Clarification Causes Worth to Change Role Regarding Psychotropic Medications

Editor’s note: This article was initially published in The Daily Gazette, Swarthmore’s online, daily newspaper founded in Fall 1996. As of Fall 2018, the DG has merged with The Phoenix. See the about page to read more about the DG.

Since the beginning of the current semester, Worth Health Center and Counseling and Psychological Services have been operating under a new policy regarding certain psychotropic medications such as Lexapro and Abilify. Essentially, students used to be able to get a few of these drugs directly from Worth with proper prescriptions, which is no longer an option. However, Worth will still work with local pharmacies to get students’ medications delivered to campus, and students with prescriptions from CAPS can still get some medications directly from the CAPS psychiatrist, Joseph Hewitt.

To understand the reasoning behind this decision, it is important to understand the history of this policy. CAPS Director David Ramirez explained that Worth used to have a small stock of some psychotropic medications, known as a “formulary.” Students with prescriptions for these drugs could pick them up directly from Worth. He noted that this practice was unusual for a college to implement.

As an effort to keep costs down for students, generic medications were often used. “However, there are still a couple drugs that are only name-brand,” Ramirez said. Consequently, Worth sometimes kept a stock of samples of these medications given to CAPS’ psychiatrist by drug companies. “In the case of name-brand drugs … for some students it’s no big deal, but for others it’s very difficult to pay for them,” Ramirez added.

While this practice was an excellent method of cheaply and quickly delivering often critical medications to students, it was found to be somewhat problematic. “My understanding is that there was some clarification … Worth’s role may have constituted part of a pharmacy’s scope of practice,” according to Ramirez.

Director of Worth Beth Kotarski helped to elaborate on this point. “Nurses can dispense many non-psychotropic meds based on protocol,” Kotarski said, but this did not necessarily carry over to the psychotropic medications in question. All of this came to light as a result of a conference Kotarski attended—hosted by the Southeastern Pennsylvania College Health Nurses Association—in an effort to determine a “uniform standard” for health centers. The change in policy is part of an effort on Worth’s part to “go toward best practices based on recommendations from the American College Health Association,” Kotarski said.

Both Ramirez and Kotarski were quick to point out that financially-strapped students who depended specifically on the samples of these medications can still get them directly from the CAPS psychiatrist. Students with prescriptions who did not depend on samples for psychotropic medication can still go to Worth who will work to have medications delivered to campus. Ramirez explained that, given the nature of these medications, it could be “troubling” to a student to be unable to get a supply in a timely manner. Ramirez and Kotarski estimated that about 30 students are on medication from CAPS, though they would be affected in varying degrees by this policy change.

One student who was affected by this situation (and requested anonymity for this article) was somewhat critical of how the situation was handled. “They didn’t warn me ahead of time that they were no longer able to dispense certain meds … it sucked for people who didn’t get a chance to see the psychiatrist before they made the change, i.e. they only told people in person,” the student said.

Ramirez admitted that under the new policy, the options are “less than what people were getting before.” However, CAPS and Worth are still working together to provide ways in which students can be given their medications with the least amount of time and cost involved possible.

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