To address prescription medication misuse in their community, Building A Safer Evansville (BASE) in Wisconsin started a comprehensive lock box initiative. The initiative provides free lock boxes to community partners or anyone who requests them at community events. Each lock box – approximately the size of lunchbox – is marked with the BASE logo and a programmable combination lock. Within each box is information about medication misuse/abuse, how/where to dispose of medication, how to return the box when it is no longer necessary, and a link to the utilization survey.

“We engaged seven key sectors/partners and have developed unique policies and practices for the promotion, distribution, and utilization of the initiative. Each policy and practice builds off the sector/partner’s sphere of influence,” said Jennifer Braun, executive director of BASE. “The key to making this initiative successful was its wide-reaching partners as well as the coalition’s promotional efforts, such as a weekly column in the newspaper, a Facebook campaign, Drop Box event fliers, and booths set up and staffed by the coalition.”

BASE serves the Evansville School District, approximately 1,740 students from the City of Evansville, town of Brooklyn, and surrounding communities of Magnolia, Union, Rutland, Center, and Porter. Over 13,000 people call Evansville and the surrounding rural area home. To make their community healthier, each sector partner at BASE has made their commitment part of their formal policies including participation, distribution and promotion.

• The police department promotes the lock boxes on their Facebook page, hands out information at Drop Box events, and visits all area businesses to hand out boxes, info sheets and talks about abuse.
• The local schools specifically ask any parent/guardian whose student has struggled with substance abuse about interest in a lock box as well as specifically asking any parent whose student takes a prescription medicine at school. The schools also use the lock box for field trips to hold prescription medicines.
• The local senior center, Creekside Place, has a sample lock box set out and offers free use to anyone along with presenting information about prescription medicine misuse/abuse and hands out the lock boxes.
• Realtors provide information on how to keep medicines safe during open houses and walk throughs.
• Local funeral homes offer boxes to their clients and provide information about the safety of locking up prescription medicines.
• Clinics, pharmacies, chiropractor, veterinarians, and dentists offer boxes to their patients along with information about how to prevent medication misuse/abuse.
• The Section 8 housing partners offer boxes to their tenants and provide information to new and existing tenants on medication abuse and disposal.
   

Over 200 medication lock boxes have been distributed to Evansville community members in the two years the program has been active. Since 2012, the perception of harm for prescription drugs has decreased in both middle and high school youth. In a 2012 focus group with youth and adults, medication misuse and abuse was a common theme among participants; in 2016 focus groups and interviews, it was not mentioned as a problem in the community.

“Since 2012, when BASE partnered with the Evansville Police Department to get a medication drop box installed, we have collected over 2,400 pounds of medications,” said Braun. “My advice to other coalitions: follow the strategic prevention framework, this model works! Be persistent, effective environmental strategies that affect community level change take time and commitment of all sectors of the community. Engage these sectors and work to keep them involved in the process.”