Difference between revisions of "Reduce Non-Medical Access to Prescription Drugs"

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= Introductory Paragraph =
''Return to [[Opioid_Top-Level_Strategy_Map|Opioid Top-Level Strategy Map]] or [[ZOOM_MAP_-_Reduce_Access_to_Opioids|Zoom Map (Reduce Access to Opioids)]]''


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It is essential that people who have prescription medications in their homes store them safely. When people begin to misuse prescription drugs, they often acquire them by stealing them from family, relatives, friends or from homes which they enter for other reasons (work, open houses, breaking and entering). If prescription drugs are safely stored, misuse can be stopped earlier, because people who have not yet developed a dependence on opioids usually do not go directly to illegal opioids like heroin or Fentanyl. Prescription drugs that are not safely stored can also be accidentally taken by young children or by curious pre-teens.


To minimize diversion, it is essential that people who have prescription medications in their homes store them safely.&nbsp; When people begin to misuse prescription drugs, they often acquire them by stealing them from family, relatives, friends or from homes that they enter for other reasons (work, open houses, breaking and entering).&nbsp; If prescription drugs are safely stored, misuse can be stopped earlier, because people who have not yet developed a dependence on opioids usually do not go directly to illegal opioids like heroin or fentanyl.&nbsp;&nbsp;&nbsp;__TOC__Prescription drugs that are not safely stored can also be accidentally taken by young children or by curious pre-teens.
= Key Information =


= Background =
Safe storage of prescription drugs within the home has been prioritized as a key strategy by many organizations and coalitions. <ref>https://end-overdose-epidemic.org/task-force-recommendations/</ref> Even if a community does an excellent job of reducing prescriptions and taking back or disposing of unused opioids, there will still be a lot of opioids in communities. Thirty-two percent of American adults received a prescription for opioids in the two years preceding 2018. <ref>https://www.norc.org/NewsEventsPublications/PressReleases/Pages/one-third-of-americans-have-received-an-opioid-prescription-in-the-past-two-years.aspx#:~:text=Nearly%20one%20in%20five%20adults,the%20prescription%20at%20least%20once.</ref> In 2019, 22% of U.S. adults with chronic pain used a prescription opioid in the previous 3 months. <ref>https://www.cdc.gov/nchs/data/nhsr/nhsr162-508.pdf</ref> Many people are legitimately being prescribed opioids for short-term pain management. These can be misused, stolen or accidentally consumed by children. Failure to securely store prescription drugs contributes to the opioid epidemic and other health hazards in several ways.


Safe storage of prescription drugs within the home has been identified as key priority strategy by many organizations and coalitions.<ref>https://www.end-opioid-epidemic.org/storage-and-disposal/</ref><ref>http://www.rxsafetymatters.org/families-and-communities/safe-storage-and-disposal/</ref>&nbsp; Even if a community does an excellent job of reducing prescriptions and taking back or disposing of unused opioids, there will still be a lot of opioids in communities. Researchers estimated that in 2005, 3-4% of people were being prescribed opioids for chronic pain<ref>https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm</ref>&nbsp;<span style="font-size: 13px;">and many others are legitimately being prescribed opioids for short-term pain management, and many others who are prescribed other drugs that can be misused, stolen or accidentally consumed by children.</span>
* Easy access to prescription drugs can lead to initial experimentation, especially by teens.


Failure to securely store prescription drugs contributes to the opioid epidemic and other health hazards in several ways.
* Stealing prescription drugs, which is much easier when they are commonly available in unlocked medicine cabinets, is often a step toward more destructive misuse.


#Easy access to prescription drugs can lead to initial experimentation, especially by teens.<ref>http://makeitasafehome.org/the-problem/</ref>
* Easy access to unsecured opioids or other prescription drugs contributes to theft by people who sell them or give them away.
#Stealing prescription drugs, which is much easier when they are commonly available in unlocked medicine cabinets, is often a step toward more destructive misuse.
#Easy access to unsecured opioids or other prescription drugs contributes to theft by people who sell them or give them away.
#Children who access unsecured drugs sometimes take them, thinking they are candy.  


= Staggering Statistics =
* Children who access unsecured drugs sometimes take them, thinking they are candy.


