When two Texas middle school students shared a quick-relief albuterol inhaler earlier this month, it sparked a debate on whether it’s appropriate for asthma patients to share inhalers as well as how schools should handle similar situations.
The students had unknowingly violated a school policy that prohibited sharing prescription medications such as inhalers and both were suspended from school.
David Stukus, MD, a pediatric allergist and immunologist at Nationwide Children’s Hospital in Columbus, Ohio, and Sally Schoessler, RN, Director of Education for Allergy & Asthma Network and a former school nurse, recently weighed in on the topic.
Q: From a medical perspective, is it ever appropriate to share an albuterol inhaler?
Dr. Stukus: Albuterol delivered through an inhaler is unlikely to cause any significant side effects whether administered to someone who does not need it or accidentally given in doses higher than recommended.
While it is never ‘appropriate’ to share prescription medication, many people can prevent worsened asthma symptoms and an emergency department visit just by receiving a few puffs of albuterol at the onset of symptoms. In this situation, the benefit from sharing albuterol far outweighs any potential harm.
Q: How can schools address the issue of sharing inhalers?
Sally Schoessler: We want students to care about each other, and in the case of a student seeing a friend in distress, the sharing of inhalers may actually save a life – while also conflicting with school policy.
It would be best for the student with the inhaler to get the attention of the nearest adult immediately and explain the situation. Whenever possible, the teacher could get the affected student to the school nurse for treatment.
But life doesn’t always work according to plan. Sometimes asthma becomes severe very quickly.
Schools should consider educating staff about asthma signs and symptoms and how to respond when a student is experiencing an asthma episode. Schools should also teach students about school policies and how to get help in an emergency.
Q: Is there an alternative to sharing inhalers?
Dr. Stukus: I believe stock albuterol legislation should be mandatory in every state. Asthma is the leading cause of chronic childhood illness, affecting roughly 9 percent of all children, with higher rates in inner city urban areas. That’s roughly two students in every classroom, in every school, in America.
Stock albuterol is similar to stock epinephrine for anaphylaxis. It’s designed to allow schools to administer albuterol without a prescription to any student with known asthma who requires treatment, but does not have their own prescription inhaler available.
Some school districts have already adopted this policy. It is safe, can decrease unnecessary calls to 911, and is the right thing to do.