Student Taking Too Many Meds?

Updated on October 25, 2010
S.D. asks from San Antonio, TX
18 answers

I volunteer in the office at a small Christian School. I've gotten to know a lot of kids and their parents. We have a new family at our school this year. I met the student "Ella", before Mom and Dad. She's a sweet girl (8th grade) who would stop in daily to get her inhaler before gym class. I didn't think anything of it.
I met Mom shortly thereafter - she didn't seem "all there". It took her a while to comprehend what I was saying and then her answers were a bit jibberish. Again, didn't think anything of it. She did tell me the Dr. had her on new medications, but didn't elaborate on her condition (which it's none of my business, so I didn't really care).
A couple of weeks ago, Mom was hospitalized overnight. After talking to them, we found out it was a reaction to new meds and the combination of what she's taking.
Since then, Ella has become more and more obessive with medication...She's on painkillers because she has a "muscle condition". She initially brought in chopped up pills in a pill box. She would come in and take 2 - 3 claiming it was really only one pill, but they're cut up because she can't take them whole. Then, she would come back and hour so later and says she was still within the guidelines to take additional meds. I guess an administrator said something because she came in the next day with a prescription pill bottle. Again, she comes in daily to take her medication. But, she takes her bottle with her at the end of the day because that's the only bottle she has?!
Well, then came the 500mg Tylenol (no more prescription meds). She comes in and wants two and her mother authorized the school to distrubute 2 at a time. I don't know anything about meds, but I'm a grown woman and I take 800mg and that's enough for me. This is a small girl...she can't weigh 100lbs.
Well...the other day, she came in and announced "It's been four hours, I can take another dose." I don't know if I should mention this to the administrators. Her mom authorized every 4 - 6 hours. I'm wondering if there is something weird going on here.
Her Mom calls 2 - 3 times a week, concerned that Ella can't participate in PE, will she be able to take water and medicine on the field trip, is there someplace where Ella can sit since she gets so tired after an hour...I mean, the concerns with this child are endless. There is at least one conversation every other week about "side effects" of new pills.
My husband says I can tell the Administrators and just make note of it. He says we should ask what Ella's condition is and get some sort of documentation (there is nothing on her Physical that says she has a debilitating disease). Since we're not governed by the State, I'm not sure what we can and can't do.
Bottom line - Should I say something or leave it alone? Maybe it's none of my business. Ella does well in classes and seems to socialize well (although, my daughter says she's a crybaby).
Any thoughts? If I should stay out of it...I will...I just think it's overly weird...

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J.S.

answers from Houston on

You have every right to be concerned about the health and well being of the child.

Talk to the administrator. If the child needs to be on daily Tylenol then she needs to have a doctor's note stating what her condition is. If she cannot participate in P.E. and has physical limitations then the office should know what is going on with the child. What if this child has a legitimate need to be on pain meds? She could have MS or RA (just two conditions that popped into my head that may require a child to take pain meds). You will never know unless someone asks.

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H.F.

answers from San Antonio on

yes, speak w/the administrator. Even at my son's private preschool, they have medical guidelines that they follow. Everything must be prescribed, doctor's information must be provided and there must be a start/finish date authorization from the doctor.

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D.M.

answers from Houston on

I agree with the other responders that there should be some sort of documentation of how much she's taking and when. That way if there is some issue down the line, you have documentation showing this is what the parent/doc has authorized and this is how much she's taken..

As far as it being too much meds for a little girl... I had major knee issues when I was a kid starting from about 10yo until I starting seeing a wonderful chiro when I was 25. Some days the pain was absolutely dibilitating- I couldn't even move in bed because it hurt so bad! I weighed about 65lbs when I first started having issues and the doc put me on prescription naproxen which ended up being increased to the same dose my 200lb father was taking b/c I have a high tolerance for pain meds- they just don't do me any good! That high of a dosage just barely allowed me to be mobile on those really bad days- it didn't hardly eliminate the pain.

The other times I've been on pain meds- after 2 c-sections and when I broke my leg, the docs were surprised at the dosage needed to control my pain. The pharmacist at one point called the doc to verify the dosage after I'd broken my leg, b/c he was surprised by how often I was taking the pills & having to refill. The doc just kept assuring me it was necessary to keep my BP down along with other issues that come with chronic pain & I didn't ever have an issue with addiction. I actually weaned myself off earlier than the doc expected.

The crying could also be due to the pain- as you said, you don't know her medical history. Personally I turn into a big ball of tears when I'm in pain like that due to not only the pain, but the sleep deprivation & depression that come with it and any little thing can set me off.