*Only 2 in 10 who have dangerous medications—such as opioid pain pills, stimulants used to treat ADHD, and sedatives—lock them up  
'''Staggering Statistics'''
*Nearly 70% of prescription opioid medications kept in homes with children are not stored safely<ref>https://www.jhsph.edu/news/news-releases/2017/majority-of-opioid-medications-not-safely-stored-in-home-with-children-survey-finds.html</ref>  
*A recent study of adults living in households with children, prescription opioids were stored in a locked or latched place in only 32.6% of households with young children and 11.7% with older children.<ref>https://pediatrics.aappublications.org/content/139/3/e20162161</ref>
* Only 2 in 10 who have dangerous medications—such as opioid pain pills, stimulants used to treat ADHD, and sedatives—lock them up. <ref> https://www.jhsph.edu/news/news-releases/2017/majority-of-opioid-medications-not-safely-stored-in-home-with-children-survey-finds.html</ref>  
*More than 1,600 teens begin abusing prescription drugs each day.<ref>http://www.rxsafetymatters.org/families-and-communities/facts-and-figures/</ref>
*Almost 1 in every 4 teens in America say they have misused or abused a prescription drug.<ref>http://www.rxsafetymatters.org/families-and-communities/facts-and-figures/</ref>
*60,000 kids under the age of 5 accidentally ingest these dangerous drugs every year and wind up in emergency rooms, according to data from the CDC<ref>http://www.consumerreports.org/drugs/best-ways-to-protect-kids-accidental-drug-poisoning-/</ref>
*12-17 year olds abuse prescription drugs more than ecstasy, heroin, crack/cocaine and methamphetamines combined.<ref>http://www.rxsafetymatters.org/families-and-communities/facts-and-figures/</ref>
*In one study, respondents reported storing their opioid medication in a locked (8.6%) or latched (20.9%) location.<ref>Kennedy-Hendricks A, et al. “Medication sharing, storage and disposal practices for opioid medications among US adults.” JAMA Intern Med 2016; 176:1027-29.</ref>
*San Diego's SafeHomes Coalition reports that more than 70% of misused prescription drugs come from someone's medicine cabinet, not from a dealer on the street. <ref>http://makeitasafehome.org/the-problem/</ref>
*The National Drug Intelligence Center reported that $184 million in prescription drug thefts occurred in 2010—a 350 percent increase since 2007<ref>https://www.nnw.org/publication/medication-theft-protecting-our-most-vulnerable-neighbors</ref>. &nbsp;They note that older people are especially vulnerable to theft of prescription drugs.
*Over half of teens, ages 12 and up, obtained prescription drugs from a friend or family member "for free"


= Shortcomings of Popular Lock Boxes and Safe Storage Products =
* A recent study of adults living in households with children found that prescription opioids were stored in a locked or latched place in only 32.6% of households with young children and 11.7% with older children. <ref> https://pediatrics.aappublications.org/content/139/3/e20162161</ref>


Given the dangers of having opioids and other medications easily accessible to teens, children or people who seek to steal pills, it is understandable that many coalitions and other stakeholders have promoted the use of medication lock boxes or other locked storage options.&nbsp; Unfortunately, many efforts to expand the use of popular safe storage products are of little value.&nbsp;
* More than 1,600 teens begin abusing prescription drugs each day. <ref>https://www.ridgefieldrecovery.com/drugs/prescription-drugs/related/commonly-abused-prescription-drugs/</ref>
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== Most Lockable Medication Boxes are Easily Opened ==


Many popular lock boxes for medications&nbsp;provide little actual protection from people who make even modest efforts to get the pills.&nbsp; A [https://www.forbes.com/sites/marcwebertobias/2018/07/02/security-containers-for-prescription-drugs-that-can-be-opened-by-kids/ 2018 article in Forbes magazine] describes how most safe storage products provide only a false sense of security.&nbsp; The author of the article, Marc Weber Tobias, an investigative attorney and physical security expert, writes:&nbsp;&nbsp;
* 1 in every 4 teens in America say they have misused or abused a prescription drug at least once. <ref> https://drugfree.org/newsroom/news-item/national-study-teen-misuse-and-abuse-of-prescription-drugs-up-33-percent-since-2008-stimulants-contributing-to-sustained-rx-epidemic/</ref>


"These containers sell for anywhere from ten to forty dollars and&nbsp;''appear secure''. And that is precisely the problem because the four major brands that we analyzed offer little real security once the “secret” about how they actually work and can be opened is understood. That “secret” is usually trivial, quickly grasped, and can be replicated easily."
* 60,000 kids under the age of 5 accidentally ingest these dangerous drugs every year and wind up in emergency rooms. <ref>http://www.consumerreports.org/drugs/best-ways-to-protect-kids-accidental-drug-poisoning-/</ref>


"The problem is that all of these products can be quickly and easily compromised. That means that if an adult relies upon the security of one of these containers to protect their meds from theft or pilfering, they may have a false sense of security and not be as vigilant as required to actually count their mediation to make sure that no doses are missing."
* 12-17 year olds abuse prescription drugs more than ecstasy, heroin, crack/cocaine and methamphetamines combined.  


"Every mechanical combination lock that we evaluated could be easily opened in a matter of seconds without dialing the correct numbers."
* In one study, only 8.6% of the respondents reported locking up their opioid medication and only 20.9% reported using a latched location. <ref>Kennedy-Hendricks A, et al. “Medication sharing, storage and disposal practices for opioid medications among US adults.” JAMA Intern Med 2016; 176:1027-29.</ref>


The following comment was made about one company's products: "They are easy to open and often can be accomplished without any expertise, and no evidence of entry. While they appear to be secure, they are not, and should not be relied upon for any real measure of security."
* The National Drug Intelligence Center notes that older people are especially vulnerable to theft of prescription drugs. They also indicate that over half of teens, ages 12 and up, obtained prescription drugs from a friend or family member "for free." <ref>https://www.nnw.org/publication/medication-theft-protecting-our-most-vulnerable-neighbors</ref>


