In response to the rising prevalence of prescription opiate painkiller diversion and misuse, the goal of this component is to implement and evaluate an intervention designed to reduce the availability of prescription pain medication in the homes of Native Americans residing in rural Southern California reservations. Employing an availability theory perspective, this study aims to assess attitudes in this area towards safely discarding unused opiate and other pain relievers, then design and deploy a culturally tailored version of existing availability reduction strategies including easy-to-use secure drop boxes, the contents of which will be periodically emptied, weighed and passed by law enforcement to their contracted disposal services.
These efforts will be bolstered by media advocacy strategies to change community norms surrounding prescription drugs. The specific aims of the project are to: (1) implement an environmental prevention strategy in order to reduce availability and misuse of prescription drugs in this area by designing and deploying a culturally-tailored drug drop-off program in secure settings, including a mobile unit to introduce the idea in pow-wows and other gatherings; and (2) conduct a process and outcome evaluation of these programs with respect to the reduction of prescription drug availability, analyzing pre-/post- surveys (N=300 each wave) about pain medication storage and disposal to assess the extent to which the intervention influenced attitudes and behavior about opiate availability.
Ethnography and objective secondary data analysis will evaluate effects of these interventions.