Opening the door of my medicine cabinet is a lot like opening the door of my refrigerator. When I look inside, I see things I use every day. I see things whose origins are completely unknown to me. And I see things that have long since expired but for some reason haven’t been thrown out.
In that last fridge category is a box of two pre-made pie crusts from Pillsbury that are “better” if used by June 2014. In that last medicine-cabinet category is a pill bottle with 16 50-milligram tablets of Tramadol prescribed to me in June 2014 by an oral surgeon. He yanked out a back molar that cracked, and he insisted that I would need the pain medication. Tramadol is a highly addictive opioid pain med that can stop your breathing if you take too much. I didn’t take any because I like breathing. But I could have gotten a refill either way and added to my stash.
I haven’t thrown out the pie crusts, because I think I’ll use them some day. Even if they’ve seen better days, I’m such a lousy cook that they’ll still be better than whatever I fill them with. I haven’t thrown out the Tramadol because … because … I’m not really sure why. Part of the reason is I forgot it was there. Part of the reason is I may need it someday. Part of the reason is the misguided cachet of having a controlled substance in my possession like a Cuban cigar. The biggest reason is I don’t know how to get rid of it.
I’m not alone. Survey results recently published in JAMA Internal Medicine found that nearly half of the more than 1,000 adult respondents said they received no information on proper storage of their opioid med after it was prescribed to them (bit.ly/1V5sP7l). And about 45 percent said they received no information on the proper disposal of the unused portion of their opioid med after it was prescribed to them. So what did they do with the leftovers? Nearly half said they kept it for future use (see chart).
Here’s why business should care. Overprescribed and saved opioid pain medications create a serious problem for employers, particularly those that like their employees breathing and on the job.
Castlight Health, a San Francisco-based health transparency firm, recently released a report that said employees who abuse opioid medications incur an average of $19,450 each year in medical expenses, compared with an average of $10,853 for employees who don’t (bit.ly/29pq6qu). Castlight defined an opioid-abusing employee as one who received more than a 90-day supply of medication and received prescriptions from four or more different providers over the five years of claims data it examined in the firm’s database. Castlight estimated that the additional medical expenses from opioid-abusing workers added as much as $8 billion per year to employers’ health care costs.
The report also ranked cities by the percentage of opioid prescriptions abused by employees. The top 25 cities included only one city from Minnesota—Rochester, home of the Mayo Clinic, where Castlight said 45 percent of the prescriptions written for opioids were abused by employees from 2011 through 2015.
Still, the Minnesota Department of Health released data on drug overdose deaths that should concern employers. The state said 572 people died in 2015 from drug overdoses. Of those deaths, 216, or nearly 38 percent, were from prescription opioid meds—nearly double the next-highest overdose drug, heroin, at 114 deaths, or about 20 percent (bit.ly/299sKEh). The number of prescription opioid overdose deaths in the state has nearly doubled over the past decade, from 111 in 2005 to 216 last year (see chart).
Here’s what employers can do to get overprescribed and saved opioid meds out of workers’ medicine cabinets, reducing the opportunity for abuse and keeping them productive and on the job. Employers should partner with local pharmacies, hospitals, physician offices and long-term care facilities to sponsor regular “take-back” programs for their workers to safely dispose of unused opioid prescriptions.
Under rules issued by the U.S. Drug Enforcement Administration two years ago, pharmacies, hospitals, physician offices and long-term care facilities can register to become “authorized collectors” of unused controlled substances (1.usa.gov/29b1K6f). Previously, unused controlled substances could be turned in only to law enforcement agencies or at official DEA-sponsored drug take-back events.
Employers could identify the authorized collectors in their area, partner with them and promote their take-back programs and events to workers. To incentivize employees to participate, employers could give out prizes or awards for notable behaviors like having the oldest unused prescription, the largest unused prescription, the most unusual unused prescription or the most unused prescriptions. Make an event out of it. Or it could be done in a more private fashion, no questions asked. Either way, it’s good for employees’ health and good for business.
I don’t know the street value of my Tramadol, but I would turn it in for a $10 Caribou Coffee gift card.
Three briefs within a brief, all about the connection between the health of a population and the health of its business community:
David Burda (twitter.com/@davidrburda, firstname.lastname@example.org) is editorial director, health care strategies, for MSP-C, where he serves as the chief health care content strategist and health care subject matter expert.