It has been 16 years since the NCAA began conducting drug tests. Anyone who may have dreamed of ending drug use in college athletics when the program began in 1986 likely feels disappointed today. But those who had more modest -- and achievable -- goals for the program have much to feel good about.

Those who understood the pervasive use of drugs in society -- and the likelihood that society would embrace new drugs that promise stronger, faster and better living -- justifiably take pride in focusing scrutiny on the appropriateness of those substances in collegiate athletics competition.

Those who understood that society increasingly has embraced a "win at all costs" attitude can point to stringent but thoughtful limits they've placed on winning with drugs.

And those who understood that more than a token effort is needed to keep substance abuse in check can appreciate the NCAA membership's willingness, so far, to provide substantial resources not only for effective testing but also to educate.

"I'm very proud of our program," said Gary Green, a longtime member and former chair of the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports, whose service on that panel -- and the drug-testing and drug-education subcommittee that oversees the Association's anti-drug effort -- ended earlier this month. "There's always room for improvement, but I think the NCAA should be very proud of the program, given the fact that most drug-testing programs are administered over a fairly homogeneous group of people -- like the NFL, the NBA or a single school that does its own drug testing -- whereas we have 1,000 schools with three divisions and 400,000 athletes."

Green and others understand that the NCAA's drug-testing effort is unique, not only in its reach but in its objectives.

 Unlike Olympic testing programs, it seeks not only to limit use of performance-enhancing substances that constantly pose a threat to fair competition, but also "street drugs" that pose a threat only to the health and safety of those who use them. There may be legitimate arguments against the NCAA assuming such a watchful presence in the personal lives and choices of student-athletes, but the Association hasn't wav- ered from that stance since committing itself to the role in the mid-1980s.

Also, in keeping with its goals as not only an athletics organization but an educational group, the Association has paired drug testing with innovative and far-reaching informational efforts. The NCAA has not merely told athletes that they can't use drugs; it also has worked to explain why they shouldn't.

In doing so, the Association is confronting some societal pressures -- as well as threats -- head-on.

"The issues we deal with can be literally life or death," said Matthew Mitten, director of the National Sports Law Institution at Marquette University Law School and current chair of the NCAA competitive-safeguards committee. "We've got real-life, cutting-edge issues."

Early urgency

That sense of danger also was present in 1986 -- the year that University of Maryland, College Park, basketball star Len Bias died of a cocaine overdose.

The program won NCAA membership approval a few months before Bias' death, but drugs' threat to student-athlete health and safety as well as fair competition definitely was on delegates' minds when they cast their votes in favor of the program.

The Association took time to develop a carefully drawn, legally sound program, but felt some urgency in putting that program in place. That was the scene that existed in mid-1986, when Frank Uryasz was hired as the program's first full-time employee.

"With the help of the (United States Olympic Committee), we had trained a few physicians to be sample collectors, but that's about all that had happened," recalls Uryasz, who left the NCAA in 1999 to found The National Center for Drug Free Sport -- the independent organization that currently conducts drug testing for the Association on a contract basis.

Uryasz had five months before the first testing to enlist and train additional sample collectors, obtain equipment, select a laboratory to analyze the samples, and produce a brochure and video explaining the program to student-athletes and the membership.

"At night, after I finished working at my desk, I'd have to go down to the basement, pack supplies and send them out because we didn't have anyone else to do that," Uryasz said.

Uryasz and his supervisors at the time, NCAA assistant executive director Ruth Berkey and director of research Ursula Walsh, arranged for the three-year-old University of California, Los Angeles, Olympic Analytical Laboratory (the only IOC-certified laboratory in the United States) and a laboratory in Montreal, Quebec, to handle analysis of samples from the first drug tests. And those first tests were scheduled at the 1986 Division I Men's and Women's Cross Country Championships and for Division I-A football teams participating in that year's bowl games.

"Frank Uryasz had to find and iden tify crew chiefs," remembers Don Catlin, who continues to direct the UCLA laboratory he established just be-
fore the 1984 Summer Olympics in Los Angeles. "He needed people who like this work, want to do it and believe in it."

"We got it running smoothly by that first championship," Uryasz said, adding, "That's my story, and I'm sticking to it."

