Maximizing Rx Drug Storage and Disposal Efforts: Lessons Learned from Florida Coalitions

Introduction: Prescription (Rx) drug abuse is a public health priority and MTF identifies Rx drugs as the second most commonly abused drug behind marijuana. Multiple drivers contribute to this issue involving clinical practice, prescribing, and perceptions about Rx drug safety. Locally, community coalitions are implementing a multi-pronged approach. However, many have prioritized strategies to reduce home access as the NSDUH reports that 70 percent of people who abuse Rx drugs obtain them from friends and relatives. Coalition survey results indicate most youth who abuse Rx drugs obtained them from a family member’s home. Furthermore, these surveys find that many community members do not monitor or lock up medications and are more likely to save drugs than dispose of them. To address this issue many coalitions are implementing Rx Drug Take-Back Programs and promoting home tracking and storage which include complementary public education campaigns. However, limited research exists to guide this work. Our study explores associations between community perceptions and home tracking, storage, and disposal practices. 

Methods: This mixed-methods study is divided into two distinct phases. Phase I is a macro-level exploration of coalitions’ Rx abuse prevention efforts using CADCA’s Annual Survey of Coalitions (2011-2015), a web-based survey completed by approximately 750 coalition leaders. In addition, Phase I includes a qualitative analysis of Rx abuse prevention logic models and action plans submitted by applicants to CADCA’s annual GOT OUTCOMES! Awards program. Phase II is a case study of three Florida coalitions broken into three steps: (A) CADCA and coalition collaboration to implement local Rx take-back initiatives, (B) Administration and analysis of a community survey to assess knowledge and perceptions associated with Rx drug disposal, and (C) Qualitative community member interviews to enhance the survey findings.

Results: Phase I findings indicate that over the past five years (2011-2015), at least 53% addressed Rx drug misuse and at least 57% considered it a top five community problem. All coalition logic models and action plans included Rx drug take-back day initiatives and a public education campaign. Other complementary interventions included increasing permanent medication drop-box locations, providing HIPPA certified medication destruction services, and distributing home lock boxes and medication tracking sheets. Phase II A results include over 1,500 pounds of collected medications across 22 take-back events and coalitions report increased community interest in the problem. To date, we have recruited around 300 community survey participants and coalitions are recruiting additional participants. Results for Phase II B and C will be reported.

Conclusions: Coalitions addressing Rx drug abuse are implementing strategies to reduce home access and take-back initiatives are common. More research can determine how to maximize Rx storage and disposal initiatives. For example, might incentives increase participation? What are the best locations for Rx drug drop-boxes? How do demographic characteristics influence disposal behavior? This study offers guidance to coalitions to inform their efforts.