Session Eight: Medication

Partnering With Families Affected by Concurrent Disorders - Facilitators' Guide

Session Goals

Provide an overview of the major classifications of psychiatric medications.
Facilitate discussion about the ways that drugs/alcohol may interact with prescribed medications.
Raise awareness of the importance of keeping up-to-date records of prescribed medications.

Content Outline

Drug therapy for mental health problems.
Drug therapy for substance use problems.
Medication management.
Medication abuse or dependence.
Drug interactions.
Ongoing treatment.
Stopping medication.

Activities

Tracking Side-effects

Leaders’ Notes

Concurrent disorders family education and support groups can be facilitated by clinicians from a variety of health care disciplines such as nursing, social work, psychology, occupational therapy and medicine. In this session it makes things easier if one of the two co-facilitators has some background expertise in psychopharmacology. If neither clinician has expertise or feels comfortable responding to family member’s questions about their relative’s medications, consider inviting a colleague such as a nurse or a pharmacist to join you for this session. You will probably be able to respond to most of the questions that come up, but it’s a good idea to ensure that family members can access a health care professional with formal training in pharmacology.

As with Session 2 (Substance Use Problems), the most important thing to remember when planning for this session is to link the educational material to participants’ real life situations. If you do invite another health care professional to this session, mention this to him or her and ask that they keep this in mind when offering information about medications or the interactions between medications and alcohol and other drugs.

We recommend giving each family member time to discuss the medications currently being prescribed to their loved one. In fact, it is a good idea to cover this immediately after the check-in for this session (and meditation exercise if you have decided to do it in this session).

Take this session slowly and respond to questions using basic language and simple terminology that everyone can understand. Briefly review the categories and classifications of psychiatric medications. You may wish to remind participants that medications each have two different names—a generic and a trade name—and that health professionals may use these names interchangeably. Since many people use the Internet to find information about medications, remind them that the trade names for medications are sometimes country-specific and that they should check the origin of the material.

Often group members make comments such as, “Oh yes, my son was taking that medication two years ago, but he started having really bad side-effects. He gained so much weight that our family doctor was concerned about him” or “My husband just kept getting worse until they switched him to the medication your son might end up taking—and did it ever work for him!”

It is very important to consider what you will do if a participant makes a misleading comment about a medication or unintentionally gives the group inaccurate information. For example, someone might relate a story about a side-effect of a particular medication that happened to their family member but is in fact a very rare side-effect. You must comment on this, gently if necessary, so other participants don’t get inaccurate information.

Since this is a family concurrent disorders group, you will probably be asked how a specific substance that is being misused interacts with psychiatric medication. Spend time on these questions because they address a reality of everyday life for families. If a general question arises that you or your guest facilitator don’t feel comfortable answering, tell the group that you’ll find out the correct answer and get back to them at next session. If one of the family members asks advice about dealing with a specific medication or a combination of medications and other substances—we were asked whether excessive daily use of marijuana would interfere with the effectiveness of olanzapine (a popular antipsychotic medication) and whether or not it would be wise for the person to take a higher dosage of this medication until he or she was able to reduce their use of marijuana—you should recommend that participants check with their family member’s pharmacist or prescribing physician.

Tracking side-effects

This is an activity to be done, if at all possible, with the ill family member. Group facilitators can discuss any side-effects related to particular medications that they have noticed, but the actual tracking of side-effects is an at-home ongoing activity (so that family members can keep a log for future reference, for informing new health professionals working with their relative, ER staff or other workers, and to support medication changes).

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