Melissa Tai, PharmD PGY-1 Pharmacy Practice Resident Henry Ford Hospital Detroit, Michigan
Michael I. Casher, MD Clinical Assistant Professor University of Michigan Medical School Attending Psychiatrist University of Michigan Health System Ann Arbor, Michigan
Jolene R. Bostwick, PharmD, BCPS, BCPP Clinical Associate Professor Department of Clinical Pharmacy University of Michigan College of Pharmacy Clinical Pharmacist in Psychiatry University of Michigan Health System Ann Arbor, Michigan
Patient assessment is a key step to in preventing abuse of psychotropic medications. Gentle inquiry about school-related stress and other risk factors for misuse can help practitioners determine if students are at risk of diversion and if additional screening is necessary.
In response to these issues, Stone and Merlo8 have suggested that, in addition to the educational programs held on college campuses on alcohol, illicit drugs, and prescription painkillers, patients should be better informed on the appropriate use of prescription psychiatric medications, instructed to avoid sharing with family and friends, and assessed for abuse risk at regular intervals.
To further protect patients from adverse outcomes during treatment, you can employ conservative and safe prescribing techniques. One strategy might be to keep a personal formulary that lists key medications you use in everyday practice, including knowledge about each drug’s dosage, potential adverse effects, key warnings, and drug−drug interactions.40
Furthermore, maintain healthy caution about newly approved medications and carefully consider how they measure up to existing agents—in other words, practice evidence-based medicine, particularly when students request a particular agent.40,41 Prescribers should evaluate the risk of abuse before prescribing and attempt to prevent misuse by limiting quantities and minimizing polypharmacy.
Last, pharmacists can be key allies for consultation and appropriate medication selection.
Bottom Line Psychotropic medications are necessary to treat the variety of conditions—anxiety, attention-deficit/hyperactivity disorder, depression, and panic disorder—common among college students. However, students are at risk of combining their prescribed medications with other medications, drugs, and alcohol or could sell or share their medication with peers. Proper counseling and identification of risk factors can be important tools for preventing such events.
Related Resources • American College Health Association-National College Health Assessment. www.acha-ncha.org. • Schwartz VI. College mental health: How to provide care for students in need. Current Psychiatry. 2011;10(12):22-29.
Disclosures The authors report no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.