Sorry this ended up being so long.. I agree it could look suspicious from the outside looking in, but it's always good to remember there are mulitple sides to a story. You just never know what someone else is going through. If you aren't privy to the information regarding her medical history & need for the meds (privacy laws & all that..), just make sure someone at the school is and it is documented.

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J.T.

answers from Victoria on

you can say something to the school nurse about your being consirned with the random meds. the girl might truly have a muscle problem and if so would you not be consirned if your daughter were in pain with out meds. i know i would make sure that she had everything she neede if out of the school. just tell someone in charge of the meds and let it go. dont dig,pry or stand there and expect an answer. just voice your consiern.

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M.B.

answers from Beaumont on

It is weird. Your school is too loose with it. I am not a school nurse, just a teacher, but I know people can not bring in unmarked pills. They must be in the original prescription bottle specifically for that child with the dosage written on it. Sounds like mom has a drug/mental problem and is projecting it on child.
for ongoing tylenol use the child would also need a written note from dr saying there was some documented injury.
should not be an ongoing illness drama going on.

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M.A.

answers from Houston on

I have worked in a small Christian school and we had only one person in the office who dispensed meds (there was no nurse). She had a filebox and had to write on the child's card the date, time, medication, and dosage given. Such a system could easily alert staff of Ella taking too much medication, if that's the case. I do think you should share your concern with an administrator and perhaps make the suggestion to start such a file on medications given. You're right about not being governed by the state which means something required in public schools could easily be overlooked, but this suggestion is all about the health and safety of the children. I also must comment in M.'s defense- I once had a reaction to a medication which caused confusion and slurred speech, so don't be too quick to jump to conclusions.

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M.D.

answers from Longview on

At minimum I would mention it to the Administrator. Too much Tylenol can cause liver damage. The strengh she is taking would border on a perscription dose for her age. If it is long term (which it sounds like it is) a note from a doctor perscribing that amount might be good to have on file even if it is just for liability. If she is being excused from PE and requiring extra consideration, a physical describing her condition and needs might also be a good thing to have on file. Claiming to needing the doctor's orders and physical describing her condition for school liabity is a good way to "meddle" with out appearing like a meddler. I would be concerned as well if I was in your shoes.

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M.G.

answers from Austin on

The MAXIMUM dosage for Tylenol is 4000mg in a 24 hour period, which equates out to either 650mg {2 regular strength tabs} every 4 hours, or 1000mg {2 extra strength tabs} every six hours. That is the dosing for an adult, and even at the hospital we do not EVER exceed this dosage.

Also, a child should not be giving the guidelines or parameters for medication administration. My 7th grade child has been on prescription medication for years, and knows exactly what she takes, how much, and when, and even then I would NEVER send her to school with meds to administer to herself. The school faces a HUGE liability if they allow her to do this. Any meds should be brought to the school nurse {or office/teacher if you don't have a school nurse} by the parent {NOT the student}, in the original bottle labeled with the student's name, the med, the dosage, and the administration guidelines, along with WHOLE pills, NOT crushed or split in any way. That bottle should remain at school. Also, there should be a log kept of what she takes and when. The administration guidelines on the bottle should never be deviated from in ANY way without a written note from her doctor's office, faxed in {NOT brought in from the parent} from that office. The written guidelines from the med bottle should trump parents' "authorization" every single time. And along with the instructions should come a detailed description of the condition for which she takes these meds in the first place

Even if you are not governed by the state, you will still have to answer to them if something goes wrong with this child {or someone else's child who got hold of the meds} because of a medication issue. Definitely say something to the administrators, and make sure all your ducks are in a row regarding accountability for administering these medications. Then if the mother calls obsessing about the meds, you can just assure her that they are being dispensed according to the doctor's instructions. I'm with you, it does seem very odd that the whole family would be so preoccupied with medications. I hate to make assumptions, but "Munchausen-by-proxy" was the first thing that popped into my head when I read your description of what's been going on. A visit with the doctor's office when the school gets that note might not be a bad idea.

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B.M.

answers from Waco on

I think you should mention your concerns to the school administrators. It sounds like this girl may have some underlying problems (possibly drug addiction?) that need to be addressed. Good luck!

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J.M.

answers from Houston on

If someone at the school is administering meds the school has the right and obligation to call the doctor on the prescription bottle and get clarification as to what the medication is for and how often it should be dispensed especially if she does not have health issues listed in her file. The school needs to be aware of all possibly side effects of the medication as well as any medical health problems to ensure the well being of the student. The school should not be administering any medication regularly without a doctors note. I can understand a Tylenol here or there but not daily by any means without a doctors note with specifics as to what the Tylenol is for. Also, I would most definitely call the doctor to get clarification just to make sure the note is legitimate. It is the school's responsibility to use good judgement and look out for the well being of this child. I am shocked that a school would dispense medication to a child without having any knowledge of an illness, condition, or disease.