Crews tested more than 3,300 student-athletes at 30 NCAA championships and 10 football bowl games that year, with 2.4 percent of those athletes testing positive for banned substances.

The program encountered its first major obstacle in January 1987, when a Stanford University diver obtained a permanent injunction from a California state court preventing the NCAA from requiring her or other Stanford student-athletes to submit to testing. The ruling placed drug testing in jeopardy of discontinuation, but the program continued pending a final decision -- an NCAA victory that finally came seven years later.

"The NCAA put a lot of resources forth in winning that case," Uryasz said.

Meanwhile, the program continued to operate much as it began -- testing about 3,300 student-athletes annually at a cost of $1 million per year, and with positive-test rates of around 3 percent.

The only significant expansion of the program came with the launch of a voluntary off-season anabolic steroid testing program in early 1988 -- an acknowledgement that year-round testing eventually would be needed to cut steroid use among NCAA student-athletes. "Eventually" came sooner than expected, when data from a 1989 student-athlete drug-use survey again generated a sense of urgency within the Association to deal with a growing steroids problem.

Uryasz believes there are five major milestones in the testing program's history, and four of those points were reached in the program's first eight years. First came adoption of the program by the membership, followed by the 1989 drug-use survey, the membership's adoption in 1990 of year-round testing for steroids, and the California ruling overturning the permanent injunction. (The fifth milestone was the 1999 contract with Uryasz's independent agency to conduct drug testing on behalf of the NCAA.)

With the legal challenge settled, sample-collection and testing procedures smoothed out, and with a year-round program in place, the drug-testing program had achieved maturity by the mid-1990s.

How effective

But maturity does not guarantee effectiveness.

"To try to make a drug-testing program that's going to fit for everyone is a really challenging task," said Green, who has served as a university team physician and is a faculty member in UCLA's family medicine department. "You might have a walk-on, Division III athlete in a nonrevenue sport, and yet you have a drug-testing program that also has to serve a Division I scholarship athlete in a revenue-producing sport."

The Association will spend more than $3 million this year on drug testing -- up from $2.9 million last year and three times the amount spent in 1986. The amount is increasing this year to cover the additional cost of testing for ephedrine in the year-round program, which recent data show is increasingly being used for performance enhancement.

Positive tests at NCAA championships have hovered around the 1 percent mark for several years now -- a not surprisingly low statistic, since most student-athletes know about the testing well in advance, giving those who are using banned substances time to eliminate traces from their bodies. The statistic offers some reassurance that drugs generally aren't present at championships, but it does not prove the overall program's effectiveness.

A more telling statistic comes from year-round testing, which currently covers Divisions I and II football and Division I men's and women's track and field. (A pilot year-round testing program in Division II baseball recently entered its second season but is not included in reported statistics.)

Year-round testing can be conducted on short notice any time during the academic year (the NCAA does not conduct testing during the summer). The program has conducted more than 9,000 tests in each of the past four full academic years. The highest recent rate of positive tests in year-round testing occurred in 1998-99 -- 1.2 percent. In the most recent full academic year for which results are available (2000-01), the rate of positives was just over 1 percent.

"Drug testing is an effective deterrent to the use of banned substances if it's implemented correctly, and the NCAA program is implemented correctly," Uryasz said.

He said an effective program must test year-round with little or no advance notice to those who are being tested. Sample collection must be directly observed by a testing crew member. And samples must be analyzed by a top-notch laboratory. "The NCAA meets all of these criteria," he said.

Cat-and-mouse game

The top-notch laboratory is an important part of the equation, especially at a time when elite international athletes constantly are finding new substances to improve performance and new ways of concealing use of those substances. Such discoveries concern NCAA drug-testing authorities because history has shown that methods developed by elite athletes eventually filter down into other areas of competition -- including collegiate play.

"Sports drug testing is the classic cat-and-mouse game," Uryasz said. "We're always chasing after the new procedure, or the new process."

"One of the things you have to realize, when you get into drug testing, is that every time you build a better mousetrap, the mice get smarter," Green said. "One of the things you always have to accept in this field is that you're always going to be one step behind -- hopefully, only one step -- because there always are going to be new drugs."

The NCAA relies heavily on the UCLA Olympic Analytical Laboratory, and an experienced staff directed by Catlin, to keep pace.

