The Indian Health Service supports safe and effective therapies to help patients and providers best manage pain and opioid use disorder. The IHS Opioid Strategy aims to improve perceptions and beliefs associated with substance use by promoting an appropriate, sensitive, and sympathetic message among health systems and the communities we serve.
In Arizona, opioid-related deaths have been steadily increasing since 2012. In addition, among the Phoenix Area IHS service population, the reported opioid-related deaths, inpatient and emergency room incidences increased by 310% from 2008 to 2016, according to data from the Arizona Department of Health Services.
Through collaborative efforts, the IHS Division of Environmental Health Services utilized an applied public health approach to raise awareness and improve prescription drug safe storage practices by pilot testing medication lock boxes for use in the home environment. The goal of the medication lock box pilot project was to identify a possible solution to opioid-related poisonings among American Indians and Alaska Natives by decreasing access to medications in the homes. Staff utilized several qualitative data collection techniques to identify a type of lock box that is effective at safeguarding medications and is accepted by the target audience, and a process for distribution, installation, and education. As a result of the project, a total of 55 lock boxes were installed at homes in eight participating tribal communities.
The program evaluation was conducted during 30 and 60-day follow-up visits through visual observations and personal interviews to determine usage and gain participant feedback. 87% of the boxes were observed in use to secure medications after the 30-day interval, and 95% were observed in use after the 60-day interval.
From our results, the medication lock box pilot project proved to be a promising complement to the clinic-based activities aimed at addressing the opioid epidemic. Coupled with patient education, this intervention has served to change behaviors and reduce risk factors regarding unsecured and improperly stored prescription medications. Medication lock boxes, like similar interventions intended to safeguard access to other lethal means of self-harm such as gun safes, represent a protective factor that aligns well with community-based approaches to injury prevention and control. Since the project’s completion, five tribes and other IHS Areas have begun to replicate this initiative.