Prescription Opioids Are Rarely Stored Securely: Predictors of Improper Storage Practices and Next Steps

Background and Purpose: From 1999 to 2017, prescription opioid overdose deaths increased five-fold (National Institute on Drug Abuse, 2019).  Studies of emergency department patients and cancer patients suggest prescription opioids are often insecurely stored. However, less is known about the opioid storage practices of the general population.  Safe storage practices reduce risks for other household members, including adolescents at risk of misusing readily accessible medication.  The present study examines prescription opioid storage practices among Michigan adults.

Methods: Adults 18 and older (N=707) were recruited through paid Facebook advertising to complete an online survey; 670 had complete data on variables of interest.  Participants were asked how often they used a safe storage method on a 7-item scale ranging from always to never (i.e., keeping prescription pain medications locked or latched; McDonald et al., 2017).  Logistic regression analyses were used to examine correlates of consistently utilizing safe storage methods, with outcomes dichotomized as always versus not always. Specifically, we examined demographic characteristics, perceptions of prescription opioid misuse and heroin use, knowing someone who has used non-prescribed opioids or heroin, knowledge of how to help someone who has overdosed, and attitudes about prescription opioid misuse and illegal drug use as predictors, utilizing previously validated measures.  

Results: Multivariable logistic regression models predicting both keeping opioids locked [x²(11, N = 670) = 40.37, p < .001] and keeping opioids latched [x²(11, N = 669) = 31.06, p = .001] were statistically significant.  Approximately 7.5% (n = 50) of the sample reported always keeping opioids locked; 12.9% (n = 86) reported always keeping opioids latched.  Those who reported knowing little about how to help someone who has overdosed (OR = 0.76, p = .03; OR = 0.78, p = .01), had a college degree compared to those with less than a college degree (OR = 0.47, p = .02; OR = 0.46, p = .002), or knew someone who had used heroin (OR = 0.47, p = .03; OR = 0.57, p = .03) had significantly lower odds of keeping opioids locked or latched, respectively.  Those who thought illegal drug use was a serious social problem (OR = 3.89, p = .03) had significantly greater odds of keeping opioids locked.  Race, gender, estimates of percentages of adults who used non-prescribed opioids or heroin, knowing someone who has used non-prescribed opioids, and attitude about prescription opioid misuse were unrelated to either outcome. 

Conclusions and Implications: Findings identify factors associated with unsafe storage and suggest opioids are seldom consistently stored appropriately. These findings add to previous research that focused on cancer and ER patients’ storage practices.  Social workers should spearhead prevention efforts seeking to increase safe opioid storage, particularly given evidence linking opioid misuse with increased risks of adverse health consequences and death.