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Using Minimum Misuse/Maximum Care to Decrease Prescription Drug Misuse on Campus

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Written by: Josh Hersh, M.D. Staff Psychiatrist, Miami University

Prescription drug misuse is a common problem on college campuses. Estimates show that up to 30% of college students experiment with prescription drugs without a prescription. There are also estimates as high as 70% of college students do not take prescription medications as prescribed. Many students take medication at erratic times, give medication away to friends, and even sell their medication to make extra money. Misuse of prescription medication can have negative consequences including psychosis and overdose.

While there is a lot of data being gathered about prescription drug misuse, there has not been a whole lot of solutions offered. I have been the staff psychiatrist at Miami University in Ohio for the last 12 years. During this time we have worked hard to create collaborative system that helps reduce prescription drug misuse on campus.

In order to combat prescription drug misuse, it is my belief that physicians cannot be asked to treat complicated mental health disorders in isolation. If we asked a single person to build a house or a car, it would probably not be built well and potentially be prone to accidents and fires. The same is true for mental health disorders. If physicians are asked to treat complicated mental health disorders in isolation then patients will be prone to problems arising from prescription drugs (just as a house or a car would be prone to accidents or fires).

Our team approach includes workshops, evaluations, and collaboration with our Learning Center on campus.  For instance, the Brain Booster Workshop is required for all students seeking treatment for attention problems (including students previously diagnosed with ADHD). It is a 90 minute workshop where students learn behavioral strategies to manage attention problems. Students learn how create structure and treat college like a full-time job.  They also learn time management and study techniques.  They are also encouraged to sign up for workshops and academic coaching (if needed) at the learning center.

We not only have the students complete the Brain Booster Workshop, but we have them complete a goal completion worksheet. This allows us to track how well the interventions are going and helps us to assist students if they are struggling. It also allows us to see if the student needs to be referred for a more in depth evaluation by a psychologist.

If the student is diagnosed with ADHD, we require attendance at an ADHD workshop prior to seeing the physician. In this workshop, students are educated about how to take medication correctly. They are told not to tell friends they are prescribed controlled substances. They are educated on how to lock up their medication. They may also be given a free lock box for medication storage as part of a pilot program.

After a student attends the workshops, I feel as a physician I can focus on the medical issues facing the individual student. I feel confident they have been well educated on behavioral techniques and how to take care of medication. If I do prescribe medication, they have the tools to take medication correctly.  I don’t have to build the whole house or car in one session. By maximizing care we can minimize misuse.

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