Environmental Strategies to Prevent the Non-Medical Use of Prescription Drugs

Pills on presription pad

Environmental Prevention Strategies (EPS) are population-based interventions that change the context in which individuals make decisions.1 EPS are important because they have the potential to alter the environment in such a way as to compel large numbers of individuals to make healthy choices. This potential for widespread change is especially appealing to substance abuse prevention leaders and practitioners working at the state and local levels whose constituents are especially concerned about increasing rates of non-medical use of prescription drugs (NMUPD) and NMUPD overdose.

There are numerous EPS designed to reduce prescription drug misuse. However, many involve prevention approaches unfamiliar to substance abuse prevention practitioners; and few have been evaluated using rigorous research methods. Still, federal agencies have recommended several environmental strategies to prevent NMUPD based on sound logic or theory as well as preliminary evidence of effectiveness.

This guide includes information gathered from existing research and practice literature on environmental strategies that aim to reduce NMUPD. For each strategy, the guide includes information on: the populations for which the original strategy was designed, evaluation outcomes that provide evidence of effectiveness, and additional resources (e.g., links to additional guidelines) for readers.

Environmental strategies designed to reduce NMUPD and/or its consequences are organized into seven main categories:

  1. Raising awareness through education (Education)
  2. Tracking and monitoring the prescribing and dispensing of prescription drugs (Tracking and Monitoring)
  3. Enacting laws, regulations and policies that reduce access to commonly abused pharmaceuticals (Retail Access)
  4. Providing ways for consumers to safely and legally return unused drugs (Proper Medication Disposal)
  5. Enforcing new and existing policies, laws, and regulations (Enforcement)
  6. Reducing overdose through harm reduction approaches (Harm Reduction)
  7. Modifying multiple aspects of the social and physical environment (Multi-component)

The overall purpose of this guide is to help substance abuse prevention leaders and practitioners working at the state and local levels understand the breadth of environmental strategies that have the potential to prevent NMUPD. In addition, practitioners can use the guide to assist in selecting strategies that fit their strategic plan as well as are feasible to implement given resources, readiness, and funding restrictions. The detail provided on each strategy also can help states track activities associated with implementation for evaluation purposes.

1 See, for example, Freiden, T. R. (2010). A framework for public health action: The health impact pyramid. American Journal of Public Health, 100(4), 590-595; McLeroy, K. R., Bibeau, D., Steckler, A. and Glanz, K. (1988). An ecological perspective for health promotion programs. Health Education Quarterly, 15(4), 351-378; and Treno, A., & Lee, J. (2002). Approaching alcohol problems through an environmental lens. Alcohol Research & Health, 26(1), 35-40.