Psychiatric Medication Management

What is Psychiatric Medication Management?

Psychiatric medication management is a strategy that individuals can employ to handle all of their different medications. When patients are using multiple varieties of pills, there needs to be a system that maintains and updates a complete and accurate list of all the products being used. On any given day, one must encounter so many different obstacles with school, work, family, friends, and other responsibilities. If you have to keep track of what medication to take and at what time, it is incredibly taxing. Medication is also incredibly serious as you cannot overdose or under-dose, so you have to make sure everything is scheduled to prevent any harm or even fatality.

The Medication Management Process

Professional medication management is not only for the patient but also for the benefit of caregivers and medical professionals. These individuals want to identify how and when their patients are taking medication. Knowing this information could help them to identify problematic behaviors of their patients that may lead to an undesirable drug event like an overdose, underdose, and missing medication. The medication management process requires that patients bring in all of the medicines they take — both over the counter and prescribed ones. This includes injections, ointments, drops, and inhalers, as well as other non-oral treatments. A list will be compiled and a schedule drafted by a medical professional or medical staff on when to take each of the treatments.

Why Use Medication Management Therapy?

The most apparent benefit of psychiatric medication management is that it ensures patient safety. About 4.5 million visits to the office and emergency rooms are made via ambulance every year due to negative drug events that resulted from poor medication management. Maintaining a medication list will help to account for any safety issues that occur with mixing treatments and reduce the chance of prescribing errors. It will also ensure that patients who are not taking their medication, which could potentially endanger their life, are staying on a fixed schedule every day.

According to the Centers for Disease Control and Prevention (CDC), medication management therapy accounted for more than two-thirds of primary care office visits, totaling 2.3 billion medication prescriptions annually. Approximately one-half of the American population has taken one prescription medication in the last month, and one in five has in the last three days. That means a lot of people are taking medication and should be doing so properly.

What is the Opioid Epidemic?

Opiates are incredibly potent drugs that are derived from the poppy plant and have been used for centuries to relieve pain. Doctors are frequently prescribing these potentially fatal drugs to their patients. Opioid abuse in the United States is an epidemic that continues to get worse each year. In 2010, over 210 million Americans filled a prescription for opiates. Also, that year, a report showed that 12 million people used opiates without a prescription. Those figures are high enough to give each individual a single pill a day for an entire month. It does not help that opioids are relatively cheap and so addictive that people may begin to abuse them right after their first dose.

Each day, more than 130 people in the United States die due to opioid overdose. The abuse of and addiction to opioids—which include heroin, synthetic opioids such as fentanyl, and prescription pain relievers—is a nationwide crisis that has tremendously impacts public health. The Centers for Disease Control and Prevention found that the numerical value of the total economic burden of prescription opioid abuse in the country is $78.5 billion annually. This includes the price of healthcare, loss of worker productivity, treatment for addiction, and legal issues.

How Does the Opioid Epidemic Relate to Psychiatric Medication Management?

Part of the reason for the opioid crisis is doctor shopping, which could be reduced using medication management therapy. Doctor shopping is defined as taking advantage of several different treatment doctors to get multiple prescription medications illegally. Many people use this method to fuel their opiate addiction and to sell drugs on the black market. For many years, this strategy has worked because healthcare professionals prescribe painkillers to their patients leisurely. They have no idea how opioid abuse could develop as a result. Despite the mounting death toll of opioid addicts, the sales of Percocet, Percodan, OxyContin, and Vicodin have all increased dramatically.

Desperate individuals know how to take advantage of the system to con their providers. They know many doctors will not look into their patient history. Addicts will lie about symptoms and omit information on forms and in meetings. Some will go so far as to fabricate stories about allergies or hurt themselves on purpose to get stronger opioids and replace “damaged” earlier prescriptions. According to a 2011 Government Accountability Office report, around 170,000 Medicare patients allegedly participated in doctor shopping in 2008. These numbers are heart-wrenching since they only look at Medicare users and not the entire population of addicts.

