Diversion of opioid drugs

April 20, 2023

Diversion of Opioid Drugs: A Growing Crisis in At-Home Care Settings

More than 106,000 persons in the U.S. died from a drug-involved overdose in 2021. According to the Centers for Disease Control and Prevention, this is estimated to be one of the country's leading causes of injury-related deaths; in most cases, these instances are related to opioid misuse.

Deaths from the misuse of synthetic opioids and stimulants have increased in recent years, and the unfortunate truth is that these numbers are on the rise. The United States makes up 4.4% of the global population and consumes over 80% of the global opioids. Additionally, overdose deaths accelerated during the COVID-19 pandemic, with synthetic opioids being the main driver of this rise.

Increase in At-Home Care and the Rise of an Opioid Epidemic

At-home care refers to healthcare-related services provided in the patient's home due to illness or injury that make it difficult for the patient to travel to a hospital or doctor’s office. Throughout the COVID-19 pandemic, different types of home care services were prioritized in an effort to solve staffing problems and ensure continuity of care for many patients. However, it also increased concerns about opioid use at home. Studies show that the U.S. home healthcare market size is expected to reach USD $253.6 billion by 2030, expanding at a Compound Annual Growth Rate (CAGR) of 7.49%. Part of this rise is attributable to the growing elderly population, who prefer to stay at home to avoid the costs of care in a healthcare or long-term care facility.

This trend is relevant, as the population of Americans over 65 is increasing and is expected to grow by 22% by 2040. In addition, the 85-and-older population is projected to more than double from 6.7 million in 2020 to 14.4 million in 2040 (a 117% increase). Further, older adults suffer the most from one or more chronic diseases, such as heart disease, cancer, diabetes, or other conditions that last a year or more and require ongoing medical care, limit daily life activities, or both. Also, they are more likely to undergo procedures that result in acute pain, such as joint replacement or spine surgery, which may require a prescription for opioids.

Dangers of Opioid Drug Diversion in At-Home Care Settings

Stericycle’s 2022 Healthcare Workplace Safety Trend Report (HWSTR) found that providers and administrators agree that the rise in at-home care makes proper medical and pharmaceutical waste disposal more challenging and that increased drug diversion risk and its impact on the opioid epidemic is a related concern. The report also found that eight in ten of the providers and administrators surveyed are concerned about increased drug diversion in their communities and agree that drug diversion puts the health of their communities at risk.

What is Drug Diversion?

Drug diversion is the illegal distribution or use of prescription drugs.

Why is Proper Pharmaceutical Waste Disposal More Challenging with the Rise in At-Home Care?

According to the HWSTR, most healthcare providers (82%) and administrators (87%) agree that improper disposal of pharmaceutical waste is one of the most significant contributors to the opioid epidemic and feel that opioid diversion from improper disposal puts the health of their communities at risk.

The reasons for this feeling are that people may not use all the medication prescribed, and they do not know what to do with the leftover material. Patients may hold on to it just in case or because they don't know how to responsibly get rid of it. Keeping medication creates opportunities for diversion by friends and family members. Those individuals may be poisoned, become addicts, or experience other harm by using such drugs.

To help avoid these repercussions, patients may consider disposing of drugs by putting them in the regular trash or discarding them down a drain. But this also has the potential to cause harm. The improper disposal of pharmaceutical waste down the drain or in the regular trash substantially impacts the environment. If disposed of without pre-treatment (such as by incineration), waste can leach into surrounding waterways and land areas. Healthcare providers and administrators agree that sustainable environmental practices benefit the health of an overall community and can be linked to positive patient outcomes.

What Can At-Home Care Patients Do to Responsibly Dispose of Unused or Expired Medications?

There are a few ways for patients to dispose of unwanted prescription and over-the-counter medications. The U.S. Drug Enforcement Administration (DEA) sponsors National Prescription Drug Take Back Day in communities nationwide. In 2023, it will take place on April 22 and October 21 and aims to provide a safe, convenient, and responsible way of disposing of prescription drugs while educating the general public about the potential for abuse of medications.

The DEA outlines some steps individuals can take to help prepare for Drug Take Back Day:

  • Locate all medications in your household and ensure that they are securely stored. All lids should be tightly secured on bottles, away from the reach of children and pets, etc.
  • Conduct an inventory of the medications and identify which are unwanted and have expired dates.
  • Clearly label medications that need disposal.
  • Take the medications to a Drug Take Back Day collection site between 10:00 a.m. and 2:00 p.m.

Many communities also have year-round drug take-back programs. Use the DEA collection site locator to locate the closest authorized collector for year-round disposal. You can also check with local law enforcement officials to find a location near you.

How Stericycle Helps Support Drug Take Back Programs

Stericycle works closely with hospital and retail pharmacies, and other organizations, to help enable the anonymous collection of unused drugs all year. Here are some ways we help take part in the disposal of unused consumer medications:

  • MedDropTM Medication Collection Kiosks 
    DEA-registered hospital and retail pharmacies can encourage responsible drug collection with our MedDrop™ medication collection kiosks. Since its launch in 2016, the MedDropTM solution has helped our customers collect over 5 million pounds of consumer medications that could otherwise have been diverted, abused, or contaminated community water supplies.  Stericycle incinerates this collected material before sending it for end disposal.
  • Seal&SendTM Consumer Medication Mail Envelopes
    For those who cannot access a drug take back location, Stericycle offers our Seal&Send™ Consumer Medication Mail Envelopes. These prepaid envelopes allow patients to send up to eight ounces of unused medication to Stericycle via USPS for incineration. Unlike drug collection kiosks, which can only be hosted by certain DEA registrants, any organization can purchase Seal&SendTM envelopes and provide them to patients, employees, students, and others.

We are committed to helping keep our communities safe. Visit our Safe Community Solutions page for more information about Stericycle’s work in helping to combat the opioid epidemic by offering at-home pharmaceutical waste disposal solutions as well as our other medical waste services.

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