Abstract and Keywords
Appearance and performance enhancing drugs (APEDs) include a wide range of substances borrowed from a wide range of medical disciplines and associated fields and have a long history in sport and competition. The defining features of APED use are discussed and include polypharmacy, body image disturbance, and disturbances in diet and exercise. Appearance and performance enhancing drugs are unique among substances of abuse in their biological action, as well as in the basic motivations for their use. Although there are a wide range of potentially serious physical and psychiatric side effects, APEDs continue to be used by millions of men and women and to a greater degree by those engaged in sport and fitness activities. It is still unclear how individuals become illicit APED users, but it is possible that legal APEDs act as a gateway substance for illicit APED use. There are few empirically supported prevention programs for APED use and a complete absence of empirically supported interventions for those using APEDs. The engagement of APED users in treatment is complicated by the ethical-legal obstacles and mistrust between the APED-using and health services communities. Future research will need to overcome these barriers to provide effective and useful interventions for those APED users in the sport or performance fields.
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