Disclosures: Anne M. Kuwabara, MD: No financial relationships or conflicts of interest

Objective: While anecdotal reports of the use of performance enhancing medications to curb anxiety in performing artists abound, there has been no research to date assessing the prevalence of usage or attitudes towards use amongst the artists themselves. The objective of this study is to evaluate the perceptions, acquisition, and use of potentially performance enhancing medications (benzodiazepines, beta blockers, and cannabinoids) in the performing artist community to clarify the use of these medications to improve patient counseling and patient safety.

Design: Cross sectional surveySetting : Anonymous survey was administered through Stanford’s REDCap system.Participants : Performing artists who are active members in the following institutions: American Federation of Musicians, National Association of Schools of Music, and the International Conference of Symphony and Opera Musicians.

Interventions: N/A

Main Outcome Measures: perceptions, acquisition, and use of performance enhancing medications (benzodiazepines, beta blockers, and cannabinoids)

Results: 264 participants completed the survey (130 women, 130 men, 4 other) from 12/2020 to 2/2021. The majority of participant’s were full-time professionals in an ensemble (30%) in the Classical/opera genre (92%). Of the three classes of medications, beta blockers were most commonly used and benzodiazepines were least used. Compared to other classes (23% benzodiazepine users, 10.8% of beta-blocker users), 46% of cannabis users reported that the drug had negative effects on performance. Medication use was not considered to be unethical (95.5% beta blockers, 92.4% benzos, 92% cannabis), performance-enhancing (65% beta blockers, 77.7% benzos, 81.4% cannabis), or an unfair advantage (87.5% beta blockers, 89.4% benzos, 95.8% cannabis). Use before performances for each drug were as follows: beta blocker 52.7%, benzo 69%, cannabis 43.5%. The number of prescriptions not by a doctor were as follows: beta blocker 27%, benzo 15.4%, cannabis 97.4%.Conclusions: Results demonstrate current use patterns of beta blockers, benzodiazepines, and cannabis-containing products. Beta blockers are well tolerated and most frequently used for performance anxiety.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/perceptions-of-performance-enhancing-medications-benzodiazepines-beta-blockers-cannabinoids/