[High on stage? Substance use and performance anxiety among professional musicians].

BACKGROUND

Substance use is commonly assumed to be widespread among musicians; however, empirical data on consumption patterns and the associations with anxiety are limited and heterogeneous. In particular, differentiated longitudinal findings across substances and musical genres are lacking.

OBJECTIVE

Therefore, the aim of this study was to investigate the use of various psychoactive substances among professional musicians from different genres, including the examination of changes over time and associations with (performance) anxiety.

MATERIAL AND

METHODS

An anonymous online study with two assessment waves (T1: January-June 2024, T2: June 2025) was conducted; 1392 musicians (including music students) participated in T1, of whom 327 also took part in T2. The frequency of use for 16 substances, indicators of problematic substance use (Cut down, Annoyed, Guilty, Eye-opener-adapted to include drugs, CAGE-AID), performance anxiety (stage anxiety questionnaire, BAF), and general anxiety symptoms (GAD-7) were assessed.

RESULTS

Overall, a generally elevated prevalence of substance use was not observed. Alcohol was the most frequently used substance and 21% of participants showed a positive screening for problematic substance use. Musicians in popular/jazz genres tended to report higher levels of substance use than classical musicians. Cross-sectionally, weak associations between some substances and performance anxiety were observed. Longitudinally, cross-lagged panel models indicated minimal changes over time and no significant longitudinal effects between substance use and anxiety.

DISCUSSION: The findings do not provide evidence for generally increased levels of substance use among musicians but point to individual risk profiles that should be considered when providing care for this population.