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.