Barbara Allen, Project Director 

Prescription opioids and home safety

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Learning Objectives

  • Recognize why prescription opioids in the home is an important safety topic for the aging adult population of Montana.
  • Better understand medication diversion and why it is important to properly store and dispose of unused prescription opioids.
  • Identify ways to safely store medications in the home.
  • Better understand the different medication disposal methods available.

Important Considerations - Montana is an “aging state”: 

2020:

  • In 66% of MT counties – 20-29.9% of population is 65+
  • In 11% of MT counties – 30-39.9% of population is 65+ 

2025: 

  • In 66% of MT counties – 20-29.9% of population is 65+ 
  • In 23% of MT counties – 30-39.9% of population is 65+ 

2030: 

  • In 55% of MT counties – 20-29.9% of population is 65+ 
  • In 38% of MT counties – 30-39.9% of population is 65+ 
  • In 2 counties – 40-49.9% of population is 65+ (Data from MT DOC/Census and Economic Information Center – 8/2010)

Keep in mind…Nationally:

  • From 1999 to 2017, the greatest percentage change in drug overdose death rates occurred among adults aged 55–64, increasing from 4.2 per 100,000 in 1999 to 28.0 in 2017, a more than 6-fold increase.

Aging Adults and Prescription Opioids in the Home

  • People ages 45+ are prescribed not only more opioids, but higher dosages as well. Increasing likelihood of trips and falls. 
  • Emerging evidence that Medicare patients have some of the highest and fastest-growing rates of opioid use disorder. 
  • Elderly less likely to recognize signs of OD 
  • Aging populations are less able to metabolize medications properly 
  • Most likely taking more than 1 prescription = drug interactions
  • More grandparents are raising grandchildren than ever before. 
    • Increases the likelihood of elder abuse as many aging individuals are raising grandchildren due to the opioid problem.
    • Increases the hazards associated with accidental poisonings among children.

Why do we care about this topic?

  • Since 2000, more than 700 Montanans have died from prescription opioid overdoses.
  • 299 of those deaths were people aged 45+ (42.7%).
  • How does this affect how we help address keeping our homes and families safe?

Safe Storage = A Safe Home

  • When not stored properly, prescription opioids can fall into the wrong hands, leading to unintentional poisoning.
    • Prescription drug diversion: the deflection of prescription drugs from medical sources into the illegal market. This includes transferring drugs to people they were not prescribed for. 
    • It’s against the law to divert drugs—you can go to jail for it. 
  • Hide and lock away prescription opioids where family, friends, or guests cannot find them. 
  • Keep medications in original container. Remove/black out your name and prescription number to protect your identity before disposing it. 
  • Make sure to always keep your medications locked up and stored away, out of reach of children or pets.

Safe Storage – Out of Sight

  • Safe Medication Storage Zone – Out of Sight, out of reach!
  • Are medications safely stored in areas that are inaccessible to children?
  • Medications should be, not only out of reach, but also out of sight!
  • Securely storing medications is as important as securely storing a gun in your home!

Safe Medication Storage – Locking Cases

  • Locking medicine cases are available for purchase on-line and at most major big box stores.
    • Costs average around $25.
  • Make every effort to store these lock boxes out of reach and most importantly, out of sight.

Safe Medication Disposal – Methods

  • 1st Choice: Utilize local medication take-back community events.
  • 2nd Choice: Utilize medication drop-boxes located in your community.
  • 3rd Choice: Utilize a Deterra® or other medication neutralization pouch.
  • 4th Choice: Utilize household disposal using coffee grounds/kitty litter, etc.
  • 5th Choice: Flush medications if directed to do so on the label. Does not apply to septic systems.

Prescription Medication Take Back Events

Encourage participation in community events such as National Take-Back Day.

Montana, 2019 event: 

  • 1,720 lbs. collected 
  • 26 collection sites

Click here to locate the next Take Back Day in your area. https://takebackday.dea.gov/

Prescription Medication Drop Boxes

Disposing of unused medications in a secure collection box is the preferred method for safely disposing of household medications. These collection boxes are available at permanent collection receptables that reside at law enforcement offices, pharmacies, or other secure locations.

As of August 2019, there are 164 drop-boxes in MT: 

  • 50 = police departments or sheriff’s offices 
  • 76 = pharmacies
  • 38 = health clinics or hospitals.

