Dr. Paul Toriello: Hello, and welcome to our webinar. My name is Paul Toriello and I’m a proud member of the Empowering Youth and Families Program. For this webinar, we have a special guest, Dr. Dana Cea, from East Carolina University and she’s going to talk with us about keeping meds safe and your family safe. Dr. Cea, thanks for joining us.
Dr. Dana Cea: Thanks for having me.
P: What I’d like to do is start out with you telling us a little bit about yourself and your professional journey that led you to be with us today.
D: Yeah, professional
journey, that’s always a loaded question for those of us that work in mental health. So, I think it really started with my own mental health and then I lost my dad to suicide in 2011. And that’s when I got involved in peer support. So eventually, I realized that I wanted to take it further and I got my master’s at Chapel Hill in Clinical Rehabilitation and Mental Health Counseling. It’s a mouthful. And then went on to ECU where I’ve just graduated with my Ph.D. in Rehabilitation Counseling Administration. So, all of that to say I feel like I touch on the mental health field from the consumer perspective and the professional perspective and where it meets in the middle is where my passion lies.
P: Wonderful, yeah, it’s been quite a journey and you’ve taken some personal experiences and transcended them into your professional work and into your career. So, you’re going to talk about a very important topic for this project and the projects on opioid use and misuse in the opioid epidemic and helping families prevent their families from succumbing to opioid use. And the important topic is keeping meds safe. Yeah. Why is that important it’s not just a simple question, it’s an important question, but it’s also complicated. What’s the importance of keeping meds safe?
D: Well, I think it really starts with a report from SAMHSA that came out in 2018, that showed that most people who had misused a pain-relieving prescription medication got it from a friend or relative. So, it’s maybe we think of the ways that people might get ahold of prescription medications and we might not be thinking about it’s in our homes and every one of us there’s an opportunity for someone else in our home or a guest that we have over to access those medications. And that goes as young as children. So, they have even found there have been calls to the poison hotline for children that are less than two years old. So, it’s a problem that we might not realize they’re getting a hold of.
P: Yeah, so it’s not so much the nefarious figures out on the street, right selling and dealing. It’s just what we have in our own medicine cabinets that we just may forget about or whatever.
P: And this report said the majority of people reported it was from like a family member or a friend. It was someone they knew. It wasn’t like a drug dealer. So, it’s not the movie typical experience that we think of, where maybe it was, someone went to the corner and tried to buy it from someone. They are just picking it up from bathrooms and kitchens where we typically think of storing our medications. What are some other aspects of the issue of keeping meds safe?
D: Well, I think if we come back to that age range of the children and teens and adolescents, they are making up thousands of calls every year to the hotline. And if you look at ages 15 to 24, there were 5,000 deaths from opioid overdose in that age group.
P: So, it’s not again, it’s not a simple thing like accidentally getting a hold of the medication. There may be some suicidal intent there. Yeah, so the children or the adolescents they’re not just thinking it’s candy and they there’s some depression, suicidality as well. Talk more about that, are there numbers behind that?
D: For that 15 to 24 range, teens and adolescents who ended up in the hospital with an overdose, the suicidal intent of those instances was
20 percent of those.
P: That sounds a bit scary, those numbers, and those tendencies. And teen suicide is obviously a huge reason why we need to keep our meds safe. Before we transition into how we keep them safe, any other reasons why we should keep our meds safe?
D: Well, we’ve got the intentional pieces which is what we talked about with suicide. If we look at the accidental piece, so the CDC reports that a major percentage of children, adolescents coming into a hospital for poisoning is because they access those medications at home. So, it wasn’t necessarily on purpose. We don’t know if it looked like candy, we don’t know why they took them, we know it was an accident and those are making up more and more of the poisoning calls and visits to hospitals.
P: Again, a bit unnerving and scary because you said the number one cause of death is accidents, which could include what you just listed.
P: Number two is suicide. Right. So even though we may be having those ongoing conversations and normalizing talking about our feelings and digital life and whatnot we still want to add that explicit preventative measure of keeping meds safe.
P: What are some of the best practices for how we do that? So, my thought kind of goes in two places. We think we have these child-resistant medication containers and it’s fine. And I actually remember as a kid my parents coming to me and being like can you get this open for me? Because the motor skills are so much more there for children, they’re just easier to grasp and turn. As long as they’re not like, maybe, three years old. So, they can get into the child-proof containers and that’s really not enough to keep medications safe. So, what is being recommended is that you not, first of all, store them where they would typically be, which is a kitchen and a bathroom. Obviously, we think you know for those of us who take medications, it makes sense, we’re going to bed we take it. Or maybe we have to take it with a meal, so we put it in the kitchen. And unfortunately, everyone’s going to be using those areas. So, we really need to move it to a place that is more secure. I would recommend locking them in a cabinet. Maybe have a lock box. Someplace where it’s that much harder for them to access it. So maybe you keep, I know I personally have a lock box with all my important paperwork in my bedroom. I would also keep my medication locked up in there. Well, and I want to take locking it up a little bit further. So we’ve got a couple of options, you know you could use a key. Think about where you’re going to keep the key. You know, is it going to be with your car keys, they could easily get a hold of your car keys, and then go and unlock the cabinet. Think about where you’re going to keep your keys. If you’re using a number lock where you’re putting in a code, I’m going to recommend from personal experience, don’t use the last four digits of your phone number. Because my parents locked up MTV on our tv and you had to plug in a code. Well, my sister and I figured out it was 4772, that’s the last part of our phone number. it was easy to figure out. Even if you’re using your pin number from maybe a debit card, if you’ve ever given that to your child to use, they’re going to have access to that. Don’t use their birthday, don’t use your birthday, think of a code that the child is not
going to know or think of when they’re plugging it into that box.
