Locking Bags, Medication Take-Back Kiosks at Forefront of State Initiative to Combat Opioid Epidemic


After a year of increasing drug overdose deaths, Washington state pharmacies are working with patients to lock up their prescriptions and bring back leftover medication they don't need in a effort to combat opioid misuse.

The Health Care Authority contracted with 21 pharmacies in northwest Washington in a pilot program to give out locking medication bags to patients this year.

"We know that about 75% of all opioid misuse starts if somebody takes a prescription that wasn't prescribed to them," said Jessica Blose, who leads the state opioid response at the Health Care Authority.

Blose said it's all too common for a family member, friend or someone living in a household who was not prescribed the medication to find it then begin using it when they don't need it. Locking up pills can help prevent this.

"A lot of people know it's the right thing to do but do not realize how simple it is and what steps they can take," she added.

Blose refers to the current COVID-19 pandemic and opioid epidemic as a syndemic, a network of health problems that have common underpinnings and exploit existing disparities and underlying health conditions.

There were 29 opioid overdose deaths recorded in Spokane County from January 2020 through September 2020 alone.

The Health Care Authority gave free locking bags to participating pharmacies in the Puget Sound region to distribute to patients who are prescribed opioids.

Andrew Heinz, a pharmacist and owner of Kirk's Pharmacy, a chain in Pierce County, ran the pilot program for the locking bags in 2019 and 2020.

"A free locking bag is a simple step to try to protect their medications, and a lot of patients were grateful because in light of the opioid crisis, providers and patients are under immense scrutiny," Heinz said.

He said he was surprised at how many people already had locking bags for their medications. Heinz estimated that about 30 to 40% of patients at his Puyallup pharmacy location didn't take a free bag because they already lock up their medications.

So far, that pharmacy has given away nearly 300 bags. The locking bags also open up conversations between pharmacists and patients about what they can do when they are finished with their prescriptions. While chronic pain patients wouldn't need to bring their medications back, acute pain patients do.

"It was built into the messaging: lock them up and once you're done with these bring them back and we can destroy them," Heinz said. "Get them out of the house once you don't need them anymore."

While none of the pilot pharmacies for the locking bags program are in Spokane County, safe disposal boxes are available throughout the county at local pharmacies and some hospitals.

The Department of Health partnered with the Medication Education and Disposal Project to open up more medication disposal sites statewide. Previously, medication take-back sites were located predominantly at fire departments and police stations, but that was a barrier for some people, Blose said. The initiative has focused on opening up take-back sites at pharmacies and more accessible locations.

Two Unify community clinics, at the Northeast Community Center and on Mission Avenue, have take-back kiosks open during pharmacy business hours to everyone, not just clinic patients.

The Unify clinics got the safe disposal kiosks in December, and while they have not advertised the kiosks, they are getting used.

"Since we've installed it we've had a lot of people use it and ask questions, and we're seeing medicines being disposed of that might not have been otherwise," said Kai Nevala, senior director of regional operations.

Nevala said it took three to four months to fill up a box. Once they are full, the staff follow the process laid out by the MED Project, then ship the medications to waste management companies to be destroyed.

Blose, with the Health Care Authority, said the idea is to continue rolling out the locking bags program across the state in the coming years, including in Eastern Washington.

Initiatives like take-back boxes and locking bags can help prevent overdoses, Blose said, and while not all opioid misuse will lead to a disorder or overdose, in some cases it will. She added that continuing programs and education about opioid misuse are crucial since the opioid epidemic is far from over.

"We are seeing an increase in opiate-related overdoses in our state, and I do think we will continue to see a sustained increase for quite some time," Blose said.