Researchers have discovered wide variations in rules and enforcement procedures in schools that they say pose a potential for abuse of Ritalin and other prescribed stimulant medication taken by children with attention deficit hyperactivity disorder (ADHD).
Cynthia Musser and colleagues at the Marshfield (Wisc.) Clinic's Medical Research Foundation, surveyed 53 school principals in rural areas and small towns in central Wisconsin, then anonymously surveyed 73 schoolchildren in rural sections of central Wisconsin and northern Michigan who had been prescribed methylphenidate (Ritalin) at least five years.
They found that some schools store the medications unlocked. Some students carry their medication with them. Sixteen percent of the children said they had been asked to sell, give, or trade their medication to others. Yet, both school principals and students said they saw no problems of medication abuse. Study findings are published in the June issue of the Journal of Developmental and Behavioral Pediatrics.
"The potential for abuse exists...with 16 percent (of the students) having been asked to either sell, give, or trade their stimulant medication," the researchers write. "Although the survey did not address whether the children had actually given, sold, or traded their medication, it is possible that some of them did, given the significance of peer pressure. The potential for unauthorized access or theft also exists at all grade levels."
Most schools, they report, keep medication in a locked cabinet in a central location. Most students either carry their own medication or store it in a school office, nurse's office, or principal's office.
The researchers recommend that states and schools adopt and enforce policies regarding the use and dispensing of medication, and that school administrators, teachers, health care providers, and affected families all be consulted to develop such policies.
"It is incumbent on the physician to educate parent and child regarding the appropriate use, as well as the potential for abuse of these drugs," Musser and her colleagues write. "Monitoring prescription usage, periodic follow-up..., and continuing education of parents, teaching staff, and child should all be part of a multimodal treatment plan for (ADHD)."
Findings are limited because the students completed their surveys at home and may have been influenced by parents. The researchers also note that results from a largely rural population might not be the same as for other geographic areas where diagnosis and treatment approaches might differ.
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