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WEB EXCLUSIVE: School Nurses Take Aim at Prescription Drug Abuse

Monday September 8, 2008
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Peggy McKibbin, RN, BSN, NCSN, didn't think students at her middle school had problems with prescription drugs, but she signed up for the National Association of School Nurses' "Smart Moves, Smart Choices" program anyway. She soon learned her decision was a smart move.

At her school's May kick-off assembly for the national program, a local high school student shared how he had a seizure at school because of an overdose of prescription drugs. A couple of days later, two of her eighth-grade students confided in her that they abused prescription drugs.

"I realized it was a problem," says McKibbin, the school nurse at F. Niel Postlethwait Middle School in Camden, Del.

School nurses nationwide will need to arm themselves with information to combat prescription drug abuse by teenagers. Every day, 2,500 people age 12 to 17 abuse a prescription pain killer for the first time, according to the January 2008 report "Prescription for Danger" by the White House Office of National Drug Control Policy.

"I believe the problem is more rampant than we know," says Kara Erickson, RN, BSN, MS, a school nurse at Shawnee Mission South High School in Overland Park, Kan. "For so long, we have focused on illegal drug abuse, and right under our noses in our own medicine cabinets, we find a new supplier."

School nurses are in a position to help because of the trusting relationship they establish with students, says Amy Garcia, RN, MSN, National Association of School Nurses executive director.

Garcia says because school nurses are in the presence of students every day, students feel comfortable talking with them.

"They tell you everything," McKibbin says. "They tell you things they would never tell their parents."

Nurses, therefore, have the chance to assess whether students are having serious problems that need to be addressed, Garcia says.

The problem

According to the Office of National Drug Control Policy's report, "abuse of prescription drugs among 12 and 13 year olds now exceeds marijuana use, and among 18 to 25 year olds, it has increased 17% during the past three years." The increase is partly to blame on the myth that prescription drugs are not as dangerous as street drugs, the report states.

"Kids think it's safer," Garcia says. "They believe it's not illegal."

Also, prescription drugs — from medicine cabinets in their homes or their friends' homes — can be easier to obtain than illegal drugs, the report states.

The report says abuse of opioids, such as OxyContin and Vicodin, are especially dangerous "because of the large number of users, the high addictive potential, and the potential to induce overdose or death."

Education about prevention

The new school year gives nurses the opportunity to raise awareness about the dangers of teenage prescription drug abuse, and the National Association of School Nurses has compiled materials to help school nurses.

A toolkit of resources assembled by the National Association of School Nurses includes a brochure, by Scholastic and the National Institutes of Health's National Institute on Drug Abuse, that describes the drugs most abused by teens. The list includes —

• Opioids - Used to treat severe pain, these drugs slow breathing and are especially harmful when taken with alcohol.

• Benzodiazepines - These central nervous system depressants, such as Xanax and Valium, are prescribed to treat anxiety. Prolonged abuse can lead to withdrawal and seizures.

• Stimulants - These highly addictive drugs, which include Ritalin and Adderall, are often prescribed for Attention Deficit Hyperactivity Disorder.

• Anabolic Steroids - These types of artificial testosterone, such as Anadrol and Oxandrin, can cause infertility, liver tumors, and cancer.

"Education for students, parents, healthcare professionals, and educators will be our most important tool to address this emerging issue," says Beth Mattey, RN, MSN, NCSN, a nurse at a high school in Wilmington, Del.

The Association's "Smart Moves, Smart Choices" program with PriCara, a division of Ortho-McNeil-Janssen Pharmaceuticals, includes four videos for students, plus a fifth video for parents, the association stated on its Web site, www.nasn.org.

The student videos debunk the myths about prescription drug abuse, explain the science of addiction, portray how the drugs can affect students' lives, and describe how students can analyze media messages about drugs.

Each video comes with lesson plans. For example, the lesson plan accompanying the video about the myths of prescription drug abuse has students identify four misconceptions plus demonstrate a way to provide accurate information about prescription drugs.

The fifth video, aimed at parents, includes an accompanying parent guide.

"Parents may not be aware that they need to lock up medication," says Mattey. "Parents also need to prevent their children's friends and even other family members [such as nieces, nephews and grandchildren] from access to prescription medication."

In some cases, parents give doses of their prescription drugs to their children, which shows the growing need for education on the topic, Mattey says.

The Association also has a toolkit on its Web site with resources for school nurses, students, parents, and community members.

"This isn't an inner-city problem," Garcia says. "It's a problem across families, across socio-economic status."

Karen Long is a freelance writer. To comment, e-mail editorNTL@gannetthg.com.