Legal Drugs Pose Dilemma

By Jessica L. Tonn — December 06, 2005 8 min read
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When Rachel Warrick, a 15-year-old sophomore at Chancellor High School in Fredericksburg, Va., learned that the local sheriff’s office would be conducting a drug search at her school two years ago this month, she didn’t think anything of it. The honor student had never been in trouble at school before, and she let the drug dogs sniff her backpack.

A few hours later, Ms. Warrick, now a senior, was suspended for five days because her bag contained two Tylenol tablets. She had violated the 23,000-student Spotsylvania County schools’ ban on student possession of any over-the-counter or prescription drug, “even if recommended or prescribed for the student’s use.”

Possession of illegal drugs by students gets more headlines and elicits more concern, but schools also are grappling with what, if any, place common drugstore remedies have on campus.


Some experts say abuse of over-the-counter medications by teenagers is a growing problem that calls for outright bans like the one in Ms. Warrick’s Virginia district. But a number of policymakers believe that schools can set reasonable ground rules that allow safe use of nonprescription drugs.

Differences in policies around the country reflect the debate.

For example, if Ms. Warrick were enrolled in any grade from 6th through 12th in the 3,000-student Rice Lake, Wis., school district, she could carry and self-administer a single dose of an over-the-counter drug with the permission of a parent, as long as the drug was in the original labeled retail container.

If she were attending school in New York state, guidelines recommend that she would be able to get medication, whether prescription or nonprescription, only from a registered school nurse. The state education department there recommends that schools not stock over-the-counter medications, and says that a parent should supply the school with any drug, accompanied by a written statement from both the parent and a physician, that a child needs.

Advocates of strict policies point to recent statistics about the abuse of over-the-counter medications.

According to a national survey of 7,300 students in grades 7-12 conducted by the New York City-based Partnership for a Drug-Free America last April, 9 percent of adolescents admitted to having taken over-the-counter cough medicines to get high, the same percentage who said they had used cocaine, crack, or Ecstasy. Six percent of the respondents said they had used LSD, and 4 percent said they had used heroin. This is the first time in the 17-year history of the survey that it gathered data about adolescent abuse of over-the-counter drugs.

Taking over-the-counter drugs to get high is “the new rush,” said Sgt. Christopher Goodyear of the Clarkstown police department in Rockland County, N.Y., who has seen abuse of legal drugs in many of the schools in his police district.

Other communities are seeing similar trends.

Last week, for example, four sophomores at the 3,700-student Carl Sandburg High School in Orland Park, Ill., overdosed on NoDoz pills, a caffeinated product used to stay alert. The three girls and one boy were treated and released from two local hospitals, according to Jim Sibley, a spokesman for District 230, which includes Carl Sandburg High.


Despite strict rules against possession of medications, some students still bring them to school, sometimes with dangerous consequences.

In March 2004, four girls at A. MacArthur Barr Middle School in Nanuet, N.Y., had to go to the hospital after overdosing on Robitussin cough tablets, a form of getting high known as “robo-tripping.” The students, who were found in a restroom at the school, were lethargic and had dilated pupils at the time they were discovered. One later admitted to taking 20 of the pills, and another admitted to taking eight, according to Sgt. Goodyear, whose police district includes the middle school.

School Medication Rules

State and district policies on student possession of over-the-counter medications at school vary widely.

Minnesota: A student in grades 7-12 may possess and use nonprescription pain relievers if the district has received a written authorization from the student’s parents permitting him or her to self-administer the medication.

New York State: Guidelines recommend that a student should get medication, both prescription and nonprescription, only from a registered school nurse. The state education department recommends that schools not stock over-the-counter medications, and that a parent should supply the school with any medication, accompanied by a written statement from both the parent and a physician, the child needs.

Leon County Public Schools, Tallahassee, Fla.: A student does not need a note from a physician for the first five days’ administration of over-the-counter medicine by school health personnel, as long as the student’s parents have completed medication-permission forms.

Rice Lake Area School District, Rice Lake, Wis.: A student in grades 6-12 may carry a single dose of an over-the-counter drug with the permission of a parent, as long as the drug is in the original labeled retail container.

Spotsylvania County Schools, Fredericksburg, Va.: No student may have in his or her possession any over-the-counter medication, even if recommended or prescribed for the student’s use.

Wichita Public Schools, Wichita, Kan.: A student may carry a single day’s supply of an over-the-counter medication, as long as he or she has a physician’s order, written parental permission, and a self-administration form completed by the school nurse and the student’s parents. All medication must be in its original container, and labeled with the student’s name and the dosage.

SOURCE: Education Week

The product’s label recommends that adults and children over the age of 12 “take 2 capsules every 6 to 8 hours, as needed,” and “do not take more than 8 capsules in any 24-hour period.”

Officials of the 2,200-student Nanuet Union Free School District, which prohibits students from carrying over-the-counter drugs on campus, would not comment on what, if any, disciplinary measures were taken against the girls.

