Once a month, I go to the pharmacy to fill three prescriptions. I take five pills every day. When I travel, when there’s a holiday, or I’m going to be unable to get downtown, I have to plan far ahead to make sure I have enough. Thanks to my insurance, I can afford it reasonably.
My medication is my lifeline, but it’s also an inconvenience and, at times, a burden. And that makes me extremely fortunate.
About 70 percent of Americans take some form of prescription medication. For unsheltered folks or those in tentative or transitional housing, access to those necessary medications is restricted by any number of hurdles. Filling a prescription can be exceptionally challenging, whether it’s insulin for diabetes, antibiotics for an infection or pharmaceutical interventions for behavioral or mental health.
When you don’t know where you’re going to sleep at night, how can you make an appointment three weeks out? When you’re not sure how much a medication might cost, how can you determine what you’ll need to do to get the money?
It’s no wonder that many choose to self-medicate with something available over the counter or from someone’s pocket for cash.
There are resources in King County. The Seattle-King County Medical Respite program is an in-patient treatment option for homeless people who have acute illnesses and need medication management. For up to eight weeks, clients can stay and receive round-the-clock care to help them get back on their feet. But that’s an extreme option and the space is very limited.
There’s also the Mobile Medical program, which provides meals, primary care, family planning services and testing for various diseases, but it doesn’t carry narcotic prescription medications and, because it moves around, it may be unreliable for continued services.
Mental health care is a special focus for the Mobile Medical program; in 2009, King County Public Health found that just 1 percent of unsheltered people were receiving the mental health attention they needed. Mobile services have increased that number to 20 percent.
Getting a prescription from a doctor at the mobile van is just one step. With skyrocketing drug costs and the Trump administration’s threat to dismantle the Affordable Care Act, making room in an already impossible personal budget for prescriptions is just not feasible. Even with state-sponsored drug discount programs in place to help alleviate the burden, being on prescription medications is complicated and challenging for homeless folks.
As a result, many people go without, landing them in the emergency room when things get really bad. And of course, that’s something everyone pays for, whether we realize it or not.
Hanna Brooks Olsen is the cofounder of Seattlish; her work has appeared in The Atlantic, The Nation, Salon, Fast Company and Vice.