This Weeks' Topic

School Medication

Every parent worries about illegal drugs in schools. Prescription and even over-the-counter drugs can be a cause for concern as well. With the number of children on medications increasing, and the number of school nurses per student decreasing, students might not be getting enough medical supervision during the school day.

Legal medications in school - How many children are on prescription drugs?

According to the Centers for Disease Control and Prevention, in 2003 more than nine million children in the U.S. used prescription drugs within the last three months.

That's 13 percent of the children in the country. At the same time, the number of school nurses per student has declined to about one nurse for every 1,300 students.

Is it illegal for children to take their medication themselves?

Children carrying and self-administering their own prescription, or even over-the-counter drugs, violates policies in many school districts, and it can also violate state and local laws, depending on the drug involved.

Many of these policies were written under the doctrine of zero-tolerance, which lead to extremes where children were expelled for carrying aspirin. Policies are being reworked now in light of cases like that, as well as a few tragic cases where a child had an emergency of some kind and school officials were not able to administer the medication in time. 

So it isn't always a great idea to keep children's medications under lock and key?

It depends on the medication. Some prescription drugs can be abused or can be dangerous if not taken carefully. Ritalin, for example, should be carefully controlled. However, a 5th grader in California died from an asthma attack because school officials could not find and assemble his inhaler in time. The child's mother was awarded more than $2 million dollars in a subsequent lawsuit. Now, California and other states, including Missouri, have laws that allow children to carry their asthma inhalers and use them as needed. But a doctor's note is required.

A federal law was also passed that allows inhalers to be self-administered, and gives preference to states with their own inhaler laws when it comes to respiratory health grants.

What are the specifics of Missouri's inhaler law?

The parents have to provide school administrators with written authorization that explains the nature of the medication and the child's respiratory illness. The school board also needs written authorization from the child's physician. The parents are also required to accept that the school and the state have no liability, except in the case of negligence, if the child suffers some injury due to self-administering his or her medication. A duplicate prescription may be required to be kept by the school nurse. All of these authorizations must be renewed each school year.

What happens if a medication does have to be administered by a school official?

The ideal situation is that the school nurse, who is highly trained, administers each dose and documents it. Unfortunately, in many schools a nurse is not available every day. In some cases health aides, secretaries or other officials are giving out the medications.

This is obviously a problem, because people who are not medically trained are involved in medicating your child. Worse, the person giving the medication might not be the same person from day to day.

This can easily lead to errors such as missed doses or even overdoses. Schools can be vulnerable to liability claims in these cases.

How can schools make the medication process as safe as possible if a nurse isn't always available?

• Make sure specific staff members are designated to administer medications.
• Thoroughly train staff members to administer each medication.
• Write a clear policy on prescription and over-the-counter drug use, and make it available to parents.
• Carefully document every dose of every drug that is given out in school.
• Keep medications secure. 

Is there somewhere that school officials who are not medically trained can get help writing these policies? 

The Center for Health and Health Care in Schools has written a paper called "A Systems Approach to Reducing Risk and Strengthening Quality in School Medication Management." This paper outlines many of the procedures schools should be following. The Center provides other helpful information for school officials as well as this paper at their website www.healthinschools.org/home.asp.

Disclaimer
This information is general and may or may not apply to your situation. The information contained on this web site is not to be considered as legal advice. Since no two cases are identical, we recommend that you contact an attorney in your jurisdiction to discuss the specific facts of your case. Furthermore, since statutes and case law change so frequently and due to information provided by other sources, we make no warranty or guarantee concerning the accuracy of the content of this or any other web sites to which we link.