In addition to its continuing extensive involvement in Olympic testing -- including work at the recent Winter Olympics in Salt Lake City -- the UCLA lab analyzes samples collected by the NFL. As a result, the lab is on the front lines of observing and analyzing the use of new substances -- a position that "enormously" benefits the NCAA, Catlin said.

"We keep our ears to the ground," he said. "And we incorporate that directly into the testing."

But "cat and mouse" may not be the best phrase to describe the lab's work, he added. When the lab observes a new substance, the reaction is not to sound the alarm, but to methodically learn more about the substance and develop reliable tests to uncover its use.

"We can't just have an idea to test for a substance, and then test for it. We have to learn about it, study it, and obtain results," Catlin said.

Illustrating the point, Catlin described how the lab encountered a substance earlier this year that no lab in the world previously has reported finding in athletes' urine. Through research, Catlin and others at the lab determined that the substance is norbolethone, an anabolic steroid developed by a pharmaceutical firm during the mid-1960s and tested clinically, but never sold by the company.

The lab obtained a sample of the substance from the company and analyzed its properties, then compared it to the substance found in the urine of a female athlete and confirmed that the properties matched. The researchers, who also noted other characteristics that may assist in identifying the substance in future tests, recently published their findings about the substance in the journal "Rapid Communications in Mass Spectrometry."

"These kinds of things help close one more loophole," Catlin said of the lab's methodical approach. "There aren't many loopholes left."

Anabolic steroids likely will remain the NCAA's primary target for at least the near future, but there are other substances that also prompt concern.

They include substances that increasingly are cropping up among elite athletes and for which testing still is being developed, such as erythropoietin (EPO), a naturally occurring hormone that increases production of red blood cells and increases endurance by improving the oxygen-carrying capacity of blood.

Another potentially more troublesome substance is human growth hormone (hGH). Catlin concedes there currently is no effective test for hGH, a substance that already occurs naturally in the body and that is used by athletes to add muscle mass.

No one discounts the possibility that these substances are used by student-athletes at NCAA institutions, but there is considerable skepticism that the use is widespread. Green says that athletes occasionally have claimed to be using hGH, but further investigation typically reveals that they actually are using a product that implies or misrepresents possessing hGH properties.

But Green realizes that even if such substances -- not to mention developing therapies such as genetic engineering -- aren't currently being abused in NCAA competition, they may be in the future.

"If you look at the history of drug use, that's how it started," Green said. "The anabolic steroid started with the elite athlete, then it went to professional athletes and then college athletes -- and now it's used in all three (NCAA) divisions. Now, high-school kids are using it.

"If it's available, people will find a way to get it."

Substances designed to mask use of steroids also are a continuing concern, and as with steroids themselves, researchers at the UCLA lab and elsewhere continuously are on the lookout for new masking agents. But generally speaking, it is easier to discover and then develop effective tests for uncovering such agents than it is to uncover the substances that they mask.

Once the NCAA learns that a particular substance has masking applications or obtains evidence of use, it typically is added to the list of banned substances.

The problem of masking is one of several areas in which the easy and legal availability of dietary supplements -- many containing substances on the NCAA's banned-substances list -- poses problems not only for the drug-testing program, but often for the student-athletes who use the supplements.

"Athletes frequently use supplements as a masking of real steroid use," Green said, adding that doing so often backfires. "For instance, someone might have been taking nandrolone, which is an anabolic steroid. Norandrostenedione, which is a supplement, comes out in a urine test as the same result. It doesn't happen so much as before, but a student-athlete might say, 'I just took a supplement,' thinking they would get a lesser penalty."

But androstenedione and norandrostenedione were added to the banned-substances list because the body converts them into the banned steroids testosterone and nandrolone, respectively, subjecting those who use them to the same penalty that they receive for using the steroid.

And on occasion, student-athletes might be better off not using the masking agent. "There are instances of using banned substances to mask substances that we don't test for anyway," Uryasz said.

Still, the cat-and-mouse game continues, and not just in the laboratory.

Movies and books have portrayed such drug-testing dodges as sneaking "clean" urine into collection vessels, or tampering with samples after they have been collected.

