Text Message Intervention to Facilitate Secure Storage and Disposal of Prescription Opioids to Prevent Diversion and Misuse: Protocol for a Randomized Controlled Trial (Preprint)

Abstract

Nonmedical use of prescription opioids remains a critical public health issue; 8.5 million people in the United States misused opioids in 2022. Most people obtain prescription opioids for misuse from family or friends. Thus, facilitating secure storage and disposal of opioid medications during and after treatment is needed to prevent medication diversion and subsequent misuse.

The primary objective of this study is to test the feasibility of a novel intervention that utilizes a persuasive, informational text message reminder system to enhance the impact of secure storage and disposal of unused opioid medications. We hypothesize that the text message intervention will increase secure storage during and disposal of prescription opioids after treatment.

We will utilize a two-arm randomized controlled trial to test the intervention for feasibility and preliminary efficacy. Participants (ages 18+ who have received an opioid prescription in the past two weeks) will be randomized to either receive the text message intervention or standard of care educational materials. Participants in the intervention will receive four text messages related to secure storage and three messages related to disposal. All participants will complete a baseline, mid-point (Day 25) and post-intervention (Day 45) evaluation survey. We will test whether receipt of the intervention is associated with two primary outcomes: 1) secure storage of prescription opioid medication (locked v. unlocked) and 2) disposal of unused prescription opioid medication (disposed v. not disposed).

This protocol represents the entire structure of the randomized controlled trial. Ethical approval for the study has been obtained and we expect implementation and data collection to be complete by December 2024.

Results from this study will indicate whether a text message reminder system can increase secure storage and disposal behaviors for individuals who receive an opioid medication. This type of intervention has the potential to be integrated into currently used health care delivery systems, such as prescription pickup reminders at pharmacies. Thus, the intervention is scalable across systems of care, thus expanding the reach of secure storage and disposal programs to prevention prescription opioid misuse.

ClinicalTrials.gov NCT05503186