For specific locations, visit https://dphhs.mt.gov/amdd/substanceabuse/dropboxlocations

The Following Items CAN Be Disposed of in Medication Drop Boxes

  • Prescriptions Medications 
  • Pet Medications
  • Over-the-Counter Medications 
  • Prescription Ointments 
  • Prescription Patches 
  • Vitamins

The Following Items CAN NOT Be Disposed of in Medication Drop Boxes

  • Needles and Syringes
  • Thermometers 
  • Hydrogen Peroxide 
  • Inhalers 
  • Lotions and Liquids 
  • Aerosol Cans

Safe Disposal – Medication Deactivation Pouches

Single-use medication deactivation pouches: 

  • Contain a substance that neutralizes prescription medications when combined, rendering it safe to dispose of in household garbage. 
  • Allows individuals to deactivate prescription medications in the home for quick and easy disposal. * Ideal for those who cannot travel to medication drop box locations.

Safe Disposal – Household Trash

If a community dropbox is unavailable, medicines can be:

  • Mixed: Mix medicines (do not crush tablets or capsules) with an unpalatable substance such as dirt, kitty litter, or used coffee grounds;
  • Place:  Place the mixture in a container such as a sealed plastic bag;
  • Throw:  Throw the container in your housedhold trash;
  • Scratch Out:  Scratch out all personal information on the prescription lael of your empty pill bottle or empty medicine packaging to make it unreadable, then dispose of the container. 

Why Can’t I Flush My Medications?

Safe Medication Disposal - Flushing

  • Septic systems are used in many rural areas of Montana.
  • IF on a septic system, it is recommended that ALL Rx meds are disposed of via the household garbage.
    • OTC meds are ok to flush on a septic system
  • *Flushing Fentanyl patches is never recommended.
  • Rx medications and septic systems don’t get along, even if they are “expired.” 
  • Pharmaceuticals vs. Over the Counter Medications – OTC medications are ok to flush on septic systems; prescription medications (antibiotics, anti-depressants, cancer-related drugs, or painkillers) are not! 
  • Rx meds can harm the septic system: 
    • Potential to clog the system 
    • Can harm the biological processes needed for proper septic system functioning (just using the bathroom while taking pharmaceuticals can be a problem) 
    • Medications, like antibiotics, can kill off the healthy microbes that you need in your septic system. (Bacteria and enzymes aid in filtering the wastewater from your house.)
  • Some pharmacies will place a label on prescriptions indicating whether the medicine is flushable or not.
  • Check your prescriptions for these labels before flushing medications down the drain.

Safe Medication Disposal - Flushing:  Fentanyl Patches

Municipal system only (not applicable to septic systems): 

  • FDA recommends: Fold patch in ½, sticky sides together, flush down the toilet. 
  • Don’t dispose in household trash where kids and pets can find it. (Also, think about sanitation works and others who may come into contact with it.) 
  • FDA recognizes there are environmental concerns about flushing medicines down the toilet, however, believes the risk associated with accidental exposure outweighs any potential risk associated with disposal by flushing.

Safe Medication Disposal – Quick Tips

Safe Medication Disposal - In Conclusion

  • Prescription opioids need to be securely locked up and out of reach AND sight! 
  • Taking the time and effort to ensure that opioid-based medications are properly stored/disposed of can:
    • Prevent accidental overdoses in children 
    • Prevent diversion of medications by friends, family, or even acquaintances.

Information Links

Montana Department of Public Health and Human Services: https://dphhs.mt.gov/Portals/85/publichealth/documents/EMSTS/opioids/MedicationPr operUseStorageDisposal.pdf

Addressing Substance Use Disorder in Montana, Strategic Plan: Interim Draft Report: https://dphhs.mt.gov/Portals/85/Documents/AddressingSubstanceUseDisorderInMonta na.pdf

Prescription Medication Take Back Day Event in your area: https://takebackday.dea.gov/

Medication Drop Box Locations in your area: https://dphhs.mt.gov/amdd/substanceabuse/dropboxlocations

FDA flush list: https://www.fda.gov/drugs/disposal-unused-medicines-what-you-shouldknow/drug-disposal-flush-potentially-dangerous-medicines#FlushList

Conference Conclusion:

This concludes the 2021 Rural Opioid Technical Assitance Training, "Prescription Opioids and Aging Adults:  What In-Home Caregivers Need to Know".  Than you for engaging with these materials and we hope you gained knowledge and resources to help your communities.  Please contact our Project Director Barb Allen at blallen@montana.edu with any quesitons you may have.  To get printable/downloadable educational resources, return to our project webpage here

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