title: Cognitive and Performance Enhancing Medication Use to Improve Performance in Poker.
abstract: Use of neuroenhancers has been studied in groups ranging from students to surgeons; however, use of cognitive and performance enhancing medications (CPEMs) to improve performance in poker has remained largely overlooked. To assess the use of CPEMs to improve poker performance, a survey of poker players was conducted. Participants were recruited via Internet poker forums; 198 completed the online survey. Approximately 28 % of respondents used prescription CPEMs, with the most commonly used including: amphetamine/dextroamphetamine (62 %), benzodiazepines (20 %), and methylphenidate (20 %). CPEMs were used in poker to focus (73 %), calm nerves (11 %), and stay awake (11 %). Caffeine (71 %), as well as conventionally counter-intuitive substances like marijuana (35 %) and alcohol (30 %) were also reported to enhance poker performance. Non-users of CPEMs were dissuaded from use due to not knowing where to get them (29 %), apprehension about trying them (26 %), and legal or ethical concerns (16 %). Respondents most frequently acquired CPEMs via friends/fellow poker players (52 %), or prescription from physician (38 %). Additionally, greater use of CPEMs was associated with living outside the United States (p = 0.042), prior use of prescription medications for improving non-poker related performance (p < 0.001), and amateur and semi-professional player status (p = 0.035). Unmonitored use of pharmacologically active agents and their methods of acquisition highlight safety concerns in this cohort of poker players, especially among non-professional players. The current state of guidance from national organizations on CPEM use in healthy individuals could impact prescribing patterns.
authors.affiliation: Department of Pharmacy Practice, College of Pharmacy, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Caballero
authors.affiliation: College of Osteopathic Medicine, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL, USA.
authors.forename: Raymond L
authors.initials: RL
authors.lastname: Ownby
authors.affiliation: Department of Pharmacy Practice, College of Pharmacy, Nova Southeastern University, 3200 South University Drive, Fort Lauderdale, FL, USA.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Rey
authors.affiliation: Department of Pharmacy Practice, College of Pharmacy, Lipscomb University, One University Park Drive, Nashville, TN, USA. kevin.clauson@lipscomb.edu.
authors.forename: Kevin A
authors.identifier: http://orcid.org/0000-0003-2774-8169
authors.initials: KA
authors.lastname: Clauson
mesh_terms: D000328:Adult; D016739:Behavior, Addictive / Q000523:psychology*; D024803:Biomedical Enhancement; D000697:Central Nervous System Stimulants / Q000008:administration & dosage; D003071:Cognition / Q000187:drug effects*; D005260:Female; D005715:Gambling / Q000523:psychology*; D006304:Health Status; D006801:Humans; D008297:Male; D012309:Risk-Taking; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants
keywords: Cognition; Gambling; Medications; Neuroenhancer; Poker