Talk About Meds With Your Patients to Help Prevent Med Abuse

Whether you are prescribing, administering, or consuming medication, you have a role to play in reducing medication abuse. As nurses, we're all involved in finding solutions to the opioid crisis no matter what our role or job description. One of the most effective ways I have found to help prevent prescription medication misuse and abuse is to help patients talk more about their medications both in the healthcare setting and at home.

Having serious conversations about medication misuse and abuse matters because the CDC records the number of drug overdose deaths in the US in 2017 alone at 72,000. While the sharpest increase in this high number of drug overdose deaths were due to fentanyl and synthetic opioids (often from illegal non-prescription sources), the abuse of prescription opioids and other prescription medications remains a problem. According to the 2016 National Survey on Drug Use and Health, approximately 1 in 10 people struggle with substance abuse including addiction to prescription drugs. The same source indicates that some 54 million people over age 12 admit using prescription drugs for nonmedical reasons.

The 5 Rights...

The 5 Rights of Medication Administration-- right patient, right drug, right dose, right route, and right time-- are a fundamental part of our nursing education. Administering medication is so important, and such a challenge, that the basic 5 rights are sometimes expanded to include other "rights" as well, such as right documentation, right reason, and right response. As professionals, we're confident that we know what to do when administering medication to a patient in our presence. But are we always equally confident that our patients know what to do when they get home with the medication?

Patient Education

This is where effective patient education comes into play. How many of us are actually having meaningful dialog with our patients and their families about medications? Or are we guilty of spouting off a memorized list of side-effects and administration do's and don'ts and assuming the patient understands?

Effective patient education about medication includes so much more than the professional recitations of purpose, dosing, potential side effects, and optimal methods of self-administration that we memorize and recite to the patient while administering or during discharge. To help ensure medication adherence and safety at home, we must engage in a meaningful dialog with the patient that includes ideas for empowering the patient to monitor their inventory, secure their supply, and dispose of unused doses properly. The quality of the conversation influences how much the patient understands and acts upon at home.

Here are some questions to ask your patient that may help prevent medication misuse and abuse.

-Monitor your inventory:

Ask your patient how they monitor their pill supply at home, including how many pills or doses they have left of each medication type, and when each medication is due for refill. Help the patient understand that this will help them double-check that they are taking the medication as directed and gives them a way of knowing immediately if any pills are missing. Help them understand that tracking is a key factor in risk awareness, and a big part of safe medication use.

-Secure your supply:

Ask your patient if they have a secure location at home for storing their prescriptions and OTC medications. Advise them to secure their medications at home and while traveling the same way they would secure other valuables, like jewelry or cash. Limiting access to the medication limits the potential for abuse. Gently invite them to consider that anyone they come into contact with- this includes the patient's family members, children, grandchildren and their friends, household employees, healthcare professionals who make home visits, and other visitors-could be potential medication misusers or abusers, even though we don't like to think of them that way.

-Dispose of unused doses properly:

Ask your patient if they know how to safely dispose of any medication they aren't taking any more, or that has expired. It can be helpful to find out what they've done in the past, then provide them with a rationale for a better way. Advise them on viable options for safe medication disposal, as DEA Take-Back days vary by location geographic location. Help them understand that it's not just the medication, but also the packaging it comes in that needs to be disposed of properly. This includes removing labels with names and phone numbers before tossing containers in the trash.

The Bottom Line...

The bottom line is this: Talk with your patient about their medications, instead of throwing information at them. Provide your patients with useful, real-world resources to make med-related conversations easier and reinforce your in-person teaching. For example, an excellent list of questions patients can ask providers can be accessed here: 10 Questions to ask about the medicines you take. An excellent document with examples of how to talk to your teen about medication abuse can be found here: Parent Talk Kit. Above all, be patient with your patients. For many, communicating effectively with healthcare providers and their family members, requires learning new skills.

Talking about medications is a meaningful way for nurses to make a difference in the opioid epidemic. When you talk to your patients about medications and provide them with excellent communication resources to help them engage in conversations on the topic of medication use with their families, your patients will be better informed, you'll see better medication adherence, and ultimately better health outcomes.

Questions for discussion:

Which of the questions above are the best fit for helping you round out your patient education on medications? Which resources mentioned in this article are most useful in your professional setting?

Sources and Resources:

8 rights of medication administration | NursingCenter

10 questions to ask about the medicines you take

New Medicine? Need-to-Know Drug Information | BeMedWise

2018: Taking Action to Prevent Opioid Misuse and Abuse

218: Taking Action to Prevent Opioid Misuse and Abuse | NCPIE BeMedWise

About BeMedWise

National Council on Patient Information & Education | BeMedWise

Key Substance Use and Mental Health Indicators in the United States: Results From the 2016 National Survey on Drug Use and Abuse

Overdose Death Rates

Overdose Death Rates | National Institute on Drug Abuse (NIDA)

Parent Talk Kit

Partnership for Drug-Free Kids [Parent Helpline]

Partnership for Drug-Free Kids - Where Families Find Answers

Safe Drug Disposal: A Guide for Communities Seeking Solutions [Download your free PDF copy]

Take Action to Address Medicine Abuse

Talk About Your Medicines.org

Talk Before You Take [Video Resources]

What is the scope of prescription drug misuse?