Kentucky Partnership for Families
and Children, Inc.
Deprescribing Medications
by Carol W. Cecil

When my teenage son was diagnosed with bipolar disorder, it was heart-breaking to see the amount of medication he was prescribed by the psych-hospital. He was "zombie-like" and "HE" seemed to be very far away hiding in his own mind behind all the medication. When I questioned this, I was told that it was either this option or back to the manic behavior.....those were my choices and neither was acceptable. Over time we learned how to communicate his behaviors and the psychiatrist was able level out his medications. I finally saw my son in there again!

Over the years, I've heard many parents and young people share similar experiences. Many children living outside their family home, either in foster care or congregate care settings (residential facility), are often prescribed medications to control their behavior. According to healthline.com, psychotropic medications work by adjusting levels of brain chemicals, or neurotransmitters, like dopamine, gamma aminobutyric acid (GABA), norepinephrine, and serotonin. By affecting a person's brain chemicals, it is hoped that the person's behavior, mood, thoughts, or perceptions are improved. This is where "deprescribing" comes in!

"Deprescribing provides a chance to look at each medicine your child takes to help you and your provider know why they take it, and the pros and cons. The goal is to take the right amount of medicine needed to keep your child as healthy as possible." At the University of Louisville School of Medicine Department of Pediatrics, a new program, Kentucky SafeMed, is working to deprescribe medications. Kentucky SafeMed recognizes that "youth are generally at a higher risk of medication adverse effects and much is unknown about long-term effects of psychotropic meds on the developing brain."

What do parents and young people need to know?
  1. Keep a current list of your medications and dosages with you at all times.
  2. Share how the medication helps and/or harms you or your child.
  3. Explain what "thinking" or mood differences you are seeing.
  4. As you, or your child, grows and changes, re-visit with the psychiatrist/psychologist to see if different medications would be more approrpriate or if better medications have been developed with fewer side effects.
Deprescribing is an intentional way of providing the right medications at the right dose with the patient/customer's input.

Resources
  • https://louisville.edu/medicine/departments/pediatrics/research/cahrds/safemed/KYsafemed
  • https://deprescribing.org/what-is-deprescribing/
  • https://www.healthline.com/health/what-is-a-psychotropic-drug#fast-facts
  • http://ohiomindsmatter.org/sites/ohiomindsmatter/files/2018-10/personal-decision-guide-2-2015.pdf
Breast Cancer and Mental Health
In honor of October being "Breast Cancer Awareness Month," KPFC would like to look at the connection between breast cancer and mental health. The American Cancer Society shares that a cancer diagnosis can affect the emotional health of patients, families, and caregivers. Common feelings during this life-changing experience include anxiety, distress, and depression. In specific, Reuters Health, states that breast cancer survivors are more likely to experience anxiety, depression, distress and sleep issues. "Newer screening, diagnosis and treatment options have transformed breast cancer from a fatal illness into a chronic illness for many women, leaving survivors to contend with a wide range of physical and mental health issues that may result from the tumors or from treatments to destroy the tumors (Lisa Rapaport, 2018).

  1. Anxiety means feeling uncomfortable, worried, or scared about a real or possible situation. It's important to recognize anxiety and take steps to manage it or prevent it from getting worse. Breast cancer survivors had up to twice the odds of developing anxiety as women who never had cancer.
  2. Feelings of depression are common in cancer patients, families, and caregivers. Learn how to spot depression and if there is reason to be concerned. Breast cancer survivors also had up to twice the risk of depression.
  3. Distress is an unpleasant emotion, feeling, thought, condition, or behavior. Being distressed can affect the way you think, feel, or act, and can make it hard to cope with the effects of having cancer (Cancer.org).

Good news! The mental health challenges experienced by breast cancer survivors was most pronounced in the first years after their diagnosis; survivors that have experienced five + years cancer-free have rates of mental health challenges to those who never had cancer.

Show your support by wearing a pink ribbon or giving a pink rose to someone who has breast cancer, or is a survivor of breast cancer, to brighten their day!

