Improving outcomes for MAT patients by keeping medication secure

Medication-assisted treatment (MAT) programs are a clinically effective approach for treating substance use disorders. 

The medications used are approved by the FDA, are clinically tailored to meet each patient's needs and are dispensed over a period of months, years or more under close supervision to help treat opioid use disorder and associated withdrawal symptoms and psychological cravings. The number of health centers offering medication-assisted treatment programs continues to increase, with 9,920 OUD treatment facilities indicating that they provide or allow medications in their program.

More and more, MAT programs are being considered the standard of care for patients with OUD. Plus, according to JAMA, patient enrollment in MAT generates a 74 percent reduction in 12-month acute care utilization on average. However, as the number of programs increase, an important factor to consider is medication security. In fact, keeping medication secure is a common barrier for health centers considering MAT programs. This is due to several factors, including patients with young kids at home, patients in shared housing, or for those who need to take medication to work or somewhere unsupervised.

There are several approaches clinics can take to effectively minimize and control the diversion of drugs used in MAT programs, such as creating multidisciplinary teams, patient-centered treatment planning, enhanced incident report training and secure medication dispensing.

According to the Federal Register, approximately 85 percent of unintentional poisonings take place in the home where medicines are stored. Additionally, new studies have found that opioids are the leading cause of fatal poisonings among children aged 5 years old and younger in recent years.

That's why as pharmacists, we have a responsibility to educate patients and their families on the unintended consequences of failure to safeguard and secure prescription medications, especially for those in our MAT programs.

At Lower Lights Christian Health Center in Columbus, my team and I have created an innovative program for addressing this very issue. Patients in our MAT programs are dispensed their medication in a locking prescription vial. Nearly 250 patients are prescribed suboxone strips in the vials, which require a four-digit code aligned from top to bottom to open.

Our goal is to increase compliance and prevent abuse, misuse and drug diversion and we’ve set up a system for assessing feedback from patients, prescribers and pharmacists to understand how it’s working. Due to its early success, the pilot expanded from its original urban setting in Columbus to rural Marysville, in nearby Union County — the only county in Ohio experimenting with medication security for medications for opioid use disorder treatment programs.

Our pilot program found that locking prescription vial dispensing was proven to reduce one of the top three barriers to patient enrollment in MAT programs: medication safety and security. As a headline excerpt, data from the trial indicated that 0 percent of patients had medication missing from their vial, compared to approximately 40 percent of patients that had previously experienced medication missing from a standard prescription vial.

So far, the responses from this program are showing promising results, with more than 80 percent of patients stating that their medications are more secure. Patients and parents who already had their own security measures in place also recognized the need for safe storage, with one parent of 5 young children reporting that "the locking prescription vial gives reassurance that their curious kids are protected from dangerous medications."

Moreover, initial data shows that pharmacists didn't notice a significant impact to normal workflow and found the encoding process manageable. Probation officers and sober living housing managers have reported a reduction in theft and loss of medication. In fact, 100 percent of providers surveyed were in support of using a locking prescription vial for controlled substances as a means of safe storage.

By increasing awareness about treatment options, educating other pharmacists through patient feedback and testimonials, and removing barriers to MAT programs, we hope that these programs will become more accessible to patients and providers as means prevent misuse and diversion. 

To find out more information about the pilot program visit

John Ahler, RPh, is the pharmacy director at Lower Lights Christian Health Center, a federally qualified health center in Columbus. He has more than 30 years of experience in the field of pharmaceuticals and has led operations at companies including CVS Health and Medco Health Solutions. John received a Bachelor of Science in Pharmaceutical and Biomedical Sciences from Ohio Northern University.

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