
The issue is that the use of these medications and substances are allowed to fly under the radar of national and international bodies dedicated to the “clean” sports.
The problem is that, so far, they’re not considered a problem at all.