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."