Implementation and use of community-based prescription drug disposal programs

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
Kathleen L. Egan (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site:
Michael Perko

Abstract: Encouraging disposal of unused prescription medications through the establishment of community-based prescription drug disposal programs is one prevention strategy that has been used by local communities to combat nonmedical prescription drug use (NMPDU) and associated consequences. The premise is that disposal programs (i.e., drop-boxes and take-back events) provide opportunities for community members to dispose of their unused or expired prescription drugs, ultimately reducing their availability for nonmedical use. While drop-boxes have been growing in popularity since their introduction in the early 2010s, the extent of their implementation and associated community characteristics had not been assessed. The first objective of this dissertation was to address this gap in knowledge by examining the diffusion of drop-boxes and community characteristics associated with drop-box implementation. Between 2007 and 2016, 311 drop-boxes had been implemented in North Carolina (NC), and 91 out of 100 NC counties had at least one drop-box. The majority of drop-boxes were located at law enforcement agencies but the number of drop-boxes installed in pharmacies had increased in recent years. Counties with a higher percentage of whites and college educated residents, a substance abuse prevention coalition, higher rates of controlled medications (i.e., prescription drugs with abuse potential) dispensed, higher prescription opioid overdose rates, and counties considered to be Appalachian were more likely to be early implementers of drop-boxes. Prescription drug disposal programs are primary prevention strategies intended to prevent initiation of NMPDU among adolescents by reducing the availability of prescription drugs in the home. While several studies have examined self-reported disposal of unused prescription drugs, none have specifically examined disposal of unused medications by parents of adolescents. The second objective of this dissertation was to examine prescription drug disposal by parents of adolescents. Among 2,300 parents residing in a household prescribed a controlled medication in the past year, only 33.9% disposed of unused medications. Of these, 9.8% used a take-back event, 10.0% a drop-box, 12.8% flushed the medication in a toilet, and 15.0% threw the medication in the trash within the past year (disposal practices were not mutually exclusive). Use of prescription drug disposal programs was associated with awareness of these programs, receiving a prescription for Attention Deficit Hyperactivity Disorder (ADHD), and permissiveness of underage drinking parties. Being a grandparent raising a grandchild, permissiveness of underage drinking parties, and being prescribed pain relievers or medications for ADHD were associated with awareness of prescription drug disposal programs. Additional research is needed as disposal programs continue to be implemented, especially drop-boxes at pharmacies. It will be important to study the diffusion of drop-boxes at pharmacies, motivations for- and barriers to implementation, and utilization (e.g., quantity of controlled medications disposed) in order to assess the impact of location on the effectiveness of prescription drug disposal programs. Given that awareness of disposal programs is related to utilization, developing and implementing effective awareness campaigns should be a priority of both research and practice. Despite being implemented in practice for at least 10 years (according to my findings) the research on prescription drug disposal programs is limited but increasing. It is imperative that researchers and practitioners work together to improve, implement, and evaluate this strategy within the context of a comprehensive approach to address NMPDU and associated consequences.

Additional Information

Language: English
Date: 2017
Medication disposal, Nonmedical prescription drug use
Medication abuse $z North Carolina $x Prevention
Drug abuse $z North Carolina $x Prevention

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