STUDENT ATHLETE DRUG SURVEILLANCE TRIAL

该提案旨在通过研究美国奥委会（USOC）使用的随机、无预警药物检测项目的校本版本，解决青少年运动员中药物使用增加的问题。高中运动员是一个庞大的群体，占他们学校入学人数的50%。他们的药物滥用行为与普通学生相似，而且使用“促生”（运动增强）药物的比例更高。美国最高法院认识到年轻运动员中药物滥用的高发率以及他们对其他学生的“榜样”效应，最近支持俄勒冈州学区的一项政策，即对参加学校赞助的体育运动的学生进行随机药物测试。药物测试有可能阻止青少年滥用药物。它不分性别，没有种族偏见，并提供潜在的强大环境影响。然而，尽管其合法性和理论上的有效性，学校正在实施药物监测，而没有随机前瞻性疗效研究的好处。关注青少年运动员为研究药物检测的预防效果提供了一个独特的机会。24所学校的所有运动队，同意将强制检测作为学校政策，但从未执行过这一政策，将由学校随机分配，为期三年：1)随机，无预警的药物检测，或2)3年不检测的控制期。选择学生进行药物测试将是随机的，不排除之前测试过的学生。最先进的测试将包括在研究医生（PI和Co-I）的指导下的医生标本采集人员，他们是美国奥委会认证的药物监测组长，在加州大学洛杉矶分校奥林匹克实验室使用最准确的分析技术进行标本分析，以最大限度地减少假阴性（降低政策完整性）和假阳性（错误标记学生）结果。学生运动员每年将完成两次保密问卷，以评估药物使用的风险和保护因素，并评估自我报告的药物滥用情况。监测项目对非运动员药物使用的榜样效应将通过匿名调查每年评估两次。我们将确定药物检测政策对以下方面的影响：1)青少年药物使用中介；2)学生运动员及其非运动员同龄人的实际药物使用行为；3)潜在的性别和人口统计学差异。主观问卷回答的可靠性将通过与客观药检结果的比较来评估。研究结果将有助于学区和教育机构评估、指导和实施未来的毒品预防政策决定。

This proposal is designed to address the increase in drug use among adolescent athletes by studying a school-based version of the random, no-advance warning drug testing program used by the United States Olympic Committee (USOC). High school athletes are a large group, comprising 50 percent of their school's enrollment. They have a high rate of substance abuse behaviors similar to the general school population, and an even higher use of 'ergrogenic' (athletic enhancing) drugs. Recognizing the high rate of substance abuse among young athletes and their 'role model' effect on other students, the U.S. Supreme Court recently upheld an Oregon School Districts' policy to randomly drug test students engaged in school-sponsored sports. Drug testing has the potential to deter adolescent substance abuse. It is gender-neutral, without ethnic bias and provides a potentially powerful environmental influence. However, despite its legality and theorized effectiveness, schools are implementing drug surveillance without the benefit of randomized, prospective efficacy research. Focusing on adolescent athletes provides a unique opportunity to study the prevention effect of drug testing. All sports teams in 24 schools who agree to implement mandatory testing as school policy but have never implemented this policy, will be randomly assigned by school, to three years of either: 1) random, no-advance warning drug testing or 2) a 3-year control period without testing. Selection of students for drug testing will be random, with no exclusions for having been previously tested. State-of-the-art testing will include physician specimen collectors under the direction of research physicians (PI and Co-I) who are Certified USOC Drug Surveillance Crew Chiefs with specimen analysis at the UCLA Olympic Laboratory using the most accurate analytical techniques to minimize false negative (reducing policy integrity) and false positive (mislabling students) results. Confidential questionnaires will be completed by student-athletes twice yearly to assess risk and protective factors for drug use and asess self-reported substance abuse. The role model effect of the surveillance program on nonathletes' drug use will be assessed twice yearly by anonymous survey. We will determine the effect of drug testing policy on: 1) adolescent drug use mediators, 2) actual drug use behaviors of student-athletes and their non-athlete peers, and 3) potential gender and demographic differences. Reliability of subjective questionnaire responses will be assessed by comparisons with objective drug test results. Study findings will assist school districts and education agencies evaluate, guide, and implement future drug prevention policy decisions.