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Performance-Enhancing Drug Use in Children

For some young people, participation in sport and other forms of physical activity may increase substance abuse or promote unhealthy weight control behaviors.

"I am worried that my son's sports conditioning program is turning him into a drug addict," your personal training client tells you. When you press her for more information, she explains, "I hoped that participating in sports would keep him healthy. Well, there he was yesterday in the kitchen, mixing up his recovery sports drink. I never thought much about it, but lately he is taking a lot of supplements. So I finally read the label - and couldn't believe it! Hormones, caffeine, a million chemicals I can't even begin to pronounce. I thought the product was just a protein shake. How did this stuff get into my house?" The influence of sports on the lives of young people can be good or bad, or some mixture of both. Participation in sport and other forms of physical activity offers a majority of children and teens a wealth of positive experiences. For many, participation promotes a healthful lifestyle, and may even protect against involvement in problem behaviors, such as smoking tobacco, smoking marijuana and alcohol abuse. But for other young people, participation may increase substance abuse or promote unhealthy weight control behaviors. If you run a program for children or teens, take some time to think about the influence your program is having on your participants. Physical activity and sports programs are desperately needed in our sedentary culture, so your work is probably doing a great deal of good. But as a leader, teacher, coach or administrator of youth programs, you cannot turn a blind eye to the ways that you or your program may be unintentionally promoting or condoning problem behaviors, such as the use of performance-enhancing supplements.

Problems with performance-enhancing supplements

Performance-enhancing supplements are dietary supplements that claim to enhance sport performance by increasing fitness, building muscle and decreasing fat, or increasing alertness and energy level. Many of these substances should be off-limits to children and teens for many reasons. First, many supplements, especially weight-loss and muscle-building supplements, may contain ingredients that are harmful to young people, such as prohormones and amphetamines. If not harmful, the long-term effects are unknown, especially for growing bodies. Even creatine, widely used by many high school athletes, has no long-term studies of its safety or efficacy in adults or children. Second, the use of legal performance-enhancing substances by teens has been linked to later use of illegal substances, such as steroids. Adolescents may develop a performance-enhancing, weight-control, getting-built focus that gets out of control very quickly. Lastly, promoting the use of substances detracts from what we are trying to teach young people: that the most productive path to performance enhancement lies in self-discipline and hard work that includes a well-designed training program, attending every practice or workout, good nutrition, and sufficient rest and recovery. Popping pills for a competitive edge should not be part of the youth sport picture.

Reviewing your programs

What kind of messages about performance-enhancing supplements and drugs are kids getting in your programs? You can promote healthful messages in many ways:
  • Model a healthful lifestyle, especially in front of children and adolescents. Use your supplements at home. Tell no war stories about your drunken revels. Let kids know you can have fun and enjoy physical activity/sport without drugs.
  • Teach your participants about good nutrition. Let them know, for example, that it's much cheaper to get bodybuilding protein in your daily meals than from supplements.
  • Build strong relationships and mentor your participants. Cultivate a team culture that promotes positive behavior. Do what you can to make your program fun.
  • Work with other organizations in your area to promote healthful lifestyles for children and adolescents.
References American Academy of Pediatrics. Use of performance-enhancing substances. Pediatrics 115(4): 1,103-1,107, April 2005. Elliot, D.L., L. Goldberg, E.L. Moe, et al. Preventing substance use and disordered eating: initial outcomes of the ATHENA (athletes targeting healthy exercise and nutrition alternatives) program. Archives of Pediatric and Adolescent Medicine 258(11): 1,043-1,049, November 2004. Goldberg, L., D.P. MacKinnon, D.L. Elliot, et al. The adolescents training and learning to avoid steroids program: preventing drug use and promoting health behaviors. Archives of Pediatric and Adolescent Medicine 154(4): 332-338, April 2000. Metzl, J.D. Anabolic steroids and the pediatric community. Pediatrics 116(6): 1,542, December 2005.
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