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Kymberley Lucas, PhD., director of the SBIRT program at the Center for Excellence in Aging and Geriatric Health in Williamsburg answered readers' questions about the specific program -- screening, brief intervention, referral to treatment -- and about substance abuse in general.

Ask the Experts: About Seniors and Substance Abuse

(10/12/2011)

  

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11:59

Prue:  Welcome to our weekly Wednesday health chat. Today's topic is on seniors and substance abuse -- alcohol inparticular but also prescription and other drugs. Wednesday October 12, 2011 11:59 Prue

11:59

Prue:  Please welcome Kymberley Lucas, PhD, administrator of the SBIRT program at the Center for Excellence in Aging in Williamsburg. Wednesday October 12, 2011 11:59 Prue

12:00

Prue:  Kymberley -- Please let readers know when you are ready to answer their questions about seniors and substance abuse. Thanks. Wednesday October 12, 2011 12:00 Prue

12:00

Dr. KL:  Thank you, Pure. I am so happy yo be here Wednesday October 12, 2011 12:00 Dr. KL

12:00

Dr. KL:  I am ready now! Wednesday October 12, 2011 12:00 Dr. KL

12:01

Prue:  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. Wednesday October 12, 2011 12:01 Prue

12:01

Prue:  I'll start with a question. Could you explain what the SBIRT program is? Wednesday October 12, 2011 12:01 Prue

12:04

Prue:  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? Wednesday October 12, 2011 12:04 Prue

12:04

Dr. KL:  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. Wednesday October 12, 2011 12:04 Dr. KL

12:05

Prue:  How would someone come in to the program? What are the costs? Do people self-refer? Wednesday October 12, 2011 12:05 Prue

12:05

[Comment From mary-jomary-jo: ]  What would you consider abuse of alcohol? How many drinks? Wednesday October 12, 2011 12:05 mary-jo

12:05

Dr. KL:  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. Wednesday October 12, 2011 12:05 Dr. KL

12:06

Dr. KL:  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. Wednesday October 12, 2011 12:06 Dr. KL

12:07

[Comment From GuestGuest: ]  How do you get into the SBIRT program? Wednesday October 12, 2011 12:07 Guest

12:08

Dr. KL:  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. Wednesday October 12, 2011 12:08 Dr. KL

12:09

[Comment From GuestGuest: ]  What age does the SBIRT program help? Wednesday October 12, 2011 12:09 Guest

12:09

Dr. KL:  You can be referred to SBIRT by your physician, by your therapist or as a self-referral. Wednesday October 12, 2011 12:09 Dr. KL

12:09

Dr. KL:  The SBIRT program has been used for many ages, however, at CEAGH we only provide SBIRT for ages 55 and above. Wednesday October 12, 2011 12:09 Dr. KL

12:10

Prue:  What happens once you're referred to the SBIRT program? Wednesday October 12, 2011 12:10 Prue

12:10

Prue:  Readers: We are talking to Kymberley Lucas, an expert in substance abuse among seniors Wednesday October 12, 2011 12:10 Prue

12:11

Dr. KL:  Brief intervention and if needed, referrals to treatment. Wednesday October 12, 2011 12:11 Dr. KL

12:11

Prue:  Ask your questions now. Wednesday October 12, 2011 12:11 Prue

12:11

Prue:  Can you expand on what you mean by "brief intervention" -- is that a counselor indicating they have a problem. Wednesday October 12, 2011 12:11 Prue

12:12

[Comment From GuestGuest: ]  Can you tell me some of the signs of alcohol abuse and when someone needs help Wednesday October 12, 2011 12:12 Guest

12:12

Dr. KL:  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. Wednesday October 12, 2011 12:12 Dr. KL

12:13

Dr. KL:  Signs of alcohol abuse include drinking alone, hiding beer cans, alcohol bottles, signs of depression, isolation. Wednesday October 12, 2011 12:13 Dr. KL

12:13

[Comment From frankfrank: ]  How much does it cost to visit your program? Wednesday October 12, 2011 12:13 frank

12:13

Dr. KL:  This program is completely free for all clients. Wednesday October 12, 2011 12:13 Dr. KL

12:14

Prue:  Are your clients typically developing a problem as a senior or have they always been drinking a certain amount? Wednesday October 12, 2011 12:14 Prue

12:15

Dr. KL:  We see both late onset in the senior population and also individuals who have been drinking their whole life. Wednesday October 12, 2011 12:15 Dr. KL

12:15

[Comment From GwenGwen: ]  How can I get someone to get help if they don't want it and don't think they have a problem Wednesday October 12, 2011 12:15 Gwen

