Web chat transcript: Ask the Experts about Seniors and Substance Abuse

Welcome to our weekly Wednesday health chat. Today’s topic is on seniors and substance abuse — alcohol inparticular but also prescription and other drugs.

Please welcome Kymberley Lucas, PhD, administrator of the SBIRT program at the Center for Excellence in Aging in Williamsburg.

Kymberley — Please let readers know when you are ready to answer their questions about seniors and substance abuse. Thanks.

Thank you, Pure. I am so happy yo be here

I am ready now!

Readers: This is your opportunity to ask questions in complete confidence and anonymity about a topic that is becoming of increasing concern to the medical community.

I’ll start with a question. Could you explain what the SBIRT program is?

Readers: We are chatting with Kymberley Lucas of the Center for Excellence in Aging in Williamsburg. Ask your questions now.
Kymberley – can you explain the SBIRT program and how it works?

Sure, Screening, Brief Intervention and Referral to Treatment is a SAMHSA program used to help older adults with substance use disorders, alcohol, or prescpition drugs.

How would someone come in to the program? What are the costs? Do people self-refer?

Guest, drinking alone could be a sign of an alcohol issue. Your father should seek help with any substance use disorder clinic. SBIRT would be appropriate for your father if you have one in your area.

Mary Jo, for a 55 year old woman, seven (7) drinks in a week and for a 55 year old man, 14 drinks in a week, according to HHS.

We are located in Williamsburg, Virginia at The Center for Excellence in Aging and Geriatric Heath, our website is excellenceinaging.org and our phone -number is 757-220-4751.

You can be referred to SBIRT by your physician, by your therapist or as a self-referral.

The SBIRT program has been used for many ages, however, at CEAGH we only provide SBIRT for ages 55 and above.

What happens once you’re referred to the SBIRT program?

Readers: We are talking to Kymberley Lucas, an expert in substance abuse among seniors

Brief intervention and if needed, referrals to treatment.

Ask your questions now.

Can you expand on what you mean by “brief intervention” — is that a counselor indicating they have a problem.

The brief intervention is conducted by me for 3-5 sessions. That may be the end of the process, or they may be referred out for more specialized treatment.

Signs of alcohol abuse include drinking alone, hiding beer cans, alcohol bottles, signs of depression, isolation.

This program is completely free for all clients.

Are your clients typically developing a problem as a senior or have they always been drinking a certain amount?

We see both late onset in the senior population and also individuals who have been drinking their whole life.

SBIRT is a program that doesn’t say you have to stop drinking. It says you need to cut back on your drinking. We are not using leverage or manipulation or taking things away from the person to get them to stop.

Readers: We are talking to Kymberley Lucas, administrator of the SBIRT program at the Center for Excellence in Aging in Williamsburg. She is an expert in substance abuse among seniors.

SBIRT is a program about motivational interviewing to get the person thinking about possibly quitting. But it does not say they MUST quit drinking. This is not an AA program.

Any answer for Gwen — how to get help for someone who doesn’t think they need it?

Is this something that primary care physicians screen for?

Yes. Most primary care physicians have integrated three screening questions into their intake form and then make the referral to CEAGH.

SBIRT is a program that doesn’t say you have to stop drinking. It says you need to cut back on your drinking. We are not using leverage or manipulation or taking things away from the person to get them to stop.

How many prescription drugs does he take per day?

Mixing of the alcohol and the prescription drugs could be a problem.

Is a couple of drinks two?

And is he on any anti-depressant or narcotic medication?

I think guest will have to call the center with specific questions.

No problem.

Are there prescription drugs that you should NEVER mix with alcohol?

Yes, most prescription drugs that you pick up from your local drugstore are labeled “do not mix with alcohol”. It may cause dizziness, drowsiness.

How can those concerned keep track of medications that elderly parents/loved ones are taking? Can they get a list from pharmacy? primary care provider?

What are the major concerns with alcohol abuse by older people?

They can sign a release with the primary care physician and the pcp can release that information or they could ask their loved one for that information.

Is the primary care physician responsible for tracking all medications — even if specialists are also writing prescriptions?

Yes. Most health facilities use EMRs (electronic medical records).

How often should you review the medications you’re taking?

Every time you visit your primary care physician.

Again, did you have an answer for how you can get help for someone who is resistant?

SBIRT is a program about motivational interviewing to get the person thinking about possibly quitting. But it does not say they MUST quit drinking. This is not an AA program

However, if they are drinking a bottle of Jack Daniels a day, they may need a family intervention or a court intervention.

We’ve reached the end of our chat. Kymberley if you could just tell readers how to reach you if they are interested in the free SBIRT program for themselves or a loved one.

Thank you so much for your expertise and explaining the availability of this program. Do participants have to live in Williamsburg or James City County to take advantage of it?

They can reach me at the Center for Excellence in Aging and Geriatric Health, located at 3901 Treyburn Drive, Suite 100, Williamsburg, VA 23185, phone 757-220-4751 or by email [email protected].

For all your health news, go to www.dailypress.com and dailypress.com/healthnotes.

They can live from Gloucester to Surry and participate.

Join us again at noon next Wednesday to chat with the new head of geriatric services at Riverside health system.

Dr. Lucas – thanks again so much for your information and expertise. I’m closing the chat now. Thanks.

Thank you

Bye – see you next week.