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

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''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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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.
 
= Background =
 
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>
 
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.<ref>http://makeitasafehome.org/the-problem/</ref>
#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
*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>
*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 =
 
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;
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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;
 
"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."
 
"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."
 
"Every mechanical combination lock that we evaluated could be easily opened in a matter of seconds without dialing the correct numbers."
 
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."
 
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>
 
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>
 
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.)
 
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).
 
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)
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== 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;
 
Reasons given for why seniors don't use lock boxes include:
 
*It is inconvenient or they don't want to have to remember the combination
*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 =
 
== Examples of Campaigns and Organzations Supporting Safe Storage ==
 
'''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;
 
== Launching Community-wide Collaborative Campaigns ==
 
=== Drug Disposal and Safe Storage Campaign ===
 
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.
 
'''See Details:&nbsp;&nbsp;'''[[Community_Safe_Storage_Campaign|Collaborative campaign to increase safe storage and prescription drug disposal]].<br/> &nbsp;
 
=== Self-Funding Program for Safe Storage Caps (TimerCaps) ===
 
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.
 
'''See Details:'''&nbsp;[[Details_for_a_Self-Funding_Safe_Storage_campaign|Self-Funding Safe Storage campaign]].<br/> &nbsp;
 
'''Case Study of Successful Coalition Campaign with TimerCaps'''
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'''
 
*Provide the PEACE OF MIND of knowing they did or did not take their medication.
*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'''
 
*Easily detect unwanted openings to the exact minute it happened
*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:
 
#[https://saferlockrx.com/product/safer-lock/ Safer Lock]
#[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;
 
== Pill Locker ==
 
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;
 
&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>
 
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= Sources =
 
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