This is the current release of the guideline.

All policy statements from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.

Use of performance-enhancing substances

Counseling
Prevention
Screening

Pediatrics

Physicians

To convey a general policy with regard to performance enhancing drugs

Pediatric patients (from birth to 18 years of age) using or at risk of using performance-enhancing substances

Screening

1. Risk assessment
2. Inquiries regarding the use of performance-enhancing drugs
3. Additional investigative tests for patients using performance-enhancing drugs

Counseling/Prevention

1. Proactive discouragement of performance-enhancing drug use
2. Patient and parent education
3. Use of training and nutrition programs
4. Counseling of patients using performance-enhancing drugs

• Incidence of performance-enhancing drug use
• Risk factors associated with performance-enhancing drug use

Searches of Electronic Databases

Not stated

Not stated

Not stated

Not applicable

Review

Not stated

Not stated

Not applicable

A formal cost analysis was not performed and published cost analyses were not reviewed.

Peer Review

Not stated

To assist the pediatrician in dealing with users or potential users of performance-enhancing substances, the American Academy of Pediatrics offers the following recommendations:

1. Use of performance-enhancing substances for athletic or other purposes should be strongly discouraged.
2. Parents should take a strong stand against the use of performance-enhancing substances and, whenever possible, demand that coaches be educated about the adverse health effects of performance-enhancing substances.
3. Schools and other sports organizations should be proactive in discouraging the use of performance-enhancing substances, incorporating this message into policy and educational materials for coaches, parents, and athletes.
4. Interventions for encouraging substance-free competition should be developed that are more positive than punitive, such as programs that teach sound nutrition and training practices along with skills to resist the social pressures to use performance-enhancing substances.
5. Colleges, schools, and sports clubs should make use of educational interventions that encourage open and frank discussion of issues related to the use of performance-enhancing substances, with the aim of promoting decisions about personal drug use based on principles of fair competition and character rather than on the fear of getting caught.
6. Coaches at all levels, including youth sports, should encourage wholesome and fair competition by emphasizing healthy nutrition and training practices, taking a strong stand against cheating, and avoiding the "win-at-all-costs" philosophy.
7. Inquiries about the use of performance-enhancing substances should be made in a manner similar to inquiries about use of tobacco, alcohol, or other substances of abuse. Guidelines for patient confidentiality should be followed and explained to the patient.
8. Athletes who admit using performance-enhancing substances should be provided unbiased medical information about benefits, known adverse effects, and other risks. When appropriate, additional testing may be necessary to investigate or rule out adverse medical effects.
9. The pediatric health care professional providing care for an athlete who admits to using a performance-enhancing substance should explore the athlete's motivations for using these substances, evaluate other associated high-risk behaviors, and provide counseling on safer, more appropriate alternatives for meeting fitness or sports-performance goals.
10. Nonusers of performance-enhancing substances should have their decisions reinforced while establishing an open channel of communication if questions about performance-enhancing substances arise in the future.
11. Pediatric health care professionals should promote safe physical activity and sports participation by providing or making available sound medical information on exercise physiology, conditioning, nutrition, weight management, and injury prevention and by helping to care for sports-related medical conditions and injuries.

None provided

The type of supporting evidence is not specifically stated for each recommendation.

Appropriate care of pediatric patients who use or may use performance-enhancing drugs

None stated

An implementation strategy was not provided.

Staying Healthy

Effectiveness
Patient-centeredness

Not applicable: The guideline was not adapted from another source.

2005 Apr

American Academy of Pediatrics - Medical Specialty Society

American Academy of Pediatrics

Committee on Sports Medicine and Fitness

Committee on Sports Medicine and Fitness, 2002-2003: Reginald L. Washington, MD, Chairperson; David T. Bernhardt, MD; *Jorge Gomez, MD; Miriam D. Johnson, MD; Thomas J. Martin, MD; Frederick E. Reed, MD; Eric Small, MD

Liaisons: Carl Krein, AT, PT, National Athletic Trainers Association; Claire LeBlanc, MD, Canadian Paediatric Society; Judith C. Young, PhD, National Association for Sport and Physical Education

Consultant: Oded Bar-Or, MD

Staff: Jeanne Lindros, MPH

*Lead author

Not stated

This is the current release of the guideline.

All policy statements from the American Academy of Pediatrics automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.

This NGC summary was completed by ECRI on May 17, 2005. The information was verified by the guideline developer on June 27, 2005.

This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions. Please contact the Permissions Editor, American Academy of Pediatrics (AAP), 141 Northwest Point Blvd, Elk Grove Village, IL 60007.