Lockable pill bottles didn't work much better.&nbsp; Tobias&nbsp;states:&nbsp; "While the design is clever it is also not secure and we found could be simply compromised in at least four different ways. The design demonstrates a consistent problem with virtually all of these products: real security is usually inconsistent with inexpensive components, especially when made of plastic."&nbsp; &nbsp;He shares a simple video that supports that statement."<ref>https://www.forbes.com/sites/marcwebertobias/2018/07/02/security-containers-for-prescription-drugs-that-can-be-opened-by-kids</ref>
'''Succesful Strategies'''


The article does state that locked pill containers can prevent accidental use by small children.<ref>https://www.forbes.com/sites/marcwebertobias/2018/07/02/security-containers-for-prescription-drugs-that-can-be-opened-by-kids/</ref>
There are four primary successful strategies for communities to consider. The four strategies are conducive for implementation in conjunction with each other, but are covered separately below:


In this [https://www.youtube.com/watch?v=9uLCZGGwJ5g&feature=youtu.be video of an interview] with a founder and executive of one of the companies that makes and sells lock boxes for medications, the executive states that they provide a&nbsp;pill count sheet with their product and encourage people to do regular pill counts so they can detect if pills are being stolen.&nbsp;(10:45 to 13:15 and 21:10&nbsp;to 22:30 in the video.)
*'''Campaigns''' - An information campaign enables a variety of sectors in the community to collaborate. For example, an awareness campaign could engage law enforcement in drug take-backs. When law enforcement hosts drop-off locations, it promotes the overall campaign. Health department staff could disseminate information. Schools could provide an avenue for reaching parents and informing them about the location of take-back events. Pharmacies and the businesses could be engaged in sponsoring the campaign. A few models of national campaigns are provided in the “Promising Practices” section below.


Other research, not in the Forbes article, has shown that family members can often guess the number used as the code for opening a lock, and once they know the code, the lock box provides no obstacle for them stealing drugs--only a false sense of security for those using the locking boxes or pill bottles. (Source needed).
*'''Proper Disposal''' — In addition to take-backs and promotion of drop-off locations, there are medication neutralization kits that are available. These provide an appealing way to engage people to take action in a one-off event that increases their readiness to take more routine medication safety actions.


In spite of these shortcomings, the use of locked medication boxes will still be a deterrent to some people who are not aware of how to open them. (Source needed)
*'''Safe Storage''' — Increasing awareness about the importance of safe storage often goes hand-in-hand with providing members of the community free or affordable storage options. A variety of vendors associated with both safe storage and disposal products are listed in the “Available Tools and Resources” section below.
</div>
== People Given Lock Boxes Usually Don't Use Them&nbsp; ==


Anecdotal evidence from the evaluation of&nbsp;the use of medicatiion lock boxes revealed that six months after they have been provided with medication lock boxes, only a small percent&nbsp;of them were being used.&nbsp; (Source needed).&nbsp;&nbsp;
*'''Education'''— Families are generally more receptive to tips for medication safety than they might be for information about other forms of prevention. While any of the statistics above can be used in an education campaigns, some basic ideas can get people thinking about their own practices in a new way. For example, most people have not considered that it makes sense to keep a medication log or an inventory of all their medication types and amounts. Updating their inventory every six to twelve months keeps medication safety in their awareness. <ref>http://www.youthconnectionscoalition.org/content/wp-content/uploads/2015/04/safe_storage.pdf</ref> Likewise, people are ready to recall that the medicine cabinet in a bathroom is often not the best place to store prescriptions, since they should be stored in a cool, dry place. Humidity, heat, and the change in temperatures in the bathroom can alter the potency of some medications, and some storage devices can help protect medications from humidity, even if they are stored in bathrooms. <ref>http://www.youthconnectionscoalition.org/content/reduce-rx-abuse-2/the-proper-storage-of-prescription-drugs/</ref> This is a good lead-in to building a desire to obtain a lock-box.


Reasons given for why seniors don't use lock boxes include:
= Relevant Research =


*It is inconvenient or they don't want to have to remember the combination
This report highlights survey results that reveal the disconnect between parent knowledge and behavior regarding safe storage of medicine.<ref>https://www.safekids.org/node/25758</ref>
*It requires a change of behavior and adds a step to taking their medications.  
*They often don't believe that their grandchildren or other people who come to their home woudl steal their medications.&nbsp;


= Programs to Encourage Safe Storage and Reduce the Theft of Prescription Drugs =
= Impactful Federal, State, and Local Policies =


== Examples of Campaigns and Organzations Supporting Safe Storage ==
'''HHS 5-Point Plan.''' HHS developed a comprehensive strategy to improve access to prevention, treatment, and recovery support services. The strategy aims to support individuals to achieve long-term recovery and to prevent the health, social, and economic consequences associated with opioid misuse and addiction: <ref>https://www.ahrq.gov/sites/default/files/wysiwyg/topics/impact-opioid-final.pdf</ref>


'''Safe Homes Coalition'''<br/> [http://makeitasafehome.org/ SafeHomes Coalition] helps communities start programs to raise awareness of the proper use, storage and disposal of prescription drugs. (They can help your community start a chapter.) This [https://www.youtube.com/watch?v=m7C01hibtBg&feature=youtu.be SafeHomes PSA] provides more information.<br/> <br/> '''Up and Away Campaign'''<br/> This [http://www.upandaway.org/#about campaign] is designed to remind families about the importance of safe medicine storage. See [[TR_-_Improve_Safe_Storage_of_Prescription_Drugs|Tools & Resources]] for resources to distribute in your community.<br/> &nbsp;
* '''Better Addiction Prevention, Treatment, and Recovery Services.''' <ref> https://www.hhs.gov/opioids/sites/default/files/2018-09/opioid-fivepoint-strategy-20180917-508compliant.pdf</ref> This involves working across the continuum of care. It has evolved to explicitly include harm reduction.


