List of References
Explore our web page for essential medication safety resources from around the web, offering articles from experts, videos, and more to help you make informed healthcare decisions.
Definitions
In-home Disposal System (or At-home Disposal System)
- A system that changes the physical integrity of the drug’s formulation,
- Renders the active ingredient(s) unusable (for all practical purposes, mitigating the risk of nonmedical use or overdose),
- Is non-toxic and non-hazardous, poses no threat to the consumer and reduces drug exposure to the environment, and,
- Acts as a deterrent for misuse.
Prescription Drug Misuse
If you take a medicine in a way that is different from what the doctor prescribed, it is called prescription drug misuse. It could be:
- Taking a medicine that was prescribed for someone else
- Taking a larger dose than you are supposed to
- Taking the medicine in a different way than you are supposed to. This might be crushing tablets and then snorting or injecting them.
- Using the medicine for another purpose, such as getting high
Misusing some prescription drugs can lead to addiction. These include opioids, sedatives, tranquilizers, and stimulants.
Every medicine has some risk of side effects. Doctors take this into account when prescribing medicines. People who misuse these drugs may not understand the risks. The medicines may not be safe for them, especially at higher doses or when taken with other medicines. Source: NIH: National Institute on Drug Abuse.
Risk Evaluation and Mitigation Strategy (REMS)
A Risk Evaluation and Mitigation Strategy (REMS) is a drug safety program that the U.S. Food and Drug Administration (FDA) can require for certain medications with serious safety concerns to help ensure the benefits of the medication outweigh its risks. REMS are designed to reinforce medication use behaviors and actions that support the safe use of that medication. While all medications have labeling that informs health care stakeholders about medication risks, only a few medications require a REMS.
Key Statistics
- $1 dollar of prevention is equal to $18 dollars of savings (28)
- 53% of Americans unsure how to safely dispose of unused medications (11)
- 66% of all adults (131 million people) take at least one medication (11)
- 92% of veterans with a substance use disorder didn’t receive treatment in 2021 (18)
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References
- 2021 US Pharmacy Market Insights Report.; 2021. https://www.onekeydata.com/downloads/reports/2021_US_Pharmacy_Market_Report.pdf
- Abuse NI on D. Investing in Prevention Makes Good Financial Sense. National Institute on Drug Abuse. Published April 28, 2022. https://nida.nih.gov/about-nida/noras-blog/2022/04/investing-in-prevention-makes-good-financial-sense
- Allen JD, Casavant MJ, Spiller HA, Chounthirath T, Hodges NL, Smith GA. Prescription Opioid Exposures Among Children and Adolescents in the United States: 2000–2015. Pediatrics. 2017;139(4):e20163382. doi:https://doi.org/10.1542/peds.2016-3382
- Bailey V. Caring for Opioid Use Disorder Patients Costs Hospitals $95B Per Year. Rev Cycle Management. Published 2023. Accessed September 5, 2024. https://www.techtarget.com/revcyclemanagement/news/366599981/Caring-for-Opioid-Use-Disorder-Patients-Costs-Hospitals-95B-Per-Year
- Barnett MJ, Clubbs B, Woodyard A, et al. Barriers and motivational factors for engaging in novel opioid and medication disposal-related services in community pharmacies. Res Social Adm Pharm. 2024;20(8):713-722. doi:10.1016/j.sapharm.2024.03.011
- Buffington DE, Lozicki A, Alfieri T, Bond TC. Understanding factors that contribute to the disposal of unused opioid medication. Journal of Pain Research. 2019;Volume 12:725-732. doi:https://doi.org/10.2147/jpr.s171742
- Caldeira K. College students rarely seek help despite serious substance use problems. Journal of Substance Abuse Treatment. 2009;37(4):368-378. doi:https://doi.org/10.1016/j.jsat.2009.04.005
- Cooper M, Gyawali S, Smith T, Yan J. Key Substance Use and Mental Health Indicators in the United States: Results from the 2022 National Survey on Drug Use and Health.; 2022. https://www.samhsa.gov/data/sites/default/files/reports/rpt42731/2022-nsduh-nnr.pdf
- The Cost of Opioid Use Disorder and the Value of Aversion | Population Health Sciences. phs.weill.cornell.edu. https://phs.weill.cornell.edu/news/cost-opioid-use-disorder-and-value-aversion
- De-An Zhang, Marilan Luong, Emmanuel Barragan, Frederic Bushnell, Robert. H. Cho, Selina Poon, Preventing Opioid Diversion and Abuse by Using an At-home Opioid Disposal Method: An Improvement Project in a Pediatric Outpatient Surgical Center, Journal of the Pediatric Orthopaedic Society of North America, Volume 3, Issue 1, 2021, 150, ISSN 2768-2765, https://doi.org/10.55275/JPOSNA-2021-150.
