One topic of prescription drug diversion not discussed as much as it ought to be these days involves your medicine cabinet. It is a huge source of prescription drug abuse for youths between 12 and 17 years of age, mostly because it is easily accessible and because teenagers have little ability to doctor shop or pass forged or altered prescriptions.
This would be enough of a concern if youths were the only individuals accessing these drugs, but there are others with access, too, whom you might not ever suspect. Over the years, I have seen cases in which individuals who paint houses, deliver refrigerators, or lay carpet pilfer drugs from bathroom medicine cabinets. Most home dwellers would not think twice about protecting these potentially dangerous and valuable commodities that sit for months or years in that “special” cabinet in the bathroom.
Other scenarios when a homeowner’s guard is down are parties when the only attendees are trusted friends or family, some of whom may have an addiction to feed. Maybe they rely on medicine cabinet drugs for recreational purposes at their own parties! In one scam that my organization often sees, a drug seeker spends Saturdays or Sundays going to real estate open houses, but not due to interest in buying a home. These drug seekers know most Americans keep their pharmaceuticals in the medicine cabinet.
One of our worst cases involved an owner of a prosthesis company who would make personal visits to fit or refit artificial legs and arms. Because many of the patients had numerous controlled substances in their homes, procuring full bottles was not difficult. My organization caught the perpetrator through a sting operation at the home of a patient with diazepam. We made the arrest as the perpetrator came out of the elevator into the apartment building’s lobby. He had consumed 6 of the tablets during the short elevator ride.
It is important for pharmacists to maintain awareness of, and educate the public about, the problem with leaving medication in medicine cabinets. In virtually every presentation I give across the country, I ask the audience to inventory their medicine cabinets, and discard old and expired medications. Crushing and then mixing them with used coffee grounds or diapers or taking them to the closest drop box prevents them from being diverted by visitors or family members.
The remaining necessary medications need to be secured, but not in the bathroom! Buying an expensive safe is impractical for most individuals, but securing medications somewhere it would take a stranger over an hour to find is a good solution. Most drug seekers want to spend just a few minutes to look in a medicine cabinet, bathroom closet, or bedroom dresser drawer.
Limiting the number of, and access to, controlled substances in a house and removing them from predictable locations could prevent a tragedy such as an overdose death. These days, drug seekers, even teens, know what is in pill vials and what drugs they want.
Don’t hesitate to take every chance to advise patients, family members, and friends that they need to keep medications out of their medicine cabinets. Because pharmacists have long ranked among the most trusted health professionals, —the public is likely to listen to your advice!