Resources
  • https://www.reuters.com/article/us-health-mentalhealth-breast-cancer/breast-cancer-survivors-may-have-lingering-mental-health-effects-idUSKBN1O627N
  • https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/emotional-mood-changes.html
  • https://academic.oup.com/jnci/article/110/12/1311/5164282
Kentucky Family and Youth Peer Support Specialist Core Competency Training
Kentucky Family Peer Support Specialists Core Competency (KFPSS CCT) PREREQUISITES
 
Each applicant must:

  1. Be eighteen (18) years of age or older;
  2. Be a self-identified parent or other family member who has lived experience with a client who has received services related to a mental health, substance use, or co-occurring mental health and substance use disability from at least one (1) child serving agency;
  3. Have a minimum educational requirement of a high school diploma or General Equivalency Diploma (GED) certificate;
  4. Have successfully completed a KFLA training approved by the department;
  5. Successfully complete a KFPSS core competency training approved by the department or receive a training waiver for this requirement in accordance with Section 5 of the administrative regulation; and
  6. Successfully complete, maintain, and submit to the department documentation of a minimum of six (6) hours of related training or education in each subsequent year.
Kentucky Youth Peer Support Specialists Core Competency (KYPSS CCT) PREREQUISITES
 
Each applicant must:
 
  1. Be a transition-age youth or young adult with lived experience who is at least 18 years of age and not older than 35 years of age who has an emotional, social, behavioral, and/or substance use disability and who has or is currently receiving state-funded services related to the disability from at least one child-serving agency. 
  2. Have a minimum educational requirement of a high school diploma or General Equivalency Diploma (GED) certificate;
  3.  Have successfully completed a KFLA training approved by the department;
  4. Successfully complete a KFPSS core competency training approved by the department or receive a training waiver for this requirement in accordance with Section 5 of the administrative regulation; and
  5. Successfully complete, maintain, and submit to the department documentation of a minimum of six (6) hours of related training or education in each subsequent year.
National Substance Abuse Prevention Month
Many Kentuckians struggle with substance use disabilities and the number of persons dying by overdoses continues to grow each year. From 2000 to 2014, Kentucky's drug overdose deaths quadrupled and is well above the national average. In 2005, more Kentuckians received inpatient treatment for alcohol, marijuana, and cocaine use (77.3%) with less than 12% being related to opioids. In 2015, inpatient treatment was due to 45.2% opioid use and less than 42% for alcohol, marijuana, and cocaine use.

In 2018, Kentucky's Department for Behaivoral Health, Developmental and Intellectual Disabilities received federal funds to support Kentucky's opioid epidemic called KORE. The Kentucky Opioid Response Effort (KORE) seeks to expand and sustain a comprehensive, equitable recovery-oriented system of care to end the opioid epidemic that has reached into every community in Kentucky. KORE-funded partners and services model policies and practices grounded in best practice and compassion and include projects focused on:
  • Overdose prevention and naloxone distribution
  • Reducing opioid overprescribing and improving safe opioid use
  • Community-guided prevention
  • Harm reduction
  • Engagement and linkage to services
  • Access to FDA-approved medications for opioid use disorder
  • Reducing unmet treatment need
  • Recovery support
  • Provider education and training

While Kentucky continues to work toward the reduction of substance use and overdose deaths, we must all be aware of the epidemic and do our part to make Kentucky healthy again. KPFC offers virtual SMART Recovery meetings for those struggling with addiction and SMART Recovery Family & Friends for those of you who have loved ones with an addiction; for more info, see flyers below.

Resources
  1. https://chfs.ky.gov/agencies/dbhdid/Pages/KORE-Map.aspx
  2. https://chfs.ky.gov/agencies/dbhdid/Documents/About%20KORE%208.24.21.pdf
  3. https://findhelpnowky.org/ky
  4. https://findtreatment.gov/
KPFC offers SMART Recovery and SMART Recovery Family & Friends
Do you have an addiction problem? Substances, gambling, other? SMART Recovery is a non-judgmental group that provides a listening ear, support, and strategies. This meeting is virtual!
Do you have a loved one who is dealing with addiction issues? This group is for you! SMART Recovery Family & Friends is an open, virtual meeting that provides information, supports, and techniques to help take care of YOU while still loving your person who has an addiction challenge.
Suicide Prevention!