Suspected Drug Use

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Hi There!

Looking to get some insight from High school School Nurses and any nurses with drug abuse assessment experience. With the recent news of students bringing drugs to school (Google Naperville North high school), I was wondering how you all are assessing students for possible drug use. The news reports that the students consumed candies laced with drugs. Other than assessing their vital signs, what else do you assess on a student who is suspected to be under the influence?

Thank in advance

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Specializes in Home Health,Dialysis, MDS, School Nurse.

I am literally from small town USA, so have never had to deal with this and *knock on wood* won't have to, but I guess if I had a student brought to me under suspicion, besides vitals, I would asses pupil size and reaction, general mood - agitated, euphoric, etc., asses if behavior/attitude/manner of speaking was per normal for him. We have a police officer and drug dog in the area that we could have in the school fairly quickly. I'm sure others have more experience!

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We have a Substance Abuse Form that is completed when Admin tells us to check them for this. The form includes witnesses, medical history, medications they're taking, checking their pupils for size and reaction in light and darkness, gait, behavior, odd odors, tongue inspection, general appearance, speech, mental status, student comments, summary of abnormalities, nurse signature and date. We also have a second form that is for the person to state briefly what they saw that caused them to contact the administrators. We get a copy of both and the original ones goes to the principal.

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Specializes in Complex pedi to LTC/SA & now a manager.

They test any student grade 7-12 who falls asleep. Always interesting when a kid actually has narcolepsy. Fortunately the nurses have the authority to use discretion. They have a screener (bed time? Ate breakfast/lunch? What was going on in class..darkened room with movie, or bright lights for a science experiment.) then an algorithm for suspected drugs of abuse use (personally, physical appearance, mental state, vitals, pupils). They can do a seven panel screen in the nurses office (only athletes are subject to random drug and steroid check right now. But the county is looking for a county wide policy for random checks with the increased overdoses & issues lately).

the nurses were also all given narcan by the county prosecutor for staff student or visitor use at no cost. (County will replenish).

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We use a drug abuse screening form. I can send it to you if you'd like. Luckily, I've not had to do this at the elementary level, yet!

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Specializes in school nursing, ortho, trauma.

I haven't had to deal with this in quite a while (big knock on wood here) but i have a form that runs through things like coordination, neuro checks, overall appearance and affect, as well as vitals. Basically I feel like I'm just making the call as to whether or not they're safe. Not a definitive of high or not. I have worked in places where we have collected urine samples before. That was a bigger ordeal and i am happy i don't have to do that here.

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They test any student grade 7-12 who falls asleep. Always interesting when a kid actually has narcolepsy. Fortunately the nurses have the authority to use discretion. They have a screener (bed time? Ate breakfast/lunch? What was going on in class..darkened room with movie, or bright lights for a science experiment.) then an algorithm for suspected drugs of abuse use (personally, physical appearance, mental state, vitals, pupils). They can do a seven panel screen in the nurses office (only athletes are subject to random drug and steroid check right now. But the county is looking for a county wide policy for random checks with the increased overdoses & issues lately).

the nurses were also all given narcan by the county prosecutor for staff student or visitor use at no cost. (County will replenish).

Seriously.

Any kid that falls asleep?

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Specializes in Pediatrics, Community Health, School Health.

My students are only in K and first grades, but let me tell you there have been MANY dads that have shown up to school reeking of pot and clearly under the influence of other stuff. Really sad :(

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Specializes in Complex pedi to LTC/SA & now a manager.
Seriously.

Any kid that falls asleep?

The teachers must send to or call the nurse. Nurse uses her judgement. Sadly 3 narcan uses in schools this academic year.

They don't want to miss the kid that's "sleeping" because of respiratory depression due to opiates. The one school is called "Heroin High" issues are so rampant. They'd rather have the nurse call than miss a kid that could have been saved. At least it's the nurse'/ decision what to do next not teacher, coach, or administrator as it's considered a medical/nursing decision.

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Specializes in School nursing.

In MA, all schools will be required to add SBIRT screenings to the usual screenings. (More info about SBIRT here.) I did an online training and an in-person training at the end of last school year - very interesting, but need to find time to do it. I do all my screenings by myself.

But that is hopefully to prevent and also identify students at risk/using. As for being brought an actual student suspected of being under the influence at school, I do similar assessments like the above posters described. I do not have any actual to actual drug testing at my school.

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Specializes in kids.
The teachers must send to or call the nurse. Nurse uses her judgement. Sadly 3 narcan uses in schools this academic year.

They don't want to miss the kid that's "sleeping" because of respiratory depression due to opiates. The one school is called "Heroin High" issues are so rampant. They'd rather have the nurse call than miss a kid that could have been saved. At least it's the nurse'/ decision what to do next not teacher, coach, or administrator as it's considered a medical/nursing decision.

Yikes!!!

Can't even get our school board on board for Narcan...

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Thank you everyone for your responses. If you have screening forms please post them. I would greatly appreciate it.

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