P: So, a different direction and you know when I say it, it sounds like common sense, but then when I look at my medicine cabinet it looks like a small pharmacy in there because we have not thrown out in ever.
D: Oh yes.
P: What are your thoughts there, I mean throw it out obviously, but many people don’t, or am I just an anomaly there?
D: No, I think that’s pretty common because we don’t really know what to do with it. Like you said, we kind of hang on to the medication. Oh well, maybe I’ll use this. I have a thyroid medication that’s a different dose, right, and I held onto it. Maybe my thyroid will change and I’ll go back to that dose. I never did. So, think about, to your point, how do you want to dispose of that? And if we think about movies, we often think of flushing medications, and that is definitely an option. The FDA actually has a list of medications that you can flush, and some of those that they recommend are like fentanyl that might be in medications, or oxycodone that are in medications. If you have those, you’re not going to use them, maybe they’re outdated, you can flush them. However, they first recommend that you find some sort of drop-off program. So, to find out about that, you might call your doctor, you might call your local pharmacy. You can also, there are some resources online that will list drop-off locations. So, if you get to a place where you’ve got medications that you’re not going to use, maybe they’ve expired, first, find the drop-off. And then if they are high-risk medications like those that contain fentanyl, oxycodone, then you can flush them that is an option. And often our first thought is if we flush them like where do they go? And they’ve done a little bit of research, again, this is another area that needs more. What they found is very very low detectable levels of medications. And this includes in rivers and streams as well as drinking water. So again, very very low levels, and actually the majority of that was contributed by our own bodily way of disposing of medication, which is through urine or feces, so it wasn’t majority from flushing medications, it was actually just the typical lifespan of how the medication flows through. So, keeping meds safe, disposing of meds safely, is not just a snap decision, it takes some thought and some planning.
P: What are some other ways to dispose of meds?
D: Okay, so we talked about flushing, which is kind of a last option. You can take it to a program where you can drop it off. There are also some packets you can buy where you put the medication inside, add some water, and it neutralizes the medication. So, it’s a safer way to dispose of those. I know that not everybody might have access to those. So maybe a similar version of that, that’s not as great, would be to take the medication, and to you can add water to it, and then also mix it in with like old coffee grounds, or kitty litter, or dirt or something like that, put it into another container that doesn’t look, again, as enticing as maybe a medication bottle, a zip-up bag for example, and then throw that away. So, you’ve got some other options. It doesn’t have to be as fancy as going to a doctor, but you just want to make sure.
P: It’s yeah, making sure, taking a few extra steps to make sure your children your family are okay. Right. Other thoughts on keeping meds safe, disposing of meds safely. Any other angles, tricks of the trade, that come to your mind to share with us?
D: Absolutely. So, track your medications as you’re taking them. You want to see which medications are you taking, when do you take them, how much are you taking. That way if something goes missing, you’re more likely to catch it ahead of time. Our children may think well I’ll just take one of these, and mom or dad or whoever may not notice.
P: Uh-huh, very good. Right.
D: And I’m thinking just for myself, it can be really hard to keep track of, how many do I have, when do I need to refill? So, there are some phone apps that you can get, you might have like an excel program if you’re along those lines, want to create a table of some sort, so it doesn’t just have to be off the top of your head memory. I think using a phone app would be really really helpful and there’s some specifically designed for medication.
P: So, you’ve shared with us a lot of important information. Most opioids that are used or misused are from a friend or family member, not somebody dealing them on the streets. Youth, teens, the top two causes of death or accidents, which can include overdose of medicines, and a lot of practical suggestions for keeping meds safe and disposing of them. As we wrap up this webinar, the question I would ask you to think about and advise us on, as you wrap up, is what would you say to the caregiver who would think in their mind, my children aren’t going to use the medicines, we have the open communication, I’ll be okay, I’ll just put it in my medicine cabinet on top, or I’ll put it underneath my shirts in the closet, and kind of hide it. What would you say to those folks who don’t think they’re at risk, necessarily?
D: We are all at risk. If we go back to what we first talked about, is that the majority of people are getting access to these medications from people that they know, that they live with, that they’re related to. So, we are all at risk of this. And to your point that you’ve said multiple times, does this take more work? Absolutely. Are there more steps? Absolutely. Is it important enough to prevent those deaths and even the overdoses that don’t result in death? Yes. We want to avoid the hospital, we want to avoid harming anyone, and the best and easiest way to do that is to safely secure medication.
P: And thank you for joining this 4-H Empowering Youth and Families Program webinar. There’ll be a lot of resources at the end of this webinar, so please click on those for more information. Thank you.