== Launching Community-wide Collaborative Campaigns ==
* '''Better Data''' strengthens public health reporting to improve the timeliness and specificity of data and to inform a real-time public health response.


=== Drug Disposal and Safe Storage Campaign ===
* '''Better Pain Management''' advances the practice of pain management to enable access to high-quality, evidence-based pain care which reduces the burden of pain for individuals, families, and society while reducing the inappropriate use of opioids. <ref>https://www.hhs.gov/opioids/sites/default/files/2018-09/opioid-fivepoint-strategy-20180917-508compliant.pdf</ref>


Many communities have done some education and awareness efforts to increase prescription drug disposal and safe storage, but there is potential to reach significantly more people by engaging a diverse group of cross-sector partners in a campaign.
* '''Better Targeting of Overdose Reversing Drugs.''' This has a particular focus on high-risk populations. Increasing the availability and distribution of overdose-reversing medications ensures broader provision of these drugs to people most likely to experience or respond to an overdose.


'''See Details:&nbsp;&nbsp;'''[[Community_Safe_Storage_Campaign|Collaborative campaign to increase safe storage and prescription drug disposal]].<br/> &nbsp;
* '''Better Research.''' Supporting cutting-edge research advances our understanding of pain, overdose and addiction. This leads to the development of new treatment and identifies effective public health interventions to reduce opioid-related health harms.


=== Self-Funding Program for Safe Storage Caps (TimerCaps) ===
= Available Tools and Resources =


A local coalition, hospital, insurance company or non-profit can sponsor a program to distribute TimerCaps to people using prescription drugs. Sponsors have their logo imprinted on the cap and the label and can give them away at community events or via partners like pharmacists, community groups for seniors, or the prescribing doctors.
*'''SAFE Project:'''
*'''"At-Home Drug Disposal"''' is a SAFE Project written article that discusses the importance of proper disposal for opioid/prescription medications at home and how to do so safely.<ref>https://www.safeproject.us/disposal/</ref>
*See the wiki titled "Reduce Criminal Diversion of Prescription Drugs" for more detailed information on the illegal distribution and misuse of prescription drugs, encompassing activities like selling medications, doctor shopping, and theft or forgery of prescriptions.<ref>https://www.yoursafesolutions.us/wiki/Reduce_Criminal_Diversion_of_Prescription_Drugs</ref>
*See the wiki titled "Expand Prescription Drug Take-Back and Disposal Programs" for more detailed information on prescription drug take-back and disposal programs that enhance safety by reducing accidental exposure, protect the environment by preventing medications from contaminating water sources, and decrease drug diversion, limiting the misuse of prescription drugs that are often obtained from family or friends.


'''See Details:'''&nbsp;[[Details_for_a_Self-Funding_Safe_Storage_campaign|Self-Funding Safe Storage campaign]].<br/> &nbsp;
Here is a small sample of products which can either be distributed or advertised by community coalitions for families to purchase. Some of these are low-cost items, useful as give-ways at community events. Some of the items could have logos of local business sponsors or coalition branding added:


'''Case Study of Successful Coalition Campaign with TimerCaps'''
* '''IKeyp''' provides a safe that offers storage for personal items that need to be securely stored yet regularly accessed. It is linked to an app on a smart phone. <ref>https://www.ikeyp.com/</ref>  
South Kingston Program for Prevention and Rebels Inspiring Positive Lifestyles joined forces to raise funds to send youth leaders to CADCA training. The coalition held community awareness events and garnered local news publicity for their cause. For further details, see <div class="objectEmbed">&nbsp;</div>
= Safe Storage Products =
<div class="_">Below are list of products that can either be distributed within your community or advertised by community coalitions for families to purchase.</div> <div class="_">&nbsp;</div>  
== TimerCaps ==


[[File:Orange-TimerCap.jpg|Orange-TimerCap.jpg]]<br/> [https://timercap.com/ TimerCap] has a built-in LCD stopwatch timer. Like a stopwatch, the display on the cap counts-up, first the seconds, then minutes and hours since the cap was replaced.<br/> Timer caps come in different sizes, and they can replace an existing medicine bottle cap (or you can get a cap and bottle combination). Using a TimerCap helps accomplish all [[Six_principles_of_prescription_abuse_prevention|six principles of prescription abuse prevention]]. TimerCaps are easy to use and don't require a change in patient behavior.<br/> <br/> '''Improve Patient Safety'''
* '''Pack4U''' equips pharmacies with single-dose packaging. Using blister packs instead of having an entire bottle filled with prescription pills has been shown to help prevent accident poisonings in children. <ref>http://www.livescience.com/58351-kids-opioids-ingestion.html</ref>


