Adolescent performance enhancing substance use: regional differences across the US

Performance enhancing substances (PES) constitute a multi-billion dollar industry, fueling public health concerns regarding use in adolescents hoping to enhance athletic performance and body appearance, or fight obesity. Adverse effects may include violent behavior, suicide attempts, and premature deaths. Prevalence of use is difficult to ascertain due to secrecy issues and misinterpretation of survey questions. Healthcare providers are less familiar with PES than other types of substance use. A correlational secondary analysis of 2007 National Youth Risk Behavior Survey (YRBS) data was conducted (n =14,041) to better understand predictors of PES use (methamphetamines, steroid pills/injections, and diet pill/powder/liquids). Bandura's Social Cognitive Theory served as the organizing framework guiding the analysis. SPSS version 17.0 Complex Samples was used to examine relationships among variables; bi-variate and logistic regression analyses were performed. Feeling sad/ hopeless, considering suicide, perceiving being overweight, being offered drugs at school, geographic location, being sexually active, cigarette smoking, and alcohol use were significantly associated (p <.05) with PES use. Rates of being offered/sold/given illegal drugs at school ranged from 17-39%; PES use ranged from 5-17% across the US. Multiple factors predicted PES use; those contributing to morbidity and mortality may be preventable. Though policies are designed to ensure safe school settings, high rates of obtaining drugs at school were reported. The South US region reported the highest rates of PES use. Regional differences have implications for health professionals and policy makers who must address physical, psychological, and social issues related to adolescent PES use.