When we think of drugs in school, we might first think of groups of slackers standing in dimly-lit alleys, wafting green-tinged smoke and debating whether Yoshi is the name of the creature or the name of its species. Some drug use, like pot smoking, may be identified through behavioural markers or particular smells, but over-the-counter pill usage does not fall into easily recognized characteristics. In fact, the problem with pills is that they can be shared and consumed quite literally in plain view of educators and administrators. It is widely known that students are being medicated, for a variety of conditions, more often now than when we were in school (Netemeyer, Burton, Delaney, & Hijjawi, 2015). What is less known how the proliferation of prescription pills has fueled a market for easy access in our schools.
Prescription pill use is a problem. One in 20 Canadian students in grades 7-12 admit to abusing prescription drugs. It sits as the third most commonly abused substance, tied with synthetic cannabinoids, and only behind cannabis, 17%, and alcohol, 40% (Government of Canada, 2017). Students are aware, that where some medications can be used to help students focus, reduce anxiety, or combat depression, they can also be abused to “get high.”
Here’s the problem: students don’t always take the pills that they are supposed to take. In fact, medications are more commonly discontinued abruptly by adolescents than adults, and often without the student notifying their parents or prescribing physicians (Hosenbocus & Chahal, 2011). Students may not tell their parents or trusted adults when they discontinue their prescribed medications (such as selective serotonin reuptake inhibitors, norepinephrine reuptake inhibitors and psychostimulants) because they don’t always like how the drugs make them feel. These adverse physiological or psychological effects (Charach & Fernandez, 2013; Lars Vedel, Hanne Vibe, Koen, & Per, 2005) may be difficult for adolescents to understand and describe. When students do not take their medication, the daily doses from parents can begin to stockpile in lockers.
Motivated either by a desire to get rid of the evidence or by some entrepreneurial spirit, students can sell pills quite discretely at school. The process of selling, trading, or sharing pills is known as diversion (Elliott, Souder, Privette, & Richardson, 2008, p. 19). Diverted pills can ingested, but can also be crushed and snorted to quicken the effects. Students are not as aware of the dangers of prescription drug use as they are of the dangers of illicit drug use (Netemeyer et al., 2015). Abuse of these psychotherapeutic drugs, in their many forms, can lead to respiratory depression, comas, apnea or death. Therefore, this increase in abuse by adolescents is an obvious concern for schools and school administrators.
In my own experience as a high school administrator this can lead to difficult questions. For example, how can administrators justify responding to pill use without evidence? Unlike students who are abusing marijuana and alcohol, students abusing a focusing medication can come up with plausible and detailed explanations during an unwanted trip to the office. What if the parents side with their student? Additionally, how does one responsibly allow that student to return to class, or even worse travel home, or drive, at the end of the day if intoxication, or an overdose, could be a concern?
The pills are small and can be easily hidden and distributed. It can even happen within classrooms, as students are aware that these pills can fit inside of pens: a student, the customer, asks to borrow a pen; the distributer asks for $5 for the pen, maybe even claiming it will be returned with the return of the pen at the end of the day, the actual exchange takes place within the classroom directly in front of the teacher. In my own experience, I have found pills hidden inside of pens, hidden in the base of reusable coffee mugs and water bottles, and a hair brush. All objects that can be readily and openly passed between students.
The reality of prescription pill abuse in schools can be daunting, but what can we do?
First, be diligent! When searching students and lockers, be assiduous when examining artifacts, however mundane and school related. Pills are small and easy to hide.
Second, be a safe place! If students felt more comfortable talking to their parents about discontinuing their prescriptions, pills wouldn’t be available for diversion in schools. It is important that there is someone at the school who is a safe place for students to share their anxieties and hesitations around drug protocols. Third, be informative! While prescription pills can be extremely helpful for students who need them, those same pills can be dangerous for someone without a prescription. Students may not realize that recreational pill popping can lead to drops in dopamine levels, especially when combined with alcohol.References
Charach, A., & Fernandez, R. (2013). Enhancing ADHD medication adherence: Challenges and opportunities. Current Psychiatry Reports, 15(7), 371. doi:10.1007/s11920-013-0371-6
Elliott, E. T., Souder, C. A., Privette, T., & Richardson, W. H. (2008). Teen prescription drug abuse. Clinician Reviews, 18(11), 18-23.
Government of Canada. (2017). About problematic prescription drug use. Retrieved from: https://www.canada.ca/en/health-canada/services/substance-abuse/prescription-drug-abuse/about-prescription-drug-abuse.html
Hosenbocus, S., & Chahal, R. (2011). SSRIs and SNRIs: A review of the discontinuation syndrome in children and adolescents. Journal of the Canadian Academy of Child & Adolescent Psychiatry, 20(1), 60-67.
Lars Vedel, K., Hanne Vibe, H., Koen, D., & Per, B. (2005). Depressive and bipolar disorders: patients’ attitudes and beliefs towards depression and antidepressants. Psychological Medicine, 35(8), 1205-1213. doi:10.1017/S0033291705004605
Netemeyer, R., Burton, S., Delaney, B., & Hijjawi, G. (2015). The legal high: Factors affecting young consumers’ risk perceptions and abuse of prescription drugs. Journal of Public Policy & Marketing, 34(1), 103-118. doi:10.1509/jppm.14.073