The use of drugs to enhance physical performance and appearance has been observed for thousands of years. Today individuals, including adolescents, continue to employ a wide variety of drugs in the hope of improving their athletic performance and looking better. Unfortunately, beyond the assessment of anabolic–androgenic steroid (AAS) use, very little is known regarding the use, safety and efficacy of other performance-enhancing drugs and nutritional supplements among adolescents. Most studies report that 3–12% of adolescent males admit to using an AAS at some time during their life. Among adolescent females, studies find that 1–2% report having used steroids. The current strategy for dealing with performance-enhancing drug use by adolescents is multi-faceted and primarily involves education and prevention strategies, interdiction and drug testing programmes. However, the demand for performance-enhancing drugs has been created by our societal fixation on winning and physical appearance. In order to alter the current use of performance-enhancing drugs by adolescents, we as a society must come to grips with our addiction to sport and the importance we place on winning and appearance. We must change our values.