Zero Left helps safely remove unused opioids
By Karen Dandurant
Posted Oct 8, 2017 at 3:01 AM
EXETER - The Zero Left program offers a simple way to dispose of leftover prescription drugs.
The campaign was started by Jim and Jeanne Moser, following the death of their son, Adam, in 2015. Adam died of a drug overdose and his parents believe his substance abuse problem may have started in their own medicine cabinet.
Zero Left is a simple concept. Deterra bags, filled with inactive carbon, are distributed through medical facilities, free of charge. Unused opioids can be placed inside the bag and water is used to activate the carbon. The drugs are dissolved, deactivated and can then be thrown safely in the trash. Even the bags are biodegradable.
“Participation is now at a great level,” said Jim Moser. “Doctors are distributing the bags, but so are nurse practitioners, medical assistants and everyone involved with patients. When patients have surgery, the medical staff talks to them about the guidelines for opioid use, and they are giving out the bags. They are introducing them to Zero Left, and telling them it is for their current prescription but also for anything they may have left at home.”
The Mosers hope that Zero Left becomes a national campaign. They know it is making a difference locally and they want to raise the awareness of the dangers of unused medicine.
“Prescription medicines are a piece of the problem,” said Moser. “We still believe that if our son had a better understanding, he may have chosen differently.”
“You teach your children about the dangers of hot and cold, about safely crossing the street, and even about using drugs and alcohol,” said Moser. “We are not teaching them about the dangers of the stuff that is easily found, medicine in the cabinet. The thought is that it is a prescription, so safe, but we know it is not safe. We need to have those conversations. We need to remove the temptation.”
Exeter Hospital, and its affiliates are among those who have embraced the campaign. Debra Vasapolli, director of public relations for Exeter Hospital, said they started with the campaign when it was first proposed, and recently had a big kickoff to expand the program because they recognize the value of Zero Left.
“We held a system-wide training to kick off an all-encompassing participation,” said Vasapolli. “The Deterra bags are available all through Exeter Hospital, in the Emergency Room, through Core Physicians, inpatient and outpatient services and through Rockingham VNA and Hospice.”
Vasapolli said they distributed about 1,000 bags, which will be handed out to any patient with an opioid prescription. She said they have been given to Core offices for patients who may have leftover prescriptions they might want to dispose of.
“We are working with Granite Health, who have distributed 3,000 bags and brochures with the help of New England Delta Dental and the Tuft Health Freedom plan,” Vasapolli said.
“The more of these medications that we can get out of homes, the less accessibility there is for abuse,” said Vasapolli. “We feel it is one way of making a difference.”
Travis Harker, CMO of the Granite Health Alliance, a partnership of New Hampshire health systems (LRGHealthcare, Catholic Medical Center, Southern New Hampshire Health, Exeter Health Resources, and Wentworth-Douglass Hospital) said they embraced Zero Left when Jim Moser brought the concept to them.
“We wanted to see if we could expand his local effort to reduce excess prescription opioids in his community,” said Harker. “The Mosers’ experience and their ideas moved us to act to expand his work across the state. We know that four out of five people who use heroin or fentanyl began their addiction with prescription opioids from a legitimate prescription or from a friend who had left-over pain pills. Getting rid of excess opioids is an important step in preventing addiction.”
Harker worked with Moser and the leadership of their member systems to develop a program to improve prescribing practices and increase awareness among the public about the risks of prescription opioids.
“We were fortunate to gain grant funds from the Tufts Health Freedom Plan and from Northeast Delta Dental to bring these ideas to life,” said Harker. “Through Zero Left we are working to ensure that providers have the most up-to-date information on safe prescribing practices and are encouraging patients to dispose of leftover opioids.”
To make it easy for patients to dispose of their excess medications, Wentworth Douglass, Catholic Medical Center, Southern New Hampshire Health and LRGHealthcare are placing medication take-back boxes in their buildings. Harker said CMC and WD have installed them and have been filled up several times with excess medications. Their partners are handing out Deterra bags.
“Providers feel that handing out these pouches to patients sends a strong message that holding onto excess opioids puts them and their family members at risk for addiction,” said Harker. “Patients are grateful for an easy way to dispose of them in a safe, easy and environmentally friendly way.”
Granite Health Alliance partners are developing continuing medical education classes to be held in November and December this year to share best practices in post-surgical pain management and how to taper patients off unsafe doses of opioids.
“These topics were identified by practicing physicians across New Hampshire so that they can enhance their practice,” Harker said.
Nicky Carrier, a registered nurse at Exeter Hospital, was one of the first in the nursing field to get involved with the distribution of Deterra bags and the Zero Left Program.
“I am honored to be involved with this program,” said Carrier. “I worked with Jim in the OR for several years before transitioning to Nurse Total Joint Coordinator. I worked with Jim when he lost his son and saw how he and his family amazingly channeled their grief into such a wonderful initiative to help prevent overdose deaths related to opioids.”
Carrier works with patients before and after surgery.
“When I meet with them preoperatively, I go over the Opioid Risk Tool and Acute Opioid Prescribing Informed Consent,” said Carrier. “These tools assess risk of opioid addiction and give patients information about the medications they are going to be taking after surgery including side effects. They are shown the Deterra packets and advised that if they have any unused pills after their procedure, one will be provided for them to dispose of the medication. I
believe this is so important because so many patients are unaware of the possible dangers of taking these medications, and leaving the unused portion of them in their medicine cabinets. The reality is they do need the medication after surgery, good pain control will help with recovery and physical therapy, but we make sure if there are pills left the patients have an easy way to dispose of them.”
Carrier said she feels preventing even one family from losing a loved one from overdosing on unused opioids, makes Zero Left a worthwhile project.
Vasapolli said the Zero Left campaign has been very well received, both by the medical community and by patients.
“I think there is a deep understanding in the community about the dangers of these medications getting into the hands of a young person who is struggling,” said Vasapolli. “I think people like this idea because they may be able to help keep