Despite research showing associations between anabolic steroid use and criminal offending, the possibility of a similar association between legal performance-enhancing substance use, such as creatine, and criminal offending remained unknown. A new study published online in the journal Drug and Alcohol Dependence now shows that both forms of performance-enhancing substance use is longitudinally associated with criminal offending among U.S. adults.

The study, which analyzed a sample of over 9,000 U.S. participants from the National Longitudinal Study of Adolescent Health (Add Health), highlights the need for more research on performance-enhancing substances to understand the complex social problems associated with their use.

“This is the first study to identify relationships between legal performance-enhancing substance use and criminal offending,” says lead author Kyle T. Ganson, PhD, MSW, assistant professor at the University of Toronto’s Factor-Inwentash Faculty of Social Work. “This finding is acutely salient because these substances are easily accessible and commonly used, particularly among young people.”

The study highlights the importance of clinical professionals screening for performance-enhancing substance use and assessing patterns of criminal offending among young people.

“We need more research to identify effective prevention and intervention techniques to ensure that we reduce the use of these substances, as well as curtail any connection with criminal offending,” says co-author Jason M. Nagata, MD, MSc, assistant professor at the University of California, San Francisco’s Department of Pediatrics.

“The associations found in this study are likely explained by an intersection of behavioral, psychological, and sociocultural influences,” says Ganson. “We therefore need to target this problem from a multitude of angles, including clinically and via public health and policy interventions.”