*Provide the PEACE OF MIND of knowing they did or did not take their medication.  
*'''Safer Lock''' provides 4-digit combination lock boxes and locking caps. <ref>https://rxguardian.com/</ref>
*Help seniors avoid accidental overdoses and emergency room visits due to accidentally taking medications multiple times.  
*Easily know how long it has been since taking medication (to check before driving)
*Tracker form to help monitor their intake and pain levels or other information


<br/> '''Deter Theft of Pills'''
* '''TimerCaps''' have a built-in LCD stopwatch timer which displays how long it has been since the cap was last replaced. Timer caps come in different sizes, and they can replace an existing medicine bottle cap (or you can get a cap and bottle combination). TimerCaps are easy to use and don't require a change in patient behavior. They are also useful to track the timing since the last dosage -- reducing accidental overdoses and emergency room visits. <ref>https://www.timercap.com/</ref>


*Easily detect unwanted openings to the exact minute it happened
= Promising Practices =
*Deters kids or neighbors from sneaking a few pills--as they would be caught by the new time
*Solution to measure, monitor, manage, detect,and deter opioids abuse.
<br/> '''Economical Enough to Give Away at Events or by Partners'''<br/> TimerCaps are a low-cost option for improving safe storage (as low as $2.49 each), so they are economical as a give-away at educational events, or they can be given to people by community partners. Since the TimerCap lids and labels can be customized with a logo or other branding information, sponsors who make donations to fund the program receive valuable recognition for their support. See coalition testimonials: <div class="objectEmbed">[[File/view/Testimonials.pages/628136277/Testimonials.pages|[File:http://www.wikispaces.com/i/mime/32/empty.png Testimonials.pages]]] <div>[[File/view/Testimonials.pages/628136277/Testimonials.pages|Testimonials.pages]]
*[[File/detail/Testimonials.pages|Details]]
*[[File/view/Testimonials.pages/628136277/Testimonials.pages|Download]]
*743 KB
</div> </div> <br/> <br/> Visit [http://www.timercap.com www.timercap.com] or Contact: 800-557-4072 ext. 106<br/> &nbsp;
== Locking Storage Devices ==


'''Ikeyp'''<br/> [[File:Ikeyp Product.png|Ikeyp Product.png]]<br/> The world's first smart storage device for personal items that need to be securely stored yet regularly accessed. See [https://ikeyp.com/ website] for a comprehensive list of uses and products.<br/> Introductory video from a tech review: [https://vimeo.com/184531456 [1]]<br/> Gadgetgram Review including a video created by the manufacture of the product for CES 2018: [http://www.gadgetgram.com/2017/12/27/ikeyp-pro-smart-safe/ [2]]<br/> Retail price is $149.00 but a coordinated community-wide effort to promote safe storage of prescription drugs, bulk purchase discounts may be available.<br/> ''Contact for bulk purchasing'': 1-800-485-8904<br/> <br/> <span style="color: #67677e; font-size: 1.2em; letter-spacing: 0.5px">'''Lockable Caps'''</span><br/> '''Safer Lock'''<br/> [[File:Safer Lock Product.png|Safer Lock Product.png]]<br/> [https://saferlockrx.com/ Safer Lock] is a patented 4-digit combination locking cap. This could be purchased by communities at wholesale prices and distributed to community members at lower prices.<br/> <br/> Products:
Many communities have engaged in education and awareness efforts to increase prescription drug disposal and safe storage. There is potential to reach significantly more people by reaching a more diverse group of cross-sector partners in a campaign. The CDC promotes three different national campaigns: <ref>https://www.cdc.gov/medicationsafety/campaign_initiatives.html</ref>


#[https://saferlockrx.com/product/safer-lock/ Safer Lock]
* '''The National Action Plan for Adverse Drug Event Prevention (ADE Action Plan)''' identifies common, preventable, and measurable adverse drug events and aligns the efforts of federal health agencies to reduce patient harms from these ADEs nationwide. <ref>https://health.gov/our-work/national-health-initiatives/health-care-quality/adverse-drug-events</ref>
#[https://saferlockrx.com/product/medication-lock-box/ Safer Lock Box]
#[https://saferlockrx.com/product/safer-lock-cases/ Safer Lock Multi-Packs & Case]s
#[https://saferlockrx.com/product/book-safe/ Book Safe]


<br/> ''Contact for wholesale pricing'': (844) 209-5044<br/> &nbsp;
* '''The PROTECT Initiative''' is an innovative collaboration led by CDC. PROTECT unites public health agencies, private sector companies, professional organizations, consumer/patient advocates, and academic experts to keep children safe from unintended medication overdoses. <ref>https://www.cdc.gov/medicationsafety/protect/protect_initiative.html</ref>


