# Assessing Implementation of Pharmacy-Based Medication Disposal Programs: National Estimates, Neighborhood Inequities, and Determinants of Implementation

> **NIH NIH R03** · WAKE FOREST UNIVERSITY HEALTH SCIENCES · 2024 · $77,500

## Abstract

Project Summary
The quantity of opioid prescriptions dispensed in the United States (US) is so high that every other person
could receive one opioid prescription. Many of these opioids go unused and are kept in homes rather than
disposed after ceasing use. The primary source of prescription opioids for nonmedical use is relatives or
friends; which suggests that diversion of excess and retained prescription opioids contribute significantly to
nonmedical use and associated consequences. Without effective strategies to facilitate their secure storage
and disposal, prescription opioids will remain in communities, increasing the likelihood for nonmedical use-
related morbidity and mortality. Our long-term goal is to prevent nonmedical prescription opioid use by
decreasing accessibility of unused medications in the home. The overall objective of this R03 application is to
assess (1) the extent to which disposal boxes have been implemented in pharmacies across the US, (2)
accessibility of disposal boxes to diverse community members, and (3) determinants of implementation. To
achieve this objective, we propose two specific aims: (1) generate prevalence estimates of disposal box
implementation in US pharmacies and examine place-based health disparities in implementation, and (2)
examine determinants of pharmacy-based disposal box implementation using the Consolidated Framework for
Implementation Research (CFIR). For Aim 1, we will sample 1,000 of the nation's approximately 60,000 retail
pharmacies, geocode locations, and link with disposal box presence and neighborhood characteristics. We will
conduct logistic regression with clustering to examine inequities in neighborhood characteristics that are
associated with disposal box implementation (primary outcome). For Aim 2, we will conduct semi-structured
interviews with a sample of 60 pharmacies who have and have not implemented medicine disposal boxes and
will link geocoded neighborhood characteristics with qualitative data. The proposed research study is
innovative, in our opinion, in that it applies an approach that has been piloted by the PI in a single state to
study pharmacy-based disposal boxes by (1) developing nationwide prevalence estimates of disposal boxes
across the US, (2) examining place-based health disparities associated with implementation, (3) assessing
determinants of implementation using a theoretical framework, and (4) uniquely linking interview themes and
neighborhood characteristics. The proposed research is significant in that findings will advance the
understanding of inequities in and determinants of disposal box implementation at pharmacies and pave the
way for comparative efficacy studies. The proposed study is relevant to NIDA's priorities to implement and
evaluate theoretically-based, prevention interventions that can be implemented in healthcare settings to elicit
population-level impacts to address the ongoing opioid crisis.

## Key facts

- **NIH application ID:** 10899437
- **Project number:** 5R03DA055783-02
- **Recipient organization:** WAKE FOREST UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Kathleen Louise Egan
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $77,500
- **Award type:** 5
- **Project period:** 2023-08-15 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10899437

## Citation

> US National Institutes of Health, RePORTER application 10899437, Assessing Implementation of Pharmacy-Based Medication Disposal Programs: National Estimates, Neighborhood Inequities, and Determinants of Implementation (5R03DA055783-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10899437. Licensed CC0.

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