12:16

Dr. KL:  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. Wednesday October 12, 2011 12:16 Dr. KL

12:16

Prue:  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. Wednesday October 12, 2011 12:16 Prue

12:16

Dr. KL:  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. Wednesday October 12, 2011 12:16 Dr. KL

12:17

Prue:  Any answer for Gwen -- how to get help for someone who doesn't think they need it? Wednesday October 12, 2011 12:17 Prue

12:18

Prue:  Is this something that primary care physicians screen for? Wednesday October 12, 2011 12:18 Prue

12:18

Dr. KL:  Yes. Most primary care physicians have integrated three screening questions into their intake form and then make the referral to CEAGH. Wednesday October 12, 2011 12:18 Dr. KL

12:19

Dr. KL:  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. Wednesday October 12, 2011 12:19 Dr. KL

12:19

[Comment From GuestGuest: ]  My dad's 87 and enjoys a couple of drinks every evening. I don't know how I'd get him to stop. What is the harm in it? Wednesday October 12, 2011 12:19 Guest

12:20

Dr. KL:  How many prescription drugs does he take per day? Wednesday October 12, 2011 12:20 Dr. KL

12:20

Dr. KL:  Mixing of the alcohol and the prescription drugs could be a problem. Wednesday October 12, 2011 12:20 Dr. KL

12:21

[Comment From GuestGuest: ]  I'm not sure. A couple I think -- for high blood pressure and cholesterol Wednesday October 12, 2011 12:21 Guest

12:21

Dr. KL:  Is a couple of drinks two? Wednesday October 12, 2011 12:21 Dr. KL

12:22

Dr. KL:  And is he on any anti-depressant or narcotic medication? Wednesday October 12, 2011 12:22 Dr. KL

12:22

Prue:  I think guest will have to call the center with specific questions. Wednesday October 12, 2011 12:22 Prue

12:23

Dr. KL:  No problem. Wednesday October 12, 2011 12:23 Dr. KL

12:23

Prue:  Are there prescription drugs that you should NEVER mix with alcohol? Wednesday October 12, 2011 12:23 Prue

12:24

Dr. KL:  Yes, most prescription drugs that you pick up from your local drugstore are labeled "do not mix with alcohol". It may cause dizziness, drowsiness. Wednesday October 12, 2011 12:24 Dr. KL

12:24

Prue:  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? Wednesday October 12, 2011 12:24 Prue

12:24

Prue:  What are the major concerns with alcohol abuse by older people? Wednesday October 12, 2011 12:24 Prue

12:24

Dr. KL:  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. Wednesday October 12, 2011 12:24 Dr. KL

12:25

Prue:  Is the primary care physician responsible for tracking all medications -- even if specialists are also writing prescriptions? Wednesday October 12, 2011 12:25 Prue

12:26

Dr. KL:  Yes. Most health facilities use EMRs (electronic medical records). Wednesday October 12, 2011 12:26 Dr. KL

12:26

Prue:  How often should you review the medications you're taking? Wednesday October 12, 2011 12:26 Prue

12:27

Dr. KL:  Every time you visit your primary care physician. Wednesday October 12, 2011 12:27 Dr. KL

12:28

Prue:  Again, did you have an answer for how you can get help for someone who is resistant? Wednesday October 12, 2011 12:28 Prue

12:28

Dr. KL:  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 Wednesday October 12, 2011 12:28 Dr. KL

12:29

Dr. KL:  However, if they are drinking a bottle of Jack Daniels a day, they may need a family intervention or a court intervention. Wednesday October 12, 2011 12:29 Dr. KL

12:29

Prue:  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. Wednesday October 12, 2011 12:29 Prue

12:30

Prue:  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? Wednesday October 12, 2011 12:30 Prue

12:30

Dr. KL:  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 klucas@excellenceinaging.org. Wednesday October 12, 2011 12:30 Dr. KL

12:31

Prue:  For all your health news, go to www.dailypress.com and dailypress.com/healthnotes. Wednesday October 12, 2011 12:31 Prue

12:31

Dr. KL:  They can live from Gloucester to Surry and participate. Wednesday October 12, 2011 12:31 Dr. KL

12:32

Prue:  Join us again at noon next Wednesday to chat with the new head of geriatric services at Riverside health system. Wednesday October 12, 2011 12:32 Prue

12:32

Prue:  Dr. Lucas - thanks again so much for your information and expertise. I'm closing the chat now. Thanks. Wednesday October 12, 2011 12:32 Prue

12:32

Dr. KL:  Thank you Wednesday October 12, 2011 12:32 Dr. KL

12:32

Prue:  Bye - see you next week. Wednesday October 12, 2011 12:32 Prue

12:32