Pubdate: Fri, 26 Jan 2001
Source: Inquirer (PA)
Copyright: 2001 Philadelphia Newspapers Inc
Contact:  400 N. Broad Street, Philadelphia, PA 19101
Website: http://inq.philly.com/content/inquirer/home/
Forum: http://interactive.phillynews.com/talk-show/
Author: Matthew P. Blanchard, Inquirer Suburban Staff

PRESENCE OF RITALIN PLACES SCHOOL NURSES IN A BIND

They Often Cannot Secure The Storage Boxes. Some Students Sell The Drug, 
Used As Speed By Older Children.

When Avis Anderson became a school nurse in 1983, she kept students' 
prescription drugs in a shoe box. They were mostly antibiotics.

Since then, Anderson has seen the amount of drugs she must dispense to her 
students at Neil Armstrong Middle School in Bristol Township, Bucks County, 
balloon to fill two large, locked cabinets.

The growth is mostly in drugs such as Ritalin - a controlled substance 
meant to treat hyperactivity and attention-deficit disorder but commonly 
crushed and snorted by students to achieve a speedlike high.

Suddenly in possession of a valuable and potentially dangerous stash of 
street drugs, nurses such as Anderson say they are facing a double-barreled 
challenge.

First, their wooden desks and flimsy metal cabinets cannot stop a 
determined thief. In Warminster last Friday night, an 18-year-old junior 
allegedly made off with 300 to 400 pills of Ritalin and other drugs after 
tampering with locks in the nurse's office at William Tennent High School. 
The student, David LaSalle, was arrested Wednesday and imprisoned under 
$75,000 bond, but police still have not tracked down the hundreds of 
missing pills.

"He may have sold them already," Police Chief James Gorczynski said.

A similar thief hit Westtown-Thornbury Elementary School in Chester County 
on Dec. 22, smashing through a window to get the drug. Another break-in and 
theft of Ritalin were reported in the spring at Quarry Hill Elementary 
School in Lower Makefield, Bucks County.

Second, Anderson - also president of the Pennsylvania Association of School 
Nurses and Practitioners - complains that some schools, flooded with pill 
bottles, are forced to use unlicensed clerks to dispense powerful drugs.

"These people have no formal training. They don't know what the dosages 
are, they don't know how to look for harmful side effects," she said. "This 
is a violation of state nursing law, which demands that only licensed 
medical people distribute stuff like this."

Illicit users of Ritalin say the drug has been widely available to young 
children for years.

"You take it from your younger sister or brother - who maybe has a legit 
prescription - and you sell it to your friends," said a 22-year-old 
Philadelphia woman who first popped Ritalin at age 16 at Upper Darby High 
School.

She got her Ritalin from a neighborhood 12-year-old, who had his own 
interest in the transaction.

"What's the little kid going to say?" she said. "He'd say, 'OK, take it. 
Just make sure you get me some acid for the weekend.' "

Adam, a 28-year-old musician living in Philadelphia, said he easily scores 
Ritalin when playing shows on college campuses.

"Twenty bucks will get you ten 20-milligram pills," he said, examining a 
bottle that had been prescribed to a friend. "It's so cheap. So these 
college kids just have these Ritalin freak-outs. They can study longer. 
They can drink longer."

Most Ritalin apparently reaches the black market by children passing it out 
to their friends. And schools, charged with the responsibility of 
dispensing the drug, are trying different tactics to plug any leaks in the 
system.

At William Tennent, authorities identified LaSalle as the alleged Ritalin 
thief by videotape taken from a camera mounted in an outside hallway.

In Montgomery County, the Souderton Area School District has installed 
motion detectors to trigger an alarm if someone enters the nurse's office 
after hours, said Robin Fox, nursing coordinator for the district.

"We have been aware for many years that Ritalin has become a street drug," 
Fox said. "All medications are kept under lock and key."

In Medford, N.J., Shawnee High School nurse Debbie Canale said several 
prescription drug thefts at nearby schools have put her on alert.

Canale makes sure to watch students actually swallowing their pills.

"They can be very good at putting it on the side of the mouth and then 
selling it when they get out in the hall," she said.

Schools around the region report buying sturdier drug storage boxes or 
moving pill bottles into locked closets. Most schools will not accept pills 
delivered to the school by children, demanding instead that parents meet 
with the nurse.

But inherent dangers remain in the way many schools dispense pills to 
children, said Anderson, whose organization represents about 800 school 
nurses in Pennsylvania.

"In some schools, I know we've got secretaries handing out these pills," 
Anderson said. "These are complex treatments. Someone's got to be there to 
look for harmful side effects. By the state Nursing Practice Act, it's got 
to be a licensed person."

State law sets a minimum ratio of one school nurse to every 1,500 children. 
In many districts, Anderson says nurses are stretched among three or four 
buildings and cannot possibly administer every pill to every student. So 
districts rely on unlicensed assistants - at lower wages - to actually 
deliver medications.

In schools and group homes, untrained people administer controlled 
substances, said Jessie Rohner, executive director of the Pennsylvania 
State Nursing Association.

"If you look at the Nurse Practice Act, they should not be doing it," she 
said. "It's illegal."

Concern over schools' prescription-drug delivery has reached the 
Pennsylvania Department of Health, which last year began tracking the 
amount and type of legal drugs entering school buildings.

The first data should be ready in a few months, said department spokesman 
Richard McGarvey.

"Quite frankly, we're worried about this ourselves," he said.

But for school districts, the problems of medicating students should not 
have to be solved by hiring more nurses, said Tom Gentzel of the 
Pennsylvania School Boards Association.

Nurses are too expensive, Gentzel said, and in most cases, unnecessary.

"We absolutely respect nurses and their training," Gentzel said. "But you 
can make a pretty strong argument that it dosn't have to be a certified 
school nurse dispensing that pill. This is not an issue of evaluating the 
child's condition. It is [about] following doctors' orders."
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