A performance-enhancing drug (PED) is any substance that is used to increase muscle mass, dull pain, reduce weight, or ease stress. The use of PEDs is a growing concern among adolescents, due in part to the pressures to perform, the influence of professional role models, and a general lack of education about the dangers of these substances. Use of performance enhancers has been identified in middle school as well as high school age students. This article details the school nurse's role in identifying youth who are using a PED, providing education for students and families, and referring for treatment if needed. Although PED use is not as prevalent as use of other illicit drugs, PEDs still pose a threat to adolescent physical and mental health. Discussion about PED use can open the door to discussion about use of other substances.

The number of people diagnosed with substance abuse and dependence continues to increase with serious implications for individuals and groups.Addiction treatment can be effective, and certain principles, when adhered to, increase the likelihood of success: engagement, retention and individualization.Becker's Health Belief Model (HBM, 1974) has been used successfully to address behavior change in chronic diseases, as well as smoking and alcohol dependence. This project applies the HBM to opiate addiction treatment, specifically medication assisted treatment (MAT). The purpose of this study was to measure the relationship between self-efficacy and treatment outcomes for opiate dependent clients on MAT. A convenience sample of 50 persons with addiction to opiates was admitted to an outpatient substance abuse treatment program for MAT using methadone, and followed for a period of 6 months. Preand post-treatment self-efficacy scores were obtained using a modified General Self-Efficacy Scale (GSE; . Treatment outcomes were measured by the number of negative random monthly urine screens, attendance at group and individual counseling sessions, daily dosing adherence, and retention in treatment for at least 6 months. Pre-and post-treatment selfefficacy scores were compared using a t-test, and self-efficacy scores were compared to client outcomes using Pearson Correlation. GSE scores demonstrated improvement after 6 months in treatment (p=<.01). However, no statistically significant relationship was found between GSE scores and treatment outcomes.