Helping hospice families safely dispose of unused opioids

Date: 02/06/2019

For people with terminal illnesses nearing the end of life, pain medication can provide some relief to make those final days more comfortable. When those patients are at home or in a hospice setting, we take precautions to make sure those medications are used only as intended.
 
“It’s something we take very seriously,” said Christine Turner, RN, MA, CHPCA, Director of Hospice Care for Northern Light Home Care & Hospice. “It takes a lot of collaboration between the hospice team, physicians, and the hospital all working together and communicating to make sure these medications are managed safely and are only available to those who need them.”
 
To protect hospice and home health patients, as well as the people around them, Christine’s team has implemented a variety of interventions to prevent misuse of prescription medication. The efforts start with awareness.
 
“It’s really important for our clinicians who are providing care in this setting to be able to recognize the red flags that indicate these medications are being used by people they weren’t prescribed to and know the steps to take when misuse is suspected,” she said.
 
That’s why in 2019, all Northern Light Home Care & Hospice clinicians will be receiving additional training on opioid divergence – the use of appropriately prescribed opioids by someone other than the intended patient.
 
“We have a drug diversion policy, but this training will dig a little deeper,” Christine said. “It’s a combination of retraining on appropriate opioid use and how to identify misuse.”
 
In cases where the patient lives with a relative who has a history of opioid dependency, we take additional steps to secure medication to ensure it’s for the patient’s use only.
 
“When it’s necessary, we use lockboxes in the home,” Christine said. “We give the patient a limited amount of the medication, and limit access to the keys for them. We’re very deliberate.”
 
This process is particularly important in situations where the patient’s primary caregiver is suffering from opiod use disorder, where the availability of opiates can interfere with the caregiver’s ability to support the patient.
 
Another preventive measure involves properly disposing of medication after a hospice patient passes away. Thanks to grant funding, Northern Light Health is now using a drug deactivation system called Deterra. Deterra is a small pouch that destroys medication on contact. After death, the clinicians use the pouches to assist the family to discard the remaining supply of the patient’s medicine immediately.
 
“It’s important to destroy these medications as safely and effectively as possible,” Christine said.
 
As important as it is to make sure these medications aren’t available to people who shouldn’t have them, Christine cautions that it’s critical to keep in mind patients who benefit from proper use of opioids.
 
“My goal is making sure our patients who truly need these medications continue to have access to them,” she said. “As we fight this epidemic, we need to remember to do what’s best for the patient. The end of life should be as pain free as possible.”