But the NCAA program's administrators have been hyper-sensitive to maintaining the integrity of sample collection since the very first tests in 1986, first by producing a detailed collection protocol before testing began, then rigorously following those procedures ever since.

Just as year-round testing and the use of a quality analytical laboratory are crucial elements of an effective drug-testing program, the collection protocol -- built around direct observation of student-athletes producing the testing sample and then ensuring the quality and proper handling of the sample -- is an equally important part of the process.

"We've had very few incidents where we've caught athletes trying to manipulate the sample," Uryasz said. "I can count on one hand the number of times we've caught someone trying to alter a sample.

"Workplace drug testing has to deal a lot more with manipulation and masking. We do an end run around that in sports, through observation."

Based on drug-testing statistics from 2000-01, the Association spent about $271 for each of the 10,680 student-athletes involved in the championships and year-round programs that year. This year's addition of ephedrine to the menu of substances that will be tested in the year-round program will increase the per-student cost.

The NCAA also spends significant sums on educational efforts, including publications, posters and training programs.

But ever-present pressures to economize constantly force Association officials to judge how little testing is needed to achieve the most deterrence.

Expense appears to be a reason -- though not the only reason -- that year-round testing did not expand between 1992, when Division I track and field was added, and last year, when Division II initiated the pilot testing program in baseball.

The Division III Presidents Council rejected a competitive-safeguards committee recommendation in 1999 and again in 2000 that Division III football be included in the year-round program. The Council objected that football should not be singled out from other Division III sports for testing and expressed the view that the significant cost of the program would have limited impact.

The competitive-safeguards committee also has recommended expanding year-round testing into baseball and advocates expansion into swimming, citing the presence of steroid use in those sports as reported in NCAA student-athlete drug-use surveys.

The drug-use surveys were driving forces behind creation of the year-round programs in football and track and field, and they continue to drive not only the competitive-safeguards committee's recommendations for further expansion into other sports, but initiatives such as adding ephedrine to the list of tested substances.

However, while the NCAA membership quickly embraced the initial move into year-round testing in 1990, it recently has been hesitant to expand the program.

Expansion into baseball has been tentative so far: Division II recently decided to extend its pilot program into a second year to obtain better data for a decision on whether to make year-round testing in the sport permanent. But Division I so far has declined to initiate a pilot program, requesting additional research by the competitive-safeguards committee. To date, there has been no consideration of expanding year-round testing into swimming.

That doesn't mean new funds are not being allocated to NCAA anti-drug efforts.

For example, Division III is allocating significant new funding for student-athlete welfare programs and educational workshops through its initiatives grants program. The program is allocating $200,000 annually for grants that address, among other things, improving nutrition and other approaches that help counter substance use and abuse. Division III also allocated $90,000 during the past year to the Student-Athletes Taking Active Responsible Roles (STARR) program to combat what many believe is the Association's biggest remaining substance-abuse problem -- alcohol.

But education is not enough, Green argues.

"You could make the argument that for recreational drugs, education is a very strong component," he said. "If you take these things, you're going to have worse performance. I think athletes generally want to perform better, so you use that as a tool.

"For performance-enhancing drugs, there's such positive reinforcement that I think you have to have testing. If you take anabolic steroids, and you get a scholarship and now you're starting and you make all-conference, or you get drafted by the pros -- that's a positive reinforcement."

And those aren't the only incentives to use performance enhancers, Green said. In many cases, the simple desire to excel is sufficient.

"We looked at drug use by division from our 1997 survey, and for almost every drug that we surveyed, Division III had a higher use than Division I and Division II. It's very clear: The stereotype that drug use is rampant in Division I -- and Division III players are just nonscholarship players, pure athletes -- is not true.

"Division III athletes want to be the best players they can be, which is good, but they also are going to have the same pressures to use performance-enhancing drugs. So one of the things we've learned is that Division III has more drug use, especially performance-enhancing, than the other divisions, and one of the reasons is that they don't drug test. If you're a Division III player, the only time you could potentially be tested is at a championship."

Legal footing

There may be debate over whether NCAA drug testing should be expanded, but there are few remaining doubts about the legality of testing already being conducted by the Association.

The only major legal challenge to the program ended with the California Supreme Court's 1994 decision in Hill vs. NCAA, which overturned an injunction preventing the Association from testing student-athletes at Stanford.

