Marijuana and type 2 Diabetic / school nursing

classicdame, MSN, EdD · Mar 20, 2015

the obvious risk is that he will not be compliant and go into DKA, have a stroke or simply die. Clear enough. are you allowed to contact the parents? Other than that, I would document the times you requested to get his blood sugar tested in the office, his general affect, pupil size, etc. No judgements. Just facts. You probably will have little authority, just lots of responsibility! what a shame.

TakeTwoAspirin, MSN, RN, APRN · Mar 20, 2015

How old is this student? Are we talking high school or college? Why can't you test? If he is underage your responsibility is much greater than if this is an adult making their own decisions.

allnurses Guide · Mar 20, 2015

Hello.

You might want to move this to the School Nurse Forum.

https://allnurses.com/school-nurses/

Jules A, MSN · Mar 20, 2015

If underage I would definitely discuss with parents and regardless of his age educate him ad nauseam on the risks of marijuana use and document that you have done all the above. I'm surprised schools can't pee test for suspected drug use.

happyinmyheart · Mar 20, 2015

Just my two cents, but at my old high school we had drug testing. However, it had to be completely random- You couldn't single out a student that you wanted to be tested. I'm not sure if that's just how it works in my state, or if it's school specific. Perhaps the school OP works at has the same rule?

Editorial Team / Admin · Mar 20, 2015

Thread moved to School Nurses forum.

NutmeggeRN, BSN · Mar 20, 2015

Ha! The ACLU gets all over that, let alone the parents!!!

Farawyn · Mar 20, 2015

I have a student who is suspected to be using marijuana on a regular basis ( we cant test him) he is also incredibly non compliant with his diabetic regiment -does not come to the office to check his BS etc.
The psychologist here is very concerned about the interaction btw his marijuana use and his diabetes- the studies I see say it can cause the "munchies" and that it decrease waist circumference etc
what educational tools do you use for those suspected of using marijuana and have diabetes?
what are the risks??

Are you a school nurse? Because, if so, you know the risks.

What to do about it depends from school to school and state to state. We don't do drug testing here, either.

I would have to let the AP know about suspected illegal drug use and have them follow up in a disciplinary way, have to inform the SW or Pysch about it for social/emotional reasons and have to document document document my findings as the School Nurse.

Jules A, MSN · Mar 20, 2015

Ha! The ACLU gets all over that, let alone the parents!!!

Unbelievable but I guess a sign of the times. When I was underage and living in my parents home I had NO rights implied or otherwise. If the school contacted them with this concern they would have had me peeing in a cup so fast my head would have been spinning.

SnowyJ, RN · Mar 20, 2015

How old is the student? If underage, I would consider involving CPS because he may not be compliant at home either and that could constitute medical neglect on the part of the parents.

MollyJ · Mar 20, 2015

In the state I live in we use a drug recognition protocol that is based on field sobriety tests. I think the results are iffy at best. I also believe that in our community parents can request from the sheriff's office a drug screening kit for urine that they read themselves.

I will tell you that I am not necessarily for schools having the right to test kids.

You know when we do tests in a clinical setting we do it to facilitate decision making, clinical decision making. I don't think schools are the best people to test kids. The "zero tolerance" policy means the kid may get expelled and that might not be the best thing for him. It also may simply generate too much resistance on the part of the students and the parent.

I do not like our drug recognition protocol but it forces a discussion between child, parent and principal. That can create some movement in the situation especially if it can be connected to things the parent worries about with their child and things the child sees in his life that are signs that his/her usage is problematic. But it may not and you cannot make it so.

I would say that I would _try_ to improve my relationship with the student. Let's face it, who among us would want to be a teen diabetic? And if someone here was one, then pipe up. The age of this student matters a great deal. I am guessing that we are talking about a High School age child. I would work to just get him to test more often and help him do problem solving but acknowledge he is in the driver's seat. It is not easier but it is more effective to confront a kiddo about drug concerns if you have a relationship with him.

I think at least sometimes marijuana is a (mal-adaptive) stress coping mechanism. As you build relationship you can talk with your kid about diabetes and stress and stress management.

Also another question is, "do you have an SRO in your building?" If you do, you, the principal and the psychologist should know what the protocol is for confronting a student that you think may be acutely intoxicated.