== Pill Locker ==
* '''Up and Away Campaign.'''  "Put your medicines up and away and out of sight." This campaign is designed to remind families about the importance of safe medicine storage. <ref>https://www.cdc.gov/medicationsafety/protect/campaign.html</ref>


A promising new technology, [[Pill_Locker|Pill Locker]], uses advanced, but affordable, technology to package pills in a re-usable "locker" that dispenses pills one at a time, when they should be taken.<br/> &nbsp;
There are numerous examples of campaigns that were started by local communities. One example in Rhode Island is the partnership between
the South Kingstown Partnership for Prevention and Rebels Inspiring Positive Lifestyles. Their medication safety campaign held community awareness events and garnered local news publicity for their cause and were able to raise funds to send youth leaders to CADCA training. <ref>https://www.cadca.org/resources/coalitions-action-south-kingstown-partnership-prevention-launches-med-safety-campaign</ref>


&nbsp;
== Changing Drug Packaging ==
*Packaging opioid drugs in [https://en.wikipedia.org/wiki/Blister_pack blister packs] , or in single-dose packages, instead of having an entire bottle filled with prescription pills have been shown to help prevent accident poisonings in children<ref>http://www.livescience.com/58351-kids-opioids-ingestion.html</ref>
*One vendor of Single-dose packets is [https://pack4u.com/ Pack4U]. They provide a sophisticated, personalized option that allows pharmacies to deliver higher value to patients needing any prescriptions, including opioids.
= Education Topics =
== Educate Parents on Key Points ==
*The most secure way to keep prescription medications is in a locked storage box up and away
*If locking them is not an option keep them stored in a secured place in your home that is up and away from children.
*Keep a medication log so you know what medications you have and how many you have of each medication.
**You should try to do an inventory of all the medicines you have at least once a year, preferably every six months.<ref>http://www.youthconnectionscoalition.org/content/wp-content/uploads/2015/04/safe_storage.pdf</ref> 
*Medications whose labels specify that refrigeration is necessary should always be kept in the refrigerator.
*The medicine cabinet in a bathroom is often not the best place to store prescriptions. They should be stored in a cool dry place. Humidity, heat, and the change in temperatures in the bathroom can alter the potency of some medications.<ref>http://www.youthconnectionscoalition.org/content/reduce-rx-abuse-2/the-proper-storage-of-prescription-drugs/</ref>&nbsp;Some storage devices, such as iKeyp, can help protect medications from humidity, even if stored in bathrooms.
= Tools & Resources =
[[TR_-_Improve_Safe_Storage_of_Prescription_Drugs|TR - Increase Safe Storage of Prescription Drugs]]
= Scorecard Building =
[[PO_-_Improve_Safe_Storage_of_Prescription_Drugs|Potential Objective Details]]<br/> [[PM_-_Improve_Safe_Storage_of_Prescription_Drugs|Potential Measures and Data Sources]]
= Actions to Take =
[[PA_-_Improve_Safe_Storage_of_Prescription_Drugs|Potential Actions and Partners]]
Actions for Individuals
= Resources to Investigate =
[[RTI_-_Improve_Safe_Storage_of_Prescription_Drugs|More RTI on Safe Storage of Prescription Drugs]]<br/> <br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">PAGE MANAGER</span>:''' </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[insert name here]</span><br/> <span style="background-color: #ffffff; color: #222222; font-family: arial,sans-serif; font-size: 12.8px">'''<span style="color: #4d4d4d">SUBJECT MATTER EXPERT</span>''': </span><span style="background-color: #ffffff; color: #ff0000; font-family: arial,sans-serif; font-size: 12.8px">[fill out table below]</span>
{| border="1" class="wiki_table"
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[[Category:Pages with broken file links]] [[Category:SAFE-Prescriptions and Medical Response]]

Revision as of 18:04, 20 October 2024

Introductory Paragraph

It is essential that people who have prescription medications in their homes store them safely. When people begin to misuse prescription drugs, they often acquire them by stealing them from family, relatives, friends or from homes which they enter for other reasons (work, open houses, breaking and entering). If prescription drugs are safely stored, misuse can be stopped earlier, because people who have not yet developed a dependence on opioids usually do not go directly to illegal opioids like heroin or Fentanyl. Prescription drugs that are not safely stored can also be accidentally taken by young children or by curious pre-teens.

Key Information

Safe storage of prescription drugs within the home has been prioritized as a key strategy by many organizations and coalitions. [1] Even if a community does an excellent job of reducing prescriptions and taking back or disposing of unused opioids, there will still be a lot of opioids in communities. Thirty-two percent of American adults received a prescription for opioids in the two years preceding 2018. [2] In 2019, 22% of U.S. adults with chronic pain used a prescription opioid in the previous 3 months. [3] Many people are legitimately being prescribed opioids for short-term pain management. These can be misused, stolen or accidentally consumed by children. Failure to securely store prescription drugs contributes to the opioid epidemic and other health hazards in several ways.

  • Easy access to prescription drugs can lead to initial experimentation, especially by teens.
  • Stealing prescription drugs, which is much easier when they are commonly available in unlocked medicine cabinets, is often a step toward more destructive misuse.
  • Easy access to unsecured opioids or other prescription drugs contributes to theft by people who sell them or give them away.
  • Children who access unsecured drugs sometimes take them, thinking they are candy.

