Safe opioid storage · naloxone
Safe storage and rescue medication
Naloxone in the home and a locked place to keep controlled medication — the two cheapest interventions in this entire program, and the ones with the clearest rationale.
Why does safe opioid storage matter?
The single largest measured source of prescription opioid misuse is not theft or forgery. In the 2024 National Survey on Drug Use and Health, 31.3% of people who misused a prescription pain reliever in the past year were given it free by a friend or relative, and a further 4.0% took it from one without asking. Together that is more than a third of misuse originating in somebody else’s medicine cabinet.
That is a storage problem, and it is solvable without regulating anybody. It is also why safe storage belongs at the front of a diversion strategy rather than at the back — see the diversion evidence.
Rescue medication is the other half. CDC’s 2022 guideline recommends offering naloxone where risk factors are present, and the case for it does not depend on any particular dose threshold.
How does the safe storage and naloxone program work?
- A lockable storage container supplied as part of enrollment, not recommended in a leaflet.
- Naloxone in the home, with the patient and the household shown how and when to use it.
- Household education — because the person most likely to witness an overdose is not a clinician.
- A disposal route for medication that is no longer needed, so that leftover supply does not sit in a cabinet for years.
What this is not
It is not a compliance test. Nobody is inspecting a patient’s home to confirm the box is being used, and a patient who loses the container is not sanctioned for it.
It is not an accusation. Providing naloxone is not a statement that a patient is expected to overdose, any more than a fire extinguisher is a statement about a household’s cooking. This should be said out loud when it is offered, because patients hear it as a judgment when it is not.
Frequently asked questions
Why should opioids be kept in a lock box?
Because more than a third of prescription opioid misuse starts in someone else’s medicine cabinet. In the 2024 National Survey on Drug Use and Health, 31.3% of people who misused a prescription pain reliever were given it free by a friend or relative, and another 4.0% took it from one without asking. A locked container closes that route without regulating anybody.
Where can I get a medication lock box?
In the IntellaRx program, a lockable storage container is supplied as part of enrollment, not recommended in a leaflet. It comes with naloxone for the home, education for the household, and a disposal route for medication that is no longer needed. Nobody inspects the home to confirm the box is used, and a patient who loses it is not sanctioned.
Why keep naloxone at home?
Because the person most likely to witness an overdose is not a clinician; it is someone in the household. CDC’s 2022 guideline recommends offering naloxone where risk factors are present. Having it is not a statement that a patient is expected to overdose, any more than a fire extinguisher is a statement about a household’s cooking.
What should I do with leftover opioids?
Get them out of the cabinet. The program gives enrolled households a disposal route for medication that is no longer needed, so leftover supply does not sit at home for years. Leftover pills are exactly the supply the national survey shows being given away by friends and relatives or taken without asking.
Sources
Every figure on this page is traceable to the source listed here.
- Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Key Substance Use and Mental Health Indicators in the United States: Results from the 2024 National Survey on Drug Use and Health. HHS Publication No. PEP25-07-007, NSDUH Series H-60. July 2025. View source.
- Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R. CDC clinical practice guideline for prescribing opioids for pain — United States, 2022. MMWR Recomm Rep. 2022;71(3):1–95. PMID 36327391. View source.