Medication Disposal: Getting Unused Opioids Out of Circulation

Leftover medications from postsurgical pain management are a contributor to the crisis of opioid abuse, misuse, and diversion. But findings from a recent randomized clinical trial led by PAINWeek faculty member Chad Brummett, MD, suggest a possible approach to increasing the likelihood that patients will safely dispose of unneeded pain medications. Dr. Brummett and colleagues Jennifer Waljee, MD, and Michael Englesbe, MD, report that equipping postsurgical patients with a specially designed disposal bag, along with instruction on its use doubled the percentage of patients who safely disposed of their unneeded opioids within 6 weeks of their procedure. Brummett commented, “We need everyday disposal options that address patients’ needs and break down common barriers for safe disposal through other means, such as bringing unneeded medications to take-back drives or law enforcement locations that require a special trip and may make some patients uncomfortable.”

Brummett, Waljee, and Englesbe run the Michigan Opioid Prescribing and Engagement Network, which studies and aims to reduce the use of opioids in treating the acute pain from surgery and procedures, as well as encouraging safe disposal of leftover opioids. In this study, patients who were prescribed opioids following surgery were randomized to receive either usual care with no instruction on drug disposal; a brochure detailing proper disposal procedure; or instruction plus the special disposal bag. The bag contained activated charcoal that neutralizes the opioid and breaks down safely in the environment. 57% of patients in the last group reported that they safely disposed of their unused medication, compared to 33% who receive only the brochure and 28% who received no information. Dr. Waljee commented, “We need to help our patients understand the risks that these medications can pose once their surgical pain has subsided, and the need to get them out of their homes safely.” The findings were published in JAMA Surgery.

Read the conclusions.

The journal abstract may be read here.