{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T04:52:45Z","timestamp":1781067165929,"version":"3.54.1"},"reference-count":38,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2022,4,23]],"date-time":"2022-04-23T00:00:00Z","timestamp":1650672000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["NASN School Nurse"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:p>The purpose of this article is to provide the school nurse with the ability to recognize performance and appearance enhancing substance use and understand treatment and prevention strategies to reduce associated health risks. The use of appearance and performance enhancing drugs and substances, also known as \u201cdoping,\u201d has been an ethical and health issue in sports for many years. It is vital that school nurses learn to recognize performance and appearance enhancing substance use to ensure student athletes and exercisers receive the care and education they need. Commonly used performance and appearance enhancing substances include anabolic-androgenic steroids, stimulants, diuretics, growth hormone, and supplements. Signs and symptoms that may look similar to other health concerns include palpitations, stunted growth, acne, severe headaches, muscle cramps, dizziness, and dehydration, but some long-term severe complications occur as well. Doping can lead to severe and sometimes permanent organ damage, including liver, kidney, and heart disease. The school nurse can play a key role by working with parents, coaches, school counselors, and educators to foster an anti-doping culture.<\/jats:p>","DOI":"10.1177\/1942602x221093938","type":"journal-article","created":{"date-parts":[[2022,4,23]],"date-time":"2022-04-23T05:47:42Z","timestamp":1650692862000},"page":"263-269","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Appearance and Performance Enhancing Drugs and Substances: The Role of the School Nurse"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9606-306X","authenticated-orcid":false,"given":"Lee Anne","family":"Siegmund","sequence":"first","affiliation":[{"name":"Cleveland Clinic, Cleveland, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,4,23]]},"reference":[{"key":"bibr1-1942602X221093938","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare9010097"},{"key":"bibr2-1942602X221093938","unstructured":"American College of Medical Toxicology(2017, January 5). 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