- DigitalHubUSA. More than two-thirds of Americans don’t know how to properly dispose medications, new research reveals. digitalhub US. Published April 22, 2021. https://swnsdigital.com/us/2021/04/more-than-two-thirds-of-americans-dont-know-how-to-properly-dispose-medications-new-research-reveals/
- The Economic Toll of the Opioid Crisis Reached Nearly $1.5 Trillion in 2020 – The Economic Toll of the Opioid Crisis Reached Nearly $1.5 Trillion in 2020 – United States Joint Economic Committee. www.jec.senate.gov. https://www.jec.senate.gov/public/index.cfm/democrats/2022/9/the-economic-toll-of-the-opioid-crisis-reached-nearly-1-5-trillion-in-2020
- Frazier W, Cochran G, Lo-Ciganic W, et al. Medication-Assisted Treatment and Opioid Use Before and After Overdose in Pennsylvania Medicaid. JAMA. 2017;318(8):750–752. doi:10.1001/jama.2017.7818
- Hudgins JD, Porter JJ, Monuteaux MC, Bourgeois FT. Prescription opioid use and misuse among adolescents and young adults in the United States: A national survey study. Alegria M, ed. PLOS Medicine. 2019;16(11):1-15. doi:https://doi.org/10.1371/journal.pmed.100292s
- Hughes TD, Nowak J, Sottung E, Mustafa A, Lingechetty G. Empowering Pharmacists: Strategies for Addressing the Opioid Crisis through a Public Health Lens. Pharmacy. 2024; 12(3):82. https://doi.org/10.3390/pharmacy12030082
- JoAnn Stubbings, Stephanie Y. Crawford, Thomas E. Menighan, A safe in-home disposal system with every opioid prescription? Food and Drug Administration is considering a potential new Risk Evaluation and Mitigation Strategy that could impact pharmacists, Journal of the American Pharmacists Association, Volume 62, Issue 2, 2022, Pages 413-418, ISSN 1544-3191, https://doi.org/10.1016/j.japh.2021.11.009.
- Kennedy-Hendricks A, Gielen A, McDonald E, McGinty EE, Shields W, Barry CL. Medication Sharing, Storage, and Disposal Practices for Opioid Medications Among US Adults. JAMA Internal Medicine. 2016;176(7):1027. doi:https://doi.org/10.1001/jamainternmed.2016.2543
- Lack of treatment for substance use and mental illness among veterans U.S. 2022 | Statista. Statista. Published 2022. Accessed September 5, 2024. https://www.statista.com/statistics/1129528/substance-use-mental-illness-treatment-gap-veterans-us/
- Latimore AD, Elizabeth Salisbury- Afshar, Duff N, et al. Primary, Secondary, and Tertiary Prevention of Substance Use Disorders through Socioecological Strategies. NAM perspectives. 2023;9(6). doi:https://doi.org/10.31478/202309b
- Lipari R, Williams M, Van horn S. Why Do Adults Misuse Prescription Drugs? Samhsa.gov. Published July 27, 2017. https://www.samhsa.gov/data/sites/default/files/report_3210/ShortReport-3210.html
- Makki M, Hassali MA, Awaisu A, Hashmi F. The Prevalence of Unused Medications in Homes. Pharmacy (Basel). 2019;7(2):61. Published 2019 Jun 13. doi:10.3390/pharmacy7020061
- McCauley JL, Back SE, Brady KT. Pilot of a brief, web-based educational intervention targeting safe storage and disposal of prescription opioids. Addict Behav. 2013;38(6):2230–2235.
- Miller T, Hendrie D. Substance Abuse Prevention Dollars and Cents: A Cost-Benefit Analysis.; 2008. https://www.samhsa.gov/sites/default/files/cost-benefits-prevention.pdf
- Nakiganda R, Katende F, Natukunda F, et al. Safe Disposal of Unused Medicine among Health Professions Students at Makerere University: Knowledge, Practices and Barrier. Preprint. Res Sq. 2023;rs.3.rs-2525937. Published 2023 Jan 31. doi:10.21203/rs.3.rs-2525937/v1
- Pharmacy Technicians : Occupational Outlook Handbook: : U.S. Bureau of Labor Statistics. Bls.gov. Published April 12, 2019. https://www.bls.gov/ooh/healthcare/pharmacy-technicians.htm
- SAMHSA. HHS, SAMHSA Release 2022 National Survey on Drug Use and Health Data. www.samhsa.gov. Published November 13, 2023. https://www.samhsa.gov/newsroom/press-announcements/20231113/hhs-samhsa-release-2022-nsduh-data
- Salmon K, Hogan L. Let’s Help Maryland Put a STOP to Heroin Use and Prescription Drug Abuse. HEROIN and OPIOID AWARENESS & PREVENTION TOOLKIT. https://marylandpublicschools.org/Documents/heroinprevention/HeroinOpioidToolkit.pdf
- Smart Investment: Costs and Benefits of Substance Use Prevention and Behavioral Health Promotion We Can Improve the Lives of Young People, Their Families, and Communities -and Save Money – by Investing in Effective Prevention. Why It Matters. Accessed September 5, 2024. https://www.oregon.gov/adpc/MeetingDocuments/Cost-Effectiveness_FINAL.pdf
- U.S. Bureau of Labor Statistics. Pharmacists. www.bls.gov. Published April 25, 2023. https://www.bls.gov/oes/current/oes291051.htm
- VA equips 200,000 Veterans with lifesaving naloxone – VA News. https://news.va.gov/press-room/va-equips-200000-veterans-with-lifesaving-naloxone/
- Voepel-Lewis T, Boyd CJ, Tait AR, McCabe SE, Zikmund-Fisher BJ. A Risk Education Program Decreases Leftover Prescription Opioid Retention: An RCT. American Journal of Preventive Medicine. 2022;63(4):564-573. doi:https://doi.org/10.1016/j.amepre.2022.04.035
- Voepel-Lewis T, Farley FA, Grant J, et al. Behavioral Intervention and Disposal of Leftover Opioids: A Randomized Trial. Pediatrics. 2020;145(1). doi:https://doi.org/10.1542/peds.2019-1431
- Waddell C, Schwartz C, Barican J, Nicole L.A. Catherine. Early prevention programs for children could help end the opioid crisis. The Conversation. Published August 14, 2024. Accessed September 5, 2024. https://theconversation.com/early-prevention-programs-for-children-could-help-end-the-opioid-crisis-235760