And it is highly unlikely that the program as it exists now will be challenged in the future on constitutional grounds, due in large part to the U.S. Supreme Court's 1988 decision in NCAA vs. Tarkanian. In that case, which had nothing to do with drug testing, the court ruled that the Association cannot violate a person's constitutional rights because it is a private organization and not subject to due-process requirements of the U.S. Constitution.

At the time, NCAA legal counsel John Kitchen noted the decision's application to drug testing.

"As far as being sued for claimed violations of the Federal Constitution, this decision should be helpful because most of these cases (particularly concerning the NCAA drug-testing program) deal with search and seizure under the Fourth Amendment, or the due-process amendment," Kitchen said in The NCAA News in December 1988.

Marquette law professor Mitten, who became chair of the NCAA competitive-safeguards committee this month, described the Hill and Tarkanian decisions as "a couple of things that provide comfort" today.

That level of comfort was raised somewhat by a recent ruling by the U.S. Supreme Court, which held in a 5-4 decision that an Oklahoma school district can require students to submit to drug testing as a condition of participation in extracurricular activities. The ruling expanded the court's 1995 decision in Vernonia School District vs. Acton, which focused on public school athletics.

With constitutional questions apparently settled, the NCAA program's administrators continually focus attention on procedural matters.

The Association's drug-testing procedure always has emphasized a "blind" approach to testing. In the beginning, the NCAA hired crews to collect specimens at championships sites and later in the year-round program, but those crews adhered to a strict protocol that among other things ensured the testing laboratory did not know at any time whose urine is being tested.

"We have no clue who we're testing, so all samples are handled equally," UCLA's Catlin said.

Now, by contracting with an independent organization -- The National Center for Drug Free Sport -- to hire the crews and collect the samples, the NCAA has inserted another layer between the Association and the collection process.

The UCLA lab also works as an independent contractor. Catlin said the lab has developed stringent and reliable procedures for handling and analyzing samples.

"When I report something out as positive, we follow a regular drill," he said. "I imagine myself in a room with a bunch of scientists trying to pick it apart.

"We never lose litigation on chemistry."

The blind approach extends into the appeals process for student-athletes who choose to challenge positive results, Green said. Appeals are heard via telephone conference call by the competitive-safeguards committee's drug-testing and drug-education subcommittee, which requires that student-athletes and others participating in the appeal on the student's behalf remain anonymous.

Green, who conducted numerous appeal calls as chair of the subcommittee, said that panel takes the appeals process seriously and works to ensure that the student-athlete receives a full, fair hearing.

"My sense is that it's a very fair, transparent process," adds Mitten, who has participated in dozens of appeal calls during his two years on the committee.

Flexibility tested

After 16 years of testing, it is clear that the NCAA has a program that was well-planned and legally sound, but retains the flexibility to change with the times.

That flexibility currently is being challenged more than any other aspect of the program.

"In 1986, most of the substances on the (banned-substances) list were prescription or black market," Uryasz said. But he and others did not foresee the problems that legal dietary supplements -- and the banned substances many of those supplements contain as ingredients -- would create.

"Now, you can go to a mall or order them through the Internet," he said.

The problem is double-edged: It's a competition problem, because use of those substances by student-athletes is resulting in positive tests and ineligibility -- probably inadvertently in at least some cases; and it's an education problem, because it takes time and schools' active assistance to spread the word about the problems arising from use of the substances.

"Student-athletes aren't connecting the fact that whatever they're getting, wherever they're getting it, may be on the banned-substances list," said Mary Wilfert, NCAA program coordinator in health and safety.

"Most of our appeal calls revolve around supplements," Green said. "The typical appeal is that somebody tested positive for a substance that was in a supplement, and claims either that they didn't know the substance was on the banned list, or didn't know that it was in the supplement -- they didn't read the label -- or they didn't ask anybody about it.

"Young student-athletes naively assume if it's legal, it's OK," Mitten said.

"We've heard every excuse," Green said. " 'Well, my roommate's brother's friend who's going to go to medical school told me to take this.' Student-athletes will ask everybody -- the guy at the nutrition store, a guy at the gym, a friend's brother -- everybody except someone who's going to tell them no.