Staggering Statistics

  • Only 2 in 10 who have dangerous medications—such as opioid pain pills, stimulants used to treat ADHD, and sedatives—lock them up. [4]
  • A recent study of adults living in households with children found that prescription opioids were stored in a locked or latched place in only 32.6% of households with young children and 11.7% with older children. [5]
  • More than 1,600 teens begin abusing prescription drugs each day. [6]
  • 1 in every 4 teens in America say they have misused or abused a prescription drug at least once. [7]
  • 60,000 kids under the age of 5 accidentally ingest these dangerous drugs every year and wind up in emergency rooms. [8]
  • 12-17 year olds abuse prescription drugs more than ecstasy, heroin, crack/cocaine and methamphetamines combined.
  • In one study, only 8.6% of the respondents reported locking up their opioid medication and only 20.9% reported using a latched location. [9]
  • The National Drug Intelligence Center notes that older people are especially vulnerable to theft of prescription drugs. They also indicate that over half of teens, ages 12 and up, obtained prescription drugs from a friend or family member "for free." [10]

Succesful Strategies

There are four primary successful strategies for communities to consider. The four strategies are conducive for implementation in conjunction with each other, but are covered separately below:

  • Campaigns - An information campaign enables a variety of sectors in the community to collaborate. For example, an awareness campaign could engage law enforcement in drug take-backs. When law enforcement hosts drop-off locations, it promotes the overall campaign. Health department staff could disseminate information. Schools could provide an avenue for reaching parents and informing them about the location of take-back events. Pharmacies and the businesses could be engaged in sponsoring the campaign. A few models of national campaigns are provided in the “Promising Practices” section below.
  • Proper Disposal — In addition to take-backs and promotion of drop-off locations, there are medication neutralization kits that are available. These provide an appealing way to engage people to take action in a one-off event that increases their readiness to take more routine medication safety actions.
  • Safe Storage — Increasing awareness about the importance of safe storage often goes hand-in-hand with providing members of the community free or affordable storage options. A variety of vendors associated with both safe storage and disposal products are listed in the “Available Tools and Resources” section below.
  • Education— Families are generally more receptive to tips for medication safety than they might be for information about other forms of prevention. While any of the statistics above can be used in an education campaigns, some basic ideas can get people thinking about their own practices in a new way. For example, most people have not considered that it makes sense to keep a medication log or an inventory of all their medication types and amounts. Updating their inventory every six to twelve months keeps medication safety in their awareness. [11] Likewise, people are ready to recall that the medicine cabinet in a bathroom is often not the best place to store prescriptions, since they should be stored in a cool, dry place. Humidity, heat, and the change in temperatures in the bathroom can alter the potency of some medications, and some storage devices can help protect medications from humidity, even if they are stored in bathrooms. [12] This is a good lead-in to building a desire to obtain a lock-box.

Relevant Research

This report highlights survey results that reveal the disconnect between parent knowledge and behavior regarding safe storage of medicine.[13]

Impactful Federal, State, and Local Policies

HHS 5-Point Plan. HHS developed a comprehensive strategy to improve access to prevention, treatment, and recovery support services. The strategy aims to support individuals to achieve long-term recovery and to prevent the health, social, and economic consequences associated with opioid misuse and addiction: [14]

  • Better Addiction Prevention, Treatment, and Recovery Services. [15] This involves working across the continuum of care. It has evolved to explicitly include harm reduction.
  • Better Data strengthens public health reporting to improve the timeliness and specificity of data and to inform a real-time public health response.
  • Better Pain Management advances the practice of pain management to enable access to high-quality, evidence-based pain care which reduces the burden of pain for individuals, families, and society while reducing the inappropriate use of opioids. [16]
  • Better Targeting of Overdose Reversing Drugs. This has a particular focus on high-risk populations. Increasing the availability and distribution of overdose-reversing medications ensures broader provision of these drugs to people most likely to experience or respond to an overdose.
  • Better Research. Supporting cutting-edge research advances our understanding of pain, overdose and addiction. This leads to the development of new treatment and identifies effective public health interventions to reduce opioid-related health harms.

Available Tools and Resources

  • SAFE Project:
  • "At-Home Drug Disposal" is a SAFE Project written article that discusses the importance of proper disposal for opioid/prescription medications at home and how to do so safely.[17]
  • See the wiki titled "Reduce Criminal Diversion of Prescription Drugs" for more detailed information on the illegal distribution and misuse of prescription drugs, encompassing activities like selling medications, doctor shopping, and theft or forgery of prescriptions.[18]
  • See the wiki titled "Expand Prescription Drug Take-Back and Disposal Programs" for more detailed information on prescription drug take-back and disposal programs that enhance safety by reducing accidental exposure, protect the environment by preventing medications from contaminating water sources, and decrease drug diversion, limiting the misuse of prescription drugs that are often obtained from family or friends.