But not every student who carries over-the-counter drugs uses them to get high, emphasized Ms. Warrick, the Virginia student.

“I know tons of girls who carry Tylenol,” she said. The drug is a brand name for acetaminophen, an alternative to aspirin for relieving common aches, pains, and fever.

Karen Klinzing, a Republican state representative in Minnesota who was a high school teacher for 15 years and is also a parent, echoed Ms. Warrick.

“Kids are taking [Tylenol] anyway” for legitimate purposes, she said. “They take it behind teachers’ backs, behind nurses’ backs. I saw it happen all the time.”

In light of that reality, Rep. Klinzing co-sponsored a bill, enacted in August, that allows Minnesota secondary school students—which the state defines as 7th through 12th graders—to “possess and use nonprescription pain relief in a manner consistent with the labeling, if the district has received a written authorization from the student’s parent or guardian permitting the student to self-administer the medication.”

State Law Debated

Although the National Association of School Nurses, based in Castle Rock, Colo., defers to state laws on the matter, many school health-care professionals nationwide disagree with the new Minnesota law.

Many worry that students will share medicine, which can lead to overdosing and allergic reactions, or that they will carry unlabeled pills. Some health-care providers also note that over-the-counter drugs are not “rescue” remedies that need to be used immediately in an emergency, such as asthma inhalers or the epinephrine pens used to treat severe allergic reactions.

“I don’t think it’s a good idea,” Dr. Howard L. Taras, a pediatrician and a school physician in San Diego and Los Angeles counties, said about the Minnesota law. “I think schools should know what’s going on.”

For example, he said, if a young woman experiences severe menstrual pain every month, he recommends that she go to a doctor to be checked out for a possibly serious condition.

“If a child is in so much pain that they need to take pain relievers all the time, then they have a problem that needs to be looked into,” he said.

If the doctor determines that a girl’s cramps are merely cramps, Dr. Taras said, he or she can give the student a note to bring to school, allowing her to carry a pain reliever on campus. With the proper documentation from a physician, Dr. Taras said, the school will know which students are carrying medications, and what they are carrying.

Minnesota state Sen. Mady Reiter, a Republican who was a co-sponsor of the bill, said that students’ menstrual pain prompted the legislation. A group of high school girls approached her, she said, because they wanted to carry nonprescription pain pills at school for their cramps.

“[The girls] found that they had to wait in long lines at the nurse’s station because there were so many students waiting for meds, and the boys would crowd around trying to see what the girls were doing,” Sen. Reiter said.

But Dr. Barbara L. Frankowski, who chairs the executive committee of the American Academy of Pediatrics’ council on school health, said that allowing students to freely carry nonprescription pain relievers isn’t the right solution to an administrative problem.

“If access to the nurse’s office is the problem, then hire a nurse’s aide, or address the issue another way,” she said.

Dr. Frankowski also stressed that meeting with a school nurse can be a learning experience for many students.

“Most school nurses don’t just give out Tylenol,” she said. Nurses conduct health assessments of students, she said, and when students come in with headaches, for example, nurses will ask them questions such as if they ate breakfast, if they slept well, or if they are having problems at home, before letting them take a pill.

“There are problem-solving skills that kids miss out on if they don’t visit the nurse’s office,” she said.

Rep. Klinzing, the former teacher, however, argues that sending students to the nurse’s office causes unwarranted disruptions in class time. She said that secondary school students should be treated as young adults, and as such, should be taught how to behave responsibly, including how to use over-the-counter medications properly.

“There are plenty of laws that allow teenagers to get abortions without parental consent, but they can’t carry Tylenol in schools,” she said. “I think it’s quite an incongruity.”

District Changes Procedure

As for Ms. Warrick, the Spotsylvania County, Va., student who was suspended, her record has since been expunged. Donald Alvey, the director of secondary education for the district, said he considers the 17-year-old a “fine student.”

After the December 2003 incident, the high school’s principal told her father, Bill Warrick, that the drug-sniffing dogs weren’t attracted to her bag because of the Tylenol, but because the bag also contained a peanut-butter sandwich, according to a letter Mr. Warrick sent to the school board.

Though students in Spotsylvania County schools still are not allowed to carry any type of medication, Mr. Alvey noted that the policy has changed internally since Ms. Warrick’s suspension. Now, principals are instructed to call the superintendent before suspending a student over violating the medication policy.

In October, for example, a student whose aunt is a school bus driver found a bottle of her prescription medication that she had left on the bus. When district officials discovered the bottle on the student, he was not punished because his obvious intention was to give the pills back to his aunt, Mr. Alvey said.

Ms. Warrick acknowledges that she knew about the ban on possessing medication before she slipped the Tylenol into her bag, but she wishes that officials had followed such a procedure in her case.

“I understand that it was a rule that I broke, and that I should be punished,” she said, “but I think that there should have been some judgment used.”

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