In this interview, Pat Seltzer, a Community Wellness Nurse at Buttonwoods Community Center & Pilgrim Senior Center, discusses prescription drug misuse and abuse among older adults.
Tell me a little about the Pilgrim Senior Center & the Buttonwoods Community Center and what the organization is focusing on.
Mayor Scott Avedisian has always been the City of Warwick’s leading advocate for Human Services. The Pilgrim Senior Center & the Buttonwoods Community Center aim to provide a safe and nurturing environment where the senior community can congregate for programs and activities and also receive health and social services related resources and referrals. I work as the City’s Community Wellness Nurse, and, along with the social services team, provide on-site assessments on an as-needed basis. Seniors come in to see me with various requests including first-aid, requests for biometric screenings (blood pressure, blood glucose, BMI), and occasional requests for over-the-counter drugs like Tylenol. Our doors are always open.
What are your concerns around prescription drug use at your two centers?
We see much more prescription drug misuse than prescription drug abuse. In fact, I can’t remember a time where our services were sought out for substance abuse. I think that has a lot to do with our audience—most are active and vibrant.
However, prescription drug misuse is something that we see frequently. Regardless of the initial reason for their visit, I always ask about medications during health assessments. What kind of medications are you taking? How long have you been on those meds? Do you feel like they are doing their job? Do you need more of them?
I find individuals who are accidently taking both the brand name and the generic of the same drug, individuals who are splitting doses because they can’t afford their medications, and individuals who are sharing medications with friends. Most of our seniors are on a fixed income – with the rising cost of medications, many are looking for new ways to save.
How are you addressing prescription drug misuse among older adults at the Senior Center’s in Warwick?
Beyond my health assessments that discuss medications, we are very fortunate to partner with the University Of Rhode Island College Of Pharmacy Outreach Program. Every month, they come in to do a workshop on a variety of issues related to medication use. As part of their outreach, the pharmacists conduct individual “brown bag” program visits and have been known to sit with a client for hours to help them understand their medications. They talk about each individual’s medication: prescription and over the counter (including supplements), how to setup a schedule, how to save money on prescription costs and, if necessary, how to not fall for advertisements falsely claiming that homeopathic supplements can replace their prescriptions.
What are the biggest challenges facing communities and states in regards to older adult prescription drug abuse?
The need for outreach and education is a big challenge for all communities. Older citizens would be better served by consolidation and utilizing the resources saved to dispense a united approach for outreach, education and resource referral.
What is being done on a local level to prevent prescription abuse and misuse within the older adult population?
Primary prevention is our goal at all age levels. The Department of Behavioral Healthcare, Developmental Disabilities and Hospitals (BHDDH) funded Youth Prevention Task Force works with families to prevent substance misuse before it starts. Prevention must begin with the young people. What we see in adults didn’t just start overnight.
We also have a 24/7 drug take back program, whose initial funding came from BHDDH, housed at the Warwick Police Department—in the lobby. Any unneeded drugs are collected and destroyed. It doesn’t accept liquids or needles but AIDS Care Ocean State will take the needles. They may even pick them up at your home.
Has Rhode Island had any major successes related to prescription drug abuse by older adults?
I have been a huge advocate for the prescription monitoring program which has mandated additional training and reporting for physicians who prescribe opioids. I am really excited that it is finally finding its home. However, it does need to be tweaked. Some seniors are offended by the nature of some of the questions they are required to answer in the “Pain Contract” such as “are you giving your meds away?” and “are you selling your meds?” Others, who have been maintained on medication long-term for a chronic pain condition, are worried about their doctor’s disrupting their equilibrium. But in general, I think in it’s a great idea—the physicians who were at first a bit careless about opioid prescriptions are now required to think about it a little differently. Hopefully that helps get this stuff off the streets.