"We've stopped accepting that (excuse), if the school can demonstrate that they educated the student-athlete, and made them aware that they need to check their supplements out," Green added. "Most schools find that, once you lose an athlete for a year, you're going to do a better job educating them."

But the extent of education can vary widely from institution to institution.

The most recent NCAA Drug Education/Testing Survey -- which solicits information from member schools about the breadth of education programs and about whether they conduct institutional drug testing -- indicates that about two-thirds of the schools were providing drug- and alcohol-education programs for student-athletes in 2001.

"It's hard to measure the quality of the education and testing that's going on at campuses," said Uryasz, whose organization offers assistance to schools in designing institutional education and testing programs. "The spectrum runs from one (education) session of one hour, once a year, to schools that have integrated substance information into their life-skills programs."

The NCAA Sports Medicine Handbook recommends that an institution provide education at least once a semester.

Educational efforts have improved over time, Green said.

"Enough people have tested positive for supplements that the word is getting out that you need to be educating your student-athletes," he said. "A lot of coaches didn't even realize this was a problem. We've really tried to get the word out, and the schools are doing a relatively good job -- we know from appeal calls that relatively few schools are not doing an adequate job.

"I understand that, from the school's point of view, there's so many NCAA regulations that they have to be aware of. But there are very few where your student-athlete can walk down to the nutrition store or even a supermarket, buy something, and then test positive and be lost for a year. Schools are realizing that they have a lot at stake."

The NCAA takes a bit of a "tough love" approach in encouraging education. Where feasible, it has adopted policies that require institutions to provide at least minimal information to student-athletes. Division I adopted legislation this year requiring schools to provide each student-athlete with the current banned-substances list. Athletes must certify receipt of the list on the annual Student-Athlete Statement, and failure to provide the list subjects a school to NCAA sanctions.

Divisions II and III are expected to adopt identical legislation at the 2003 Convention.

In the past, Green said, institutions have claimed in appeals that a student-athlete did not know that a substance is banned because the school never provided the student-athlete with a banned-substances list, or otherwise failed to warn the athlete away from certain substances. "The institution would say, 'Don't blame the athlete, it's our fault,' " Green said. "But it knew there was no penalty."

Under the new legislation, the committee can refer such a failure to the NCAA enforcement staff for possible sanctions.

The membership also has adopted legislation prohibiting institutions from providing dietary supplements to student-athletes -- a once-common practice.

"We were very concerned as a committee that we were telling people not to use supplements, and yet schools were handing them out," Green said. "Schools were giving out creatine by the truckload. It was a mixed message to student-athletes, who were asking: 'Why are you telling me not to take supplements, but my school is giving me creatine -- isn't that a supplement?' "

Most of the Association's efforts, however, are focused on providing tools for improving on-campus educational efforts. The emphasis currently is on helping institutions devise programs that fit their own student-athletes, rather than trying to enforce what Green calls a "one size fits all" approach.

That goal is pursued through such programs as Athletic Prevention Programming and Leadership Education (APPLE) conferences to assist institutions in evaluating and improving alcohol- and drug-education programs, the CHOICES program specifically targeting alcohol abuse, and the NCAA/Betty Ford Clinic Professional in Residence Program, offering education in understanding drug dependency and ongoing education.

"The NCAA can be valuable by giving people resources, like a grant or training, so they can take what they've learned, come up with their own program, and take it back and make it work for their school," Green said. "If that happens, that's the best we can do. It would be sort of foolish on our part to say, 'OK, here's an education program that you have to implement,' because it might not work at that school."

"The beauty of the NCAA is that it says you have to do these things, but it also provides you the resources to do it," Uryasz said.

The NCAA isn't relying entirely on institutions to do the job, either. The competitive-safeguards committee and the national office's education services staff actively seeks opportunities to provide education and information not just to member schools, but directly to student-athletes and also to the public, Wilfert said.

Such efforts resulted in the recent creation of the Resource Exchange Center (REC) -- an NCAA-funded source of detailed information about banned substances and nutritional supplements that was established and is managed by The National Center for Drug Free Sport.

Efforts to communicate directly with owners and employees of nutrition stores also are under consideration. "Many of the clerks are just not aware. That's not their job; their job is to sell product," Wilfert said.