Psychiatric medication management is a key method to help decrease doctor shopping. When compiling a medication list for patients, healthcare professionals can utilize a database to check the history of their patient’s opioid abuse. This includes past and present medications, dosage amounts, and any patterns of abuse. The list will show if the patient is likely to somehow lose or misplace their medication, which is an immediate red flag, and if they are combining drugs. These lists are essentially records. The information provided will show if the patient has ever overdosed and where they have received all their prescription drugs in the past. Clearly medication management therapy has the potential to save numerous lives but also to deepen the trust and relationship between a doctor and patient.

How to Maintain a Regimen for Multiple Medications

According to a study published in the Archives of Internal Medicine, many people are confused when it comes to having to organize all of their different medications. The fact that sometimes medication lists are too complicated to be understood by the average civilian and the drug instructions are also incredibly vague does not facilitate the process. While medical professionals should supervise medication management, there are things you as a patient can do to prevent errors in your prescriptions and to make the process both simpler and safer:

  1. Schedule a medication review with your pharmacist to ask about any unnecessary medications on the list that you can get rid of or have to change due to their negative reactions to other substances. Healthcare workers are always supposed to have updated information to advise you about any alterations to drug products.
  2. Clear up any confusion regarding dosage. “With food” and “on an empty stomach” can have several different meanings. Does with food imply a heavy meal or light snack? Does an empty stomach mean one hour after eating or after an extended fasting period? What is the difference between taking a tablet twice a day and every 12 hours? These may seem like trivial questions, but as it relates to health, there is no harm in asking.
  3. Use technology to make your regimen more organized. There are applications specifically designed to help track all of your current and old medications, so you never forget which medication to take and when. A lot of them also allow for the addition of doctor’s notes.
  4. Make the process easier on yourself. Why take one medication three times a day when you could opt for a similar one that only requires a single daily dosage? Ask your doctor about any replacements that could make your treatment more manageable. 

Medication Management Works Well for  Those with a Dual-Diagnosis 

Dual diagnosis is when an individual suffers from both a substance use disorder, like drug or alcohol addiction, and a mental health disorder at the same time. Often, an addiction can lead to mental illness if it gets to the point of altering one’s brain chemistry or mental illness can lead to addiction as people tend to try and self-medicate rather than seek effective treatment.

Many people with a co-occurring disorder develop substance abuse due to a desire to feel accepted and like a “functioning” individual. It may start with one drink to calm social anxiety that turns into alcohol addiction. Or a hit of marijuana to try and forget memories of trauma. While these may provide short-term relief, they are not efficient long-term methods of treatment and result in a cycle of abuse that could be deadly to the individual and those around them.

Co-Occurring disorders are highly widespread in America. According to the National Survey on Drug Use and Health in 2018, nearly 9.2 million adults endured both mental illness and a substance use disorder that year. However, just 34.5% sought mental health treatment, while 3.9% went to rehab for their addiction. Sadly, only 9.1% addressed both disorders. While these statistics are grim, it is essential to note that there is treatment for mental health disorders and addiction separately, just as there are effective ways to treat both at the same time. If you have a co-occuring disorder that requires you to take multiple medications, or you’re worried your medications might negatively impact your recovery, medication management therapy might be a good option to explore.

Taking the first step is always the hardest to get effective treatment. Please contact our team by call or text at (855) 425-4846 to discuss whether or not psychiatric medication management makes sense for you or a loved one.

Reviewed for Medical & Clinical Accuracy by Brittany Polansky, MSW, LCSW

Brittany has been working in behavioral health since 2012 and is the Assistant Clinical Director at our facility. She is an LCSW and holds a master’s degree in social work. She has great experience with chemical dependency and co-occurring mental health diagnoses as well as various therapeutic techniques. Brittany is passionate about treating all clients with dignity and respect, and providing a safe environment where clients can begin their healing journey in recovery.