Exposure to medicines in the family medicine cabinet: is it a harbinger of later opioid dependence?

Grandparents and child at pharmacy counter

Stopping substance use disorder before it begins has been a long-standing goal of public health and prevention efforts. This article discusses the “how” and “why” of substance misuse, which is necessary to know in order to develop effective interventions. Also examined is the relationship between opioids being in the home of adolescents younger than 15 and how this correlates to developing opioid use disorder in later years.

Key adolescent risk factors shown to be predictors of later opioid dependence include the following:

Health practices of parents, specifically the presence of opioids in the home medicine cabinet at 14 years old
Health beliefs of adolescents, in particular, having a belief that there is a “pill for everything”
Health behaviors of adolescents – using alcohol before 15 years
Study results such as these are vital to support and design effective interventions to help prevent the development of opioid use disorder. Providing mechanisms for safe disposal and safe storage of prescription opioids are key components of impactful and effective prevention programs. In keeping with previous research, this study demonstrates that the risk of developing future substance use disorders can be minimized through prevention efforts at the family and school levels and through appropriate interventions.

The cost of opioid use disorder and the value of aversion

The consequences of opioid misuse impact human lives, families, and communities, and also have a societal and economic impact. This study analyzes the financial burden of the opioid epidemic to create a framework for responsible use of limited resources. Perspectives of taxpayers, society, and the healthcare sector are considered in estimating the mean value of opioid use disorder (OUD) aversion and are categorized by age. Data from 2015 – 2018 was used, a period which was marked by a decrease of OUD, but an increase in spending on the diagnosis. Most of this financial impact was attributed to an increasing amount of fentanyl supply and use. 

Results from the 2020 National Survey on Drug Use and Health (NSDUH): Key Substance Use and Mental Health Indicators in the United States

This annual report by the Substance Abuse and Mental Health Services Administration (SAMHSA) addresses key indicators of substance use and mental health among adolescents and adults. Unlike earlier surveys, this one was conducted during the COVID-19 pandemic and utilized a different survey instrument. Notably, it employed web-based interviews and used criteria from the Diagnostic and Statistical Manual of Mental Health Disorders, 5th edition (DSM-5), replacing the previous DSM-IV criteria.

How People Obtain the Prescription Pain Relievers They Misuse

This article highlights how people acquire prescription pain medication for nonmedical use and concludes that most are secured at no cost through friends, family, and medical providers. Such information is valuable for prevention efforts and allows for a better understanding of the ways and means individuals come in contact with potentially addictive substances. The article suggests that Americans not share prescription pain medication and dispose of any remaining medicine when the need for the prescription has passed as a way to minimize misuse.

Behavioral Intervention and Disposal of Leftover Opioids: A Randomized Trial

Results from this study suggest that the prevalence of prescription opioid use among adolescents and young adults in the US is high despite known risks for future opioid and other drug use disorders. Reported prescription opioid misuse is common among adolescents and young adults and often associated with additional substance abuse, underscoring the importance of drug and alcohol screening programs in this population. Prevention and treatment efforts should take into account that greater than half of youths misusing prescription opioids obtain these medications through friends and relatives.

Behavioral Intervention and Disposal of Leftover Opioids: A Randomized Trial

Providing a medication disposal method and an educational intervention is more effective than providing a disposal method alone. This study found that delivering disposal methods and information about the risks of retaining medication at the time of opioid prescription effectively encouraged parents to dispose of their children’s leftover medication properly. This two-pronged intervention reduced parents’ intent to retain prescription opioid medication. Additional research is needed to further determine the long-term impact of such interventions on opioid misuse and adverse events.

The Economic Toll of the Opioid Crisis Reached Nearly $1.5 Trillion in 2020

The opioid crisis cost the U.S. nearly $1.5 trillion in 2020, driven by increased opioid use and an increase in overdose deaths during the COVID-19 pandemic. Pandemic-related disruptions, including reduced access to treatment and heightened social and economic stress, were considered to be factors in these outcomes. Racial disparities were also highlighted during this time, as Black Americans faced a sharper increase in overdose rates and greater barriers to treatment. While federal and state efforts have improved funding and access to care, more is needed to expand treatment, reduce stigma, and address the ongoing crisis.

Medication-Assisted Treatment and Opioid Use Before and After Overdose in Pennsylvania

Doctor helping child with medication

This study analyzes the prescribing of opioids and medication-assisted treatment (MAT) to people who had experienced a non-fatal opioid overdose and who received their healthcare coverage through Medicaid in Pennsylvania. Individuals who have coverage through Medicaid have a three-fold risk of opioid overdose compared to those who have commercial healthcare coverage. The analysis included rates of MAT use, duration of using opioids, and prescription opioid use status prior to and following an overdose event. Results showed that patients had minimum increases in MAT use and a continued high level of prescription opioid use, suggesting that the state has ample room to improve its current system and to improve health outcomes for this at-risk population. 

Barriers and motivational factors for engaging in novel opioid and medication disposal-related services in community pharmacies

Doctor helping child with medication

The study implemented an at-home opioid disposal product in a pediatric outpatient surgical center in an attempt to address the risks of opioid misuse and diversion from leftover prescription opioid medication. Patients or guardians were provided with disposal packets and educational materials during the discharge process. This process led to a significant decrease in retention and an increase in proper disposal of unused opioid medications. Families reported finding the packets convenient and effective. This initiative demonstrated the potential of such interventions to improve opioid safety practice and highlighted the importance of integrating disposal tools and education into discharge planning as a way to help combat the opioid epidemic.