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“Why don’t you just take your meds?”
CIT Officer Wendi ShackelfordAnchorage (Alaska) Police Department
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OBJECTIVES Participants will gain practical application and
working knowledge regarding medications which they can use to train their CIT officers
Participants will begin to understand issues regarding medication compliance
Participants will engage in hands-on activity that increases empathy for mentally ill regarding medications
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MEDI-SET INTRODUCTIONDay 1
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The best time to introduce the medi-sets exercise is about thirty minutes before lunch on the first day of class
lunch hour to load their medi-sets GOAL: maintain medication compliance, as
directed, for four full days of class
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MEDI-SET PREPARATION
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1. READING YOUR PRESCRIPTIONS
ABBREVIATION LATIN TRANSLATION
WHAT IT MEANS
a.c. ante cibum before meals am morning
b.i.d. bis in die twice a dayb.i.n. bis in noctus twice a night
c cum withcap capsula capsule
d dies daydaw dispense as written
(no substituting generic or brand
name drugs)
gtt gutta droph.s. hora somni bedtime
i one doseii two dosesiii three doses
I.M. into the muscle I.V. into the veinmg milligram ml milliliter
noxt at nightO.D. oculo dextro right eye
ABBREVIATION LATIN TRANSLATION
WHAT IT MEANS
O.S. oculo sinistro left eyeO.U. oculo utro in each eyep.c. post cibum after mealspm afternoon/eveningp.o. per os by mouthp.r.n. pro re nata as needed
pil pilula pill qh quaque hora every hour
q 3 h quaque 3 hora every 3 hours qAM every morningqd quaque die daily
q.i.d. quater in die four times a dayq.o.d every other day
s sine withouts.l. sub lingual under the tonguetab tabella tablett.i.d. ter in die three times a daytsp teaspoon
tbsp tablespoonut dict as directed by
doctor
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EXAMPLE Seroquel 100 mg, po q iTID i prn for
agitation
TRANSLATION: “Take your Seroquel 100 mg pills by mouth
(po) at the rate (q) of one pill (i) three times (TID) a day plus one additional pill (i) as needed (prn) if your symptoms of agitation increase or become intolerable”
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2. MENTAL ILLNESS SELECTION Allow people to pick their mental illness of
choice (from six common diagnoses) Distribute relevant mental illness sheet to
each person
Schizoaffective disorder bi-polar type Bipolar I disorder MRE manic Schizophrenia paranoid type Bipolar II disorder Major depression Borderline personality disorder
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3. DISTRIBUTE MEDI-SETS Medi-sets should have selected
prescription information already secured to the bottom
Skittles represent psychotropic and other prescribed medications Some illnesses may need two packets of Skittles based on the
number of medications to be taken and size of the medi-set Use the Skittles that have mixed up flavors for best
impact
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3a. SELF MEDICATION Jelly Belly candies represent all other
substances people might use to manage their symptoms AKA “self-medication”
Discussion: Why do people self-medicate? What are some of the common substances
they might use?
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COMMON SUBSTANCES TO SELF MEDICATE
Benadryl Cocaine Nicotine Marijuana Alcohol Inhalants Other people’s
prescription meds Morphine Ecstasy
Methamphetamine Viagra Steroids Ambien Heroin Dextromethorphan
DM Psilocybin mushrooms K2/spice caffeine
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Allow students time to interpret their prescriptions and then load their medi-sets with prescription medications (Skittles)
Allow students to add self medications to their medi-sets at their discretion (Jelly Bellies)
Provide unlimited access to self medications throughout the entire course and remember to keep them fully stocked
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As the course instructor, provide regular, all day reminders of…
“Remember to take your medications!” “Are you medicated?” “Have you taken your meds today?”
You simulate their caseworkers, doctors, care providers, family members, nurses, neighbors, first responders, and anyone else who has a vested interest in their medication compliance
REMINDERS
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4. DAY 1 HOMEWORK Go to www.nami.org
Have students read about the following: Common symptoms of your illness Common medications used to treat your illness Common side effects of those medications
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INCREASING MEDICATION COMPLIANCE
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COMPLIANCE BY REWARDS On day 2, ask who has been med compliant.
Reward with… Play money
On day 3 or 4, ask who has been consistently med compliant. Consider rewarding with… Play credit cards Special trips i.e. to the zoo, shopping mall Other special rewards
On day 4 or 5, ask who has been consistently med compliant. Consider rewarding with… Pets Their own room or apartment
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COMPLIANCE BY PUNISHMENT On day 3, 4, or 5 publicly admonish one or
two students for failing to comply and then withhold the reward that is publicly bestowed on others
On day 4 or 5, take a reward from one or two previously compliant students who have not maintained continuous compliance
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MEDI-SET DEBRIEFINGDay 5
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DEBRIEFING WITH YOUR STUDENTS
What is the purpose of this exercise? Why were you rewarded for compliance? Why were you punished for lack of
compliance? What did you experience as you tried to
maintain medication compliance? How hard was it to take your medication
as prescribed?
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No money for medications I ran out of medications I substituted them for
another pill, substance, or drug
I took them to please the instructor, doctor, counselor, etc
I don’t know how to take them
I forgot them I lost them I swapped them with
someone else for theirs I gave them to someone
else My kids ate them I didn’t feel like taking
them
I don’t know how to read the prescription
I didn’t take them as prescribed
I took them all at once I don’t think I need them Someone stole them Medical issues that are
complicated by meds i.e. diabetes
I dropped them under the fridge, in the parking lot, on the floor
I didn’t like the way they tasted
I didn’t like the way they made me feel
My dog ate them
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PRACTICAL APPLICATIONdriving the point home
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THE MEDICATION CHALLENGE
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I am looking for 48 people willing to “medicate” for the remainder of the CIT International conference
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Pick up the following supplies at the back of the room:
One medi-set with prescription One package of Skittles One package of Jelly Bellies One mental illness sheet that matches your
medi-set prescription
IF YOU ARE WILLING…
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THANK YOU!!!
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CONTACT INFORMATION Officer Wendi Shackelford
Voice mail: 907-786-2692 Email: [email protected]