These programs (for example, the Drug Enforcement Administration’s [DEA’s] Nationwide Prescription Drug Take-Back Day and Utah’s Use Only as Directed campaign) are intended to reduce the misuse and abuse of prescription pain medications. These efforts combine media and other educational efforts to promote safe use, storage, and disposal of potentially dangerous drugs, and include opportunities for the public to return “expired, unused, and unwanted prescription drugs” to collection centers. a According to the DEA, during a Take-Back Day held in September 2010, Americans turned in more than 121 tons of prescription drugs to state and local law enforcement partners (DEA, 2011). Although such programs do not directly affect pain prevalence, the rising rates of opioid use may lead to policy and enforcement practices that make these medications less available to people who need them.
A 3-year campaign in Victoria, Australia, in the late 1990s (described in more detail in Chapter 4)—Back Pain, Don’t Take It Lying Down—used mass media and other means to promote several evidence-based concepts, including that disability can be improved by positive attitudes, that people with back pain should continue to participate in their usual activities, and that they can do much to help themselves. The campaign aimed to reach both the general public and health care professionals. Evaluation revealed dramatic improvements in what the public and clinicians believed about back pain, accompanied by a decline in related workers’ compensation claims and health care utilization during the campaign; those beliefs have persisted over time (Buchbinder, 2010).
A 2002 Institute of Medicine study found that since the 1980s, there have been a wide range of suicide prevention initiatives taking a population-based approach (IOM, 2002b). Examples include improved prevention programs in schools, research on programs to target high-risk people, and efforts to identify broader patterns of suicide and suicidal behavior in groups or populations. As discussed earlier in this chapter, chronic pain and depression, as well as other emotional disorders, often go hand in hand, and all of these conditions may increase the likelihood that a person has available prescription drugs that could be used for suicide. Some measures designed to protect the population at large, such as limiting the size of prescriptions, may have unintended consequences for people with chronic pain.
The Secure and Responsible Drug Disposal Act of 2010 allows people to dispose of controlled-substance medications by delivering them to authorized entities.
From: 2, Pain as a Public Health Challenge
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