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Legal Performance-Enhancing Substances: A New Gateway to Problematic Alcohol Use :

August 31, 2020

Adolescents in our practices often want to enhance their athletic performance.

Adolescents in our practices often want to enhance their athletic performance. While the ideal way to do this is proper diet, sleep, and exercise, some teens will turn to legal performance-enhancing substances (PES) thinking these will improve performance despite the fact that the evidence that these over-the counter products or powders improve performance and/or muscle mass in males and females is lacking. So, are they really a problem? Ganson et al (10.1542/peds.2020-0409) evaluated the use of these products and the risk of subsequent substance-use associated risk behaviors in a new study being released this month in our journal.

The authors report on over 12,000 older adolescents and young adults (18-26 years) who were assessed in four waves over a period of 14 years (1994-2008). The authors first asked about their use of alcohol use in wave I and in wave III began to ask about the use of legal PES and then in wave IV subsequent alcohol-use associated risk behaviors. The authors found that use of alcohol first was prospectively associated with legal PES use and that PES use was subsequently associated with problematic alcohol use and drinking-related risk behaviors (e.g. binge drinking, drinking while driving, legal problems) in males, and more emotional and physical health problems with alcohol use in females.

What can we do to better understand the role legal PES may be playing as a contributor to substance use problems in your adolescent and young adult patients? To answer that, we asked Drs. Steven Cuff from Nationwide Children’s Hospital in Columbus Ohio and Michelle LaBotz from Tufts (10.1542/peds.2020-012278) to share their thoughts in an accompanying commentary. They help educate us on the facts versus fiction regarding legal PES. The commentary addresses what legal PES contains, the claims about these ingredients, and the degree to which the PES can cause harm.  The commentary highlights why do we need to be asking about teens about their use PES and their associated risks. Pump up your knowledge base and that of your adolescent patients on the topic of PES by checking out this interesting study and important accompanying commentary.

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