And sometimes, current events lend a hand.

"Probably the best thing that happened to us was the Mark McGwire home-run chase, with androstenedione, because everyone read about it," Green said. "In 2002, if somebody doesn't know that androstenedione is on the banned list, we're not really going to accept that. It's kind of like not knowing that steroids are on the banned list."

But there are other things member institutions can do to assist with education.

Coaches can play a much larger role in the informational effort. The most recent survey indicated that only about one-fourth of member institutions involve coaches and other staff in drug- and alcohol-education programs.

"Student-athletes change every few years, but a lot of places, the coaches are there a long time," Green said. "If a coach tells the athlete, look, this isn't going to be tolerated, generally it's not. They're used to doing what the coach tells them."

A specific focus on nutritional education -- a goal of the NCAA's Student-Athlete Advisory Committees -- also is important.

"A lot of programs that try to get people to avoid steroids focus on good nutrition," Green said. "We see student-athletes spending a lot of money on supplements that have very little benefit, and yet they don't have proper nutrition."

Green knows of a Division I-A conference whose member schools each spent an average of $30,000 on dietary supplements for student-athletes, before the Association prohibited the practice.

"I think that money would be better spent on hiring a nutritionist, who could meet with the team and go over their nutritional needs, and talk to the coaches about training tables," Green said. "Institutions could spend a relatively small amount for the services of a part-time nutritionist, or even obtain volunteer help from nutrition-science programs that already exist on many college campuses."

In the absence of more extensive year-round drug testing, education is the best tool the Association has for dealing with the dietary supplements problem. But competitive-safeguards committee members realize the Association may have to accommodate the problem in other ways until it is more controlled.

"We've explored whether there should be a graded penalty structure or an early reinstatement option," Green said.

"We're kind of hamstrung, in that the committee has only a yea or nay option (in deciding appeals)," he said. "The committee can't say, this one is guilty but he has extenuating circumstances -- let's give him six months (instead of a year). We don't have that ability, but some of the schools don't realize that -- sometimes they'll get on the call and say, 'Look, if you accept this appeal, we promise to have him take a drug test every week, and we'll hold him out of the first game.' We say, 'Look, we can't do that,' and in some ways that hurts us."

Mitten said such a change in penalties presents problems -- including potentially inconsistent application of penalties.

That problem does not currently exist because all initial positive tests prompt a year-long suspension from competition. But he believes the competitive-safeguards committee will continue to review and discuss possible changes in the penalty structure.

An enduring necessity

In 1986, the NCAA membership stepped boldly into unmarked territory when it overwhelmingly approved the NCAA's drug-testing program.

Sixteen years later, many -- though probably not all -- doubts about the program's ability to effectively deter substance abuse have been satisfied, and questions about its legality and quality have been answered.

And, perhaps regrettably, the program probably will continue to operate for years to come.

"The desire to win and the desire to find shortcuts will always be with us," Uryasz said. "I don't know that athletes and coaches are any more ethical than they were in 1986. If we were to discontinue the program, I think we could see the level of drug use return to that of 1986, and probably beyond."

Often as not, the willingness to cheat arises from the more admirable desire to excel.

"As a sports-medicine doctor, one of the things I like about taking care of athletes is that they will do so much to make themselves better," Green said. "Whereas with most patients you have to motivate them to be compliant, athletes usually are very compliant and sometimes overcompliant. If you tell them to do five repetitions of something, they'll want to do 10.

"We use that in sports because we like to see people achieve their best, but that can sometimes become corrupted when people start turning to things that aren't ethical or healthy for them -- and not only that, but really compromise the integrity of the sport."

"That's why it's very important," Wilfert suggests, "to talk to the very young about sportsmanship, through programs like Stay in Bounds -- to develop attitudes."

A majority of NCAA athletes -- 55 percent of respondents in the 2001 drug-use survey -- believe that all college athletes should be tested by the Association, and 55 percent believe that drug testing deters drug use (25 percent disagreed with those statements).

"The program does give support to those who don't want to use substances, and lets them feel they don't have to use them," Wilfert said.

"Athletes are among the most hawkish when it comes to drug testing," Green said, "but they want it to be fair, obviously. They want to make sure the person across from them is competing fairly."