The classifications of substances as performance-enhancing substances are not entirely clear-cut
and objective. As in other types of categorization, certain prototype performance enhancers are universally classified as such (like anabolic steroids), whereas other substances (like vitamins and protein supplements)
are virtually never classified as performance enhancers despite their effects on performance. As is usual with categorization, there are borderline cases; caffeine, for example, is considered a performance enhancer by
some but not others.
Performance-enhancing substances include dietary supplements, prescription medications, and illicit drugs. Virtually no data are available on the efficacy and safety in children and adolescents of widely used
performance-enhancing substances. This statement is intended to provide a generalized but functional
definition of performance-enhancing substances. The American Academy of Pediatrics strongly condemns
the use of performance-enhancing substances and vigorously endorses efforts to eliminate their use among children and adolescents.

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