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D.N.

answers from Chicago on

I would definitely bring it to the attn of the Admins. When my kids went to a catholic school, there was no school nurse so the office held anything there for the kids if there was anything. They were not allowed to make any dispensing decisions but they did have to have a doctor's order on file. My son has a blood condition, not something that the school would have been able to handle but even so they had to have a letter from the doctor indicating what the issue is and proper treatment if needed. Even for a small Christian school, I would think this should be necessary.

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J.P.

answers from Houston on

Defend the child. You need to make your observances known.

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S.D.

answers from Austin on

Absolutely say something. It could all be legitimate, but there could be a problem, too. It should definitely be brought to someone's attention who can look into it.

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C.B.

answers from Austin on

Is she selling them or giving them to other students? Does she have to take them in front of someone? Also since your daughter has said "she's a crybaby", people tend to be like that if they are on painkillers. It is hard to control your emotions without inhibitions. I would definitely document with the administrator. I would also require the pills come in whole and they can be chopped there for her to take. Does she have to chop the tylenol up? If not I would find that suspect. You can control dosage better that way. Good luck. cb

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R.L.

answers from Houston on

Even though the school is not governed by the state, the Nurse's office or p\Principal should still have guidelines on when and how medication should be administered. To me brining chopped up pills in a pill box would not be acceptable. I would suggest that before medication could be given you would need to get a doctors note and have the original pill bottle or prescriptions bottle. Otherwise if she has a reaction while she is in school the school could be held liable.

I would talk to the administrator and have them consult their legal advisor on this, to me it seems way too dangerous to just be giving out medication.

I've worked in an afterschool program, and my son has allergies so before I could leave benedryl at either school or at the after school program I have to get a note from his doctor with specific instructions on how and when the medication should be used.

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K.P.

answers from Houston on

It is wise to say something as someone needs to come to the defense of the child. There may be a very valid reason for her medication but documentation needs to be provided.
The issue that concerns me is you haven't mentioned any med. that doesn't have acetaminophen (Tylenol) in it. Most pain pills have this as well. Cont. use over extended period of time (especially at high doses) can cause irreversible liver damage.
I would suggest documentation from the phys. that requires the reason, name of drug, dosage, freq. and then the amt. of time it is to be taken. For instance: Reason (whatever it is): Tylenol 500mg 1 tab every six hours for pain for 3 weeks. and you can request a not to exceed in 24 hour period amt. as well. Document what your school gives so if anything should happen, you have proof that you didn't over medicate her. I believe schools normally don't accept scripts that give a choice of amt. on them, either. I may be wrong but I remember not accepting them for church events. They must be in original bottle and in original condition. The bottle must state if the dosage is 1/2 or 1/4 tab. I wouldn't accepts chopped up meds b/c you really don't know what you have. As long as they are whole, there is a number on the prescription pills that you could call CDC to have identify if you were unsure. This is with any pill for any reason. Hope this helps.

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D.B.

answers from Houston on

Your school should have a policy about medication and the necessary documentation. I think it would be totally appropriate for you to alert an administrator about what is happening---there is definitely something a little off, especially if you haven't seen any documentation on this. Too much for a little girl, even that much tylenol everyday is not wise. Who is handing out these meds to her and keeping track? I agree with yoru feeling, something is definitely not right here.

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S.O.

answers from San Antonio on

Good question. I would talk to several administrators. I take it there is no school nurse---it is you, actually. right??
Ask for a meeting with several and talk to them at once. One thing you might want to discuss is YOU no longer giving Ella her meds. I think the situation has gotten to the point where admin. needs to see for themselves how much she is there for meds.
They are paid staff, you are a volunteer. God forbid something were to happen to this child on meds---there is a way different liability factor for volunteers vs. paid staff. Tell admin you will help all the other children, but would feel more comfortable having Ella get meds from one of them and her mom should be dealing with them, too.
This situation is weird. Not your job to be involved in this weirdness---someone else will have to do it.

I know of a family at our high school where the kids are constantly on meds, missing school b/c of meds, etc.... the mom makes a big deal out of it. Even emailing people for prayers b/c "we are trying YET another med for muscle pain....." or whatever. The mom gets a lot of attention from all this .... and it also, is a weird situation.

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