Here is a small sample of products which can either be distributed or advertised by community coalitions for families to purchase. Some of these are low-cost items, useful as give-ways at community events. Some of the items could have logos of local business sponsors or coalition branding added:

  • IKeyp provides a safe that offers storage for personal items that need to be securely stored yet regularly accessed. It is linked to an app on a smart phone. [19]
  • Pack4U equips pharmacies with single-dose packaging. Using blister packs instead of having an entire bottle filled with prescription pills has been shown to help prevent accident poisonings in children. [20]
  • Safer Lock provides 4-digit combination lock boxes and locking caps. [21]
  • TimerCaps have a built-in LCD stopwatch timer which displays how long it has been since the cap was last replaced. Timer caps come in different sizes, and they can replace an existing medicine bottle cap (or you can get a cap and bottle combination). TimerCaps are easy to use and don't require a change in patient behavior. They are also useful to track the timing since the last dosage -- reducing accidental overdoses and emergency room visits. [22]

Promising Practices

Many communities have engaged in education and awareness efforts to increase prescription drug disposal and safe storage. There is potential to reach significantly more people by reaching a more diverse group of cross-sector partners in a campaign. The CDC promotes three different national campaigns: [23]

  • The National Action Plan for Adverse Drug Event Prevention (ADE Action Plan) identifies common, preventable, and measurable adverse drug events and aligns the efforts of federal health agencies to reduce patient harms from these ADEs nationwide. [24]
  • The PROTECT Initiative is an innovative collaboration led by CDC. PROTECT unites public health agencies, private sector companies, professional organizations, consumer/patient advocates, and academic experts to keep children safe from unintended medication overdoses. [25]
  • Up and Away Campaign. "Put your medicines up and away and out of sight." This campaign is designed to remind families about the importance of safe medicine storage. [26]

There are numerous examples of campaigns that were started by local communities. One example in Rhode Island is the partnership between the South Kingstown Partnership for Prevention and Rebels Inspiring Positive Lifestyles. Their medication safety campaign held community awareness events and garnered local news publicity for their cause and were able to raise funds to send youth leaders to CADCA training. [27]

Sources

  1. ↑ https://end-overdose-epidemic.org/task-force-recommendations/
  2. ↑ https://www.norc.org/NewsEventsPublications/PressReleases/Pages/one-third-of-americans-have-received-an-opioid-prescription-in-the-past-two-years.aspx#:~:text=Nearly%20one%20in%20five%20adults,the%20prescription%20at%20least%20once.
  3. ↑ https://www.cdc.gov/nchs/data/nhsr/nhsr162-508.pdf
  4. ↑ https://www.jhsph.edu/news/news-releases/2017/majority-of-opioid-medications-not-safely-stored-in-home-with-children-survey-finds.html
  5. ↑ https://pediatrics.aappublications.org/content/139/3/e20162161
  6. ↑ https://www.ridgefieldrecovery.com/drugs/prescription-drugs/related/commonly-abused-prescription-drugs/
  7. ↑ https://drugfree.org/newsroom/news-item/national-study-teen-misuse-and-abuse-of-prescription-drugs-up-33-percent-since-2008-stimulants-contributing-to-sustained-rx-epidemic/
  8. ↑ http://www.consumerreports.org/drugs/best-ways-to-protect-kids-accidental-drug-poisoning-/
  9. ↑ Kennedy-Hendricks A, et al. “Medication sharing, storage and disposal practices for opioid medications among US adults.” JAMA Intern Med 2016; 176:1027-29.
  10. ↑ https://www.nnw.org/publication/medication-theft-protecting-our-most-vulnerable-neighbors
  11. ↑ http://www.youthconnectionscoalition.org/content/wp-content/uploads/2015/04/safe_storage.pdf
  12. ↑ http://www.youthconnectionscoalition.org/content/reduce-rx-abuse-2/the-proper-storage-of-prescription-drugs/
  13. ↑ https://www.safekids.org/node/25758
  14. ↑ https://www.ahrq.gov/sites/default/files/wysiwyg/topics/impact-opioid-final.pdf
  15. ↑ https://www.hhs.gov/opioids/sites/default/files/2018-09/opioid-fivepoint-strategy-20180917-508compliant.pdf
  16. ↑ https://www.hhs.gov/opioids/sites/default/files/2018-09/opioid-fivepoint-strategy-20180917-508compliant.pdf
  17. ↑ https://www.safeproject.us/disposal/
  18. ↑ https://www.yoursafesolutions.us/wiki/Reduce_Criminal_Diversion_of_Prescription_Drugs
  19. ↑ https://www.ikeyp.com/
  20. ↑ http://www.livescience.com/58351-kids-opioids-ingestion.html
  21. ↑ https://rxguardian.com/
  22. ↑ https://www.timercap.com/
  23. ↑ https://www.cdc.gov/medicationsafety/campaign_initiatives.html
  24. ↑ https://health.gov/our-work/national-health-initiatives/health-care-quality/adverse-drug-events
  25. ↑ https://www.cdc.gov/medicationsafety/protect/protect_initiative.html
  26. ↑ https://www.cdc.gov/medicationsafety/protect/campaign.html
  27. ↑ https://www.cadca.org/resources/coalitions-action-south-kingstown-partnership-prevention-launches-med-safety-campaign
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