Knowledge gap: Physicians, parents don’t know enough about the risks appearance- and performance-enhancing drugs pose to teens, national survey suggests

OTTAWA—There is a need for enhanced research, education and training on appearance- and performance-enhancing drugs and substances (APEDS) and its effects on adolescents, researchers warn in the latest results from the Canadian Paediatric Surveillance Program (CPSP). A one-time survey of paediatric specialists and subspecialists demonstrated that children and youth in Canada are experiencing negative health effects from APEDS, with some requiring hospitalization and ongoing medical care.  

APEDs, in the form of drugs and dietary supplements, are used to improve athleticism, increase muscle development and alter one’s appearance. They can have harmful effects on children and teens, particularly on their kidneys and gastrointestinal systems. Although they are easily accessible to young people, many physicians reported little to no knowledge about these substances, and they are often not screened for in routine practice.

“The most commonly used APEDS, such as dietary supplements like protein supplements and creatine, are not strongly regulated by the federal government, which may increase risks from use,” said Dr. Kyle Ganson, one of the survey’s lead researchers.

He suggests caregivers and health care providers educate themselves about the differences between appearance- and performance-enhancing drugs and substances, how accessible they are, and what their intended uses are.

“Many young people do immense research prior to using APEDS to understand which ones to use and how to use them to reach their goals; the adults in their lives need to have the same level of knowledge to be able to have productive conversations with them,” said Dr. Ganson. “Additionally, abstinence may not be an acceptable goal to all adolescents, so health care providers and parents should work with them to mitigate risks through harm reduction techniques.”

Other results highlighted in the 2024 CPSP Annual Report include:

• The first national surveillance study on life-threatening harms related to illicit substance use in children and adolescents in Canada. Overdose from illicit drug toxicity is the leading cause of deaths for adolescents in British Columbia and is a growing concern in the rest of the country. This three-year study will allow clinicians and policy makers to co-develop overdose interventions alongside youth to reduce harms and improve health outcomes.
• The final report of a two-year study investigating post-COVID-19 condition (long COVID) in children and youth has revealed significant impacts on daily activities for affected children, with almost all cases reporting a decrease in physical activities and over 85% reporting a negative impact on school performance.

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About the Canadian Paediatric Surveillance Program

The Canadian Paediatric Surveillance Program (CPSP) is a joint project of the Public Health Agency of Canada and the Canadian Paediatric Society. It contributes to the improvement of the health of children and youth in Canada by national surveillance and research into childhood disorders that are high in disability, morbidity and economic costs to society, despite their low frequency.