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What if pharmacies give a lockbox to every patient taking a controlled medication? This project aims to find out.
Mehul ParikAs a third-year pharmacy student doing a public health rotation with Pharmacy Planning Services, Inc. (PPSI) and the Marin County Pharmacists Association, I was assigned a trial project: to determine whether making lockboxes for prescription medications available in pharmacies would deter use of drugs by those for whom they were not intended.
The CDC has reported that fewer than 3% of households lock up their schedule prescription medications. It also reports that 70% of schedule medications such as narcotics, sleeping pills, and central nervous system depressants are obtained for illegal use from a friend or relative, and more frequently from their medicine cabinets.
Abuse of schedule prescription medications has led to an epidemic of drug overdose in young people. From 2000 to 2009, the number of deaths increased by 90%, and from 2010 to 2013, instances of heroin overdose tripled. The CDC has reported that 75% of heroin users began their drug use with prescription opioids. In an effort to stem this epidemic, Massachusetts became the first state to pass legislation requiring all pharmacies to make medication lockboxes available in their stores.
After my preceptor and I attended several meetings with the county public health officer at which prevention of prescription drug abuse was discussed, I realized the importance of promoting an ordinance or legislative action similar to that of Massachusetts. The county public health officer listened to the outline of my plan and authorized me to proceed.
Fifty lockboxes purchased with funds from the public health officer’s budget were supplied to a local independent pharmacy, which then gave them at no cost to patients receiving schedule prescription medications.
My classmate Katie Ho developed a survey to help gauge whether patients who used lockboxes would become more knowledgeable about the dangers of schedule drugs and more careful about keeping them from people who should not have access to them.
Our goal was to help decrease the number of young people getting into unhealthy situations through use of medications not intended for them.
Each patient who received a schedule prescription medication was given the survey to fill out. One month later, the patients who received the lockboxes were given a follow-up questionnaire to assess the effectiveness of the lockbox strategy. The project is currently ongoing and not all the medication lockboxes have been distributed yet.
To further increase awareness of safe medication storage, I promoted the medication lockbox at several events.
At a town hall meeting held in Marin, I was able to tell the recently elected State Senator Mike McGuire about schedule prescription medication abuse and about Massachusetts’ 2011 legislation requiring all pharmacies to carry medication lockboxes.
I also promoted the concept at the “Dose of Awareness” 5K Walk and Health Expo, held at a middle school in Contra Costa County to raise awareness of prescription drug abuse and its prevention. In a presentation for visitors to our booth, I emphasized the importance of storing prescription medications in lockbox devices. I was interviewed at the event by the local ABC television affiliate, which enabled me to spread the word even further.
Posters promoting safekeeping of medications in homes and away from young children, teenagers, and others who might abuse them can be ordered free of charge from the CDC (www.knowyourotcs.org/tools/).
Pharmacists are instrumental in educating their patients about the importance of maintaining safe storage of medications in their homes. For more information about the medication lockbox project and a copy of the survey, please e-mail me at mailto:firstname.lastname@example.org.
Mehul Parikh is a 2016 PharmD candidate at Touro University, Vallejo, Calif. He would like to acknowledge the assistance on this project of Aglaia Panos, PharmD, at PPSI. E-mail him at mailto:email@example.com.