* The specific substance: Some substances have harsher penalties than others.
* The governing body: NCAA, NAIA, individual conferences, and even individual schools all have their own specific rules and enforcement procedures.
* Whether it's a first offense, second offense, etc.: Repeat offenders face significantly stiffer penalties.
* The athlete's explanation and evidence presented: There may be mitigating circumstances that can influence the outcome. This is rare, though, and the burden of proof is heavily on the athlete to demonstrate these circumstances.
* The type of sport: Some sports may have stricter rules than others.
While a positive test almost always leads to some form of sanction, suspension from competition, and potentially loss of eligibility are not guaranteed outcomes in every single case. The process involves investigations, hearings, and appeals, and the final decision rests with the governing body.