It's pretty common to have a level of skepticism regarding modern athletes and performance-enhancing drugs.   A few users taint the entire field, especially if it brings some success.   Baseball, football, cycling ... all elite members are under scrutiny.  

But the levels of performance-enhancing drugs in those events is nothing, says a new study.   Participants in this big-money 'sport' have a whopping 80% rate of performance-enhancing drug use.

What are we talking about?  Poker.

The Nova Southeastern University study says poker players are using drugs such as marijuana, cocaine, amphetamines, Valium, and other prescription medications, as well as substances including caffeine, energy drinks and guarana to get an edge over their opponents.

"The use these substances could allow poker players to stay awake longer, as well as focus and concentrate better, which would be a competitive advantage," said Kevin Clauson, Pharm.D., an associate professor at NSU's College of Pharmacy, who was the principle investigator in the study. "Stamina is important for any poker player because tournament poker and cash games can go on for many hours."

Using these substances can be harmful for poker players, Clauson said. Depending on the type of substance, he pointed out; there will likely be short-term and long-term side effects.  But it's always the case that some players will trade a short-term gain for long term harm.

The NSU researchers initially interviewed players in Las Vegas during the World Series of Poker and then surveyed players online from across the globe, including North America, Europe, and Asia, with the majority of respondents coming from the US and Canada.

Respondents included professional poker players, semi-pro, amateur, and recreational players. Regardless of one's status, an overwhelming majority of poker involves some amount of money, Clauson said. The players surveyed played poker --- largely no-limit Texas hold' em ---- both in person and on the Internet. Most were males in their mid-20s.

About 73 percent of the respondents said they used drugs and other substances to focus and concentrate better. The rest used these products to calm their nerves, stay awake, and improve memory.

The results suggest that the use of substances to improve poker performance is widespread, especially at higher stakes, Clauson said. "Most people we surveyed are using some kind of a boost in order to play one of the most popular games in the world," he said.