Storage, Dispensing of Medication Varies, Study Says

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At least once a day, Principal Stephen M. LeClair sees them--fidgeting students lined up outside the nurse's office, "yapping in the hallway," and waiting for the prescription medication they need to control the symptoms of attention-deficit/hyperactivity disorder.

Mr. LeClair says that at his school, the rural Barrington (N.H.) Middle School on the edge of the state's seacoast region, only the school nurse is allowed to dispense such medication. The drugs, which include stimulants such as Ritalin, Dexedrine, and Cylert, are otherwise locked in the health clinic.

But elsewhere, schools may not be as careful about dispensing medications, a survey of mostly rural central Wisconsin schools suggests.

The lack of strict controls is troubling, the survey researchers say, because the potential for abuse is considerable. In their survey, published last week in the Journal of Developmental and Behavioral Pediatrics, as many as 16 percent of the students taking stimulants for ADHD said classmates had asked them to give away, sell, or trade their drugs.

"The message is, don't have your head in the sand. If you don't think abuse of these drugs is going on at your school, you're probably wrong," said Dr. Frederick W. Theye, one of six study co-authors and a practicing neuropsychologist at the Marshfield Clinic's Medical Research Foundation in Marshfield, Wis.

Stimulants have been used for decades in the treatment of ADHD, a disorder marked by impulsivity and an inability to concentrate. The disability affects an estimated 3 percent to 5 percent of children in the United States.

But large increases in the early 1990s in the production of Ritalin, a trade name for methylphenidate and the most widely used drug for ADHD, led to concerns that the drug was being abused. A handful of high schools and colleges also have reported that some of their students are illegally using the drug as a study aid. ("Experts, Educators Question A.D.D. Diagnoses," Feb. 22, 1995.)

Principals, Students Respond

The Marshfield Clinic researchers surveyed 53 elementary, middle, and high school principals in the rural areas and small towns the clinic serves. They also asked 73 area students who were taking Ritalin as part of a long-term clinic study to fill out anonymous questionnaires. Those students ranged in age from 10 to 21.

Most of the schools--83 percent--had a policy for dispensing prescription drugs at school, the researchers found. But 44 percent of the students and 37 percent of the principals said medications were stored unlocked during school hours. And 10 percent of the schools allowed students to carry around and administer the drugs themselves. Teachers dispensed the medications in a quarter of the schools surveyed.

Only 4 percent of the schools followed Barrington Middle School's practice of requiring a school nurse to administer the medications. Barrington, which was not part of the Marshfield survey, requires students to bring in their medications in the original prescription containers--a routine followed by only half the Wisconsin schools surveyed.

Most of the 12 students who said classmates had asked them for their drugs were age 12 or older. Students were not asked if they had complied.

Only one school administrator reported being aware that ADHD drugs were abused in his school.

While Ritalin is less addictive than some other drugs, the researchers said the findings surprised them. They said the results point up the need for school boards and state legislators to set and enforce policies controlling medication use in schools.

Vol. 17, Issue 41, Page 5

Published in Print: June 24, 1998, as Storage, Dispensing of Medication Varies, Study Says
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