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Hospice care providers are experts in pain and symptom management, with more than 90% of hospice care patients prescribed a controlled pain medication, and many given narcotic medications for symptom management. Given these prescribing patterns, it’s common for leftover medications to exist after a patient’s death, leaving them available for misuse, abuse, diversion and environmental harm.
In 2018, the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act) was signed into law, enabling hospice employees to dispose of unused controlled substances in patients’ homes. Since then, as reported in a 2020 U.S. Government Accountability Office (GAO) report, hospice care providers have experienced a variety of barriers to provide safe, at-home disposal from cost, to having a witness available to the inconsistencies between state and federal laws. Nevertheless, Capital Caring Health, one of the leading nonprofit providers of elder health, hospice, and advanced illness care for persons of all ages in the mid-Atlantic region, has found a solution that works for them.
Since December 2018, Capital Caring Health has provided Deterra® Drug Deactivation and Disposal System (Deterra Pouches and Containers) to every caregiver to dispose of all patient medications at end of life.
Prescription pain medications in the home are a known entry point for family members or visitors to begin experimenting with addictive substances. Through the use of the Deterra Pouches for safe medication disposal, Capital Caring Health permanently eliminates the possibility of diversion and abuse of unused medications.
“Our patient’s families and friends often do not know what to do with the medications of a loved one after they die. We’re in a unique position to inform them of the importance of safe medication disposal and provide them the tools to do so,” said Sue Boris, RN, BSN, Chief of Clinical Operations at Capital Caring Health. “Given its proven permanency, Deterra Pouches give providers, caregivers and families peace of mind that medications will not fall into the wrong hands.”
Capital Caring Health distributes Deterra Pouches to the patient and family and offers a team member to assist them, some often ask the team members to dispose of the medications on their behalf. Throughout the process, Capital Caring Health closely documents the medications destroyed and deactivated for record keeping purposes. The pouches are designed to be easy for family members to use: In three steps, place pills, patches, liquids or films into the pouch, add tap water, close and shake – then it is safe to throw away in normal trash. Administering the pouches upon medication changes or after death not only prevents abuse and diversion,but also prevents environmental contamination stemming from incorrect disposal methods, such as mixing with kitty litter or coffee grounds, or flushing down sinks or toilets.
“Often, our families do not have the time to take medications to drop-off sites,” said Reisha Martin, BNS, MSN, Regional Executive Director at Capital Caring. “The benefit of Deterra is truly the ease, safety and effectiveness of the deactivation – and it’s one less thing that families and friends have to worry about after the death of a loved one.”
Over the 2+ years of distributing Deterra Pouches in the hospice setting, Capital Caring Health has disposed of numerous medications and which has led to a decrease in opportunities for drug abuse and diversion. Additionally, choosing Deterra Pouches for at-home medication disposal and implementing disposal policies in the hospice setting, allows Capital Caring Health to confidently adhere to SUPPORT Act requirements.
“More than 95 percent of our patients receive their hospice care at home, making in-home medication disposal a critical factor in preventing drug diversion,” said Jason Kimbrel, PharmD, BCPS, Vice President of Hospice Services at Optum. “It is our responsibility as healthcare providers to keep our community safe and we should be doing everything we can to prevent the misuse of our patient’s medications.”
Visit DeterraSystem.com/government to explore how other organizations are using Deterra or reach out to (612) 568-1128 or Sales@DeterraSystem.com to discuss how to implement at-home drug disposal initiatives in your community.
