Deaths from prescription opioid have quadrupled since 1999, according to the Centers for Disease Control and Prevention (CDC). Some of the dangers may stem from their simple availability, as a survey from the Johns Hopkins Bloomberg School of Public Health suggests that more than half of patients who are prescribed opioids have leftover pills, with many patients saving them to use later.
Additionally, nearly half of those surveyed reported receiving no information on how to safely store their medications, either to keep them from young children who could accidentally ingest them or from adolescents or other adults looking to get high, nor were they given information about how to safely dispose of leftover medications.
Furthermore, fewer than 7% of people with extra pills reported taking advantage of “take back” programs that enable patients to turn in unused pain medication to pharmacies, polices departments, or the Drug Enforcement Administration for disposal.
“These painkillers are much riskier than has been understood, and the volume of prescribing and use has contributed to an opioid epidemic in this country,” said study leader Alene Kennedy-Hendricks, PhD, an assistant scientist at the department of health policy and management at the Bloomberg School. “It’s not clear why so many of our survey respondents reported having leftover medication, but it could be that they were prescribed more medication than they needed.”
“The fact that people are sharing their leftover prescription painkillers at such high rates is a big concern,” said senior author Colleen L. Barry, PhD, MPP, a professor who directs Bloomberg’s Center for Mental Health and Addiction Policy Research. “It’s fine to give a friend a Tylenol if they’re having pain, but it’s not fine to give your OxyContin to someone without a prescription.”
Drug overdoses, most of which involve opioid pain relievers, were the leading cause of injury death in 2014 among people between the ages of 25 and 64 years. Also, drug overdoses have surpassed car crashes as the leading cause of injury death among this group.
In March, the CDC urged doctors to avoid prescribing powerful opioid painkillers for patients with chronic pain, saying the risks of such drugs outweigh their benefits for most people. Dental opioid prescriptions decreased by 5.7% from 2007 to 2012, though some dentists still prescribe hydrocodone (Vicodin) and oxycodone (OxyContin or Percocet) to address orofacial pain during or after treatment.
The researchers gathered a national sample of 1,032 adults in the United States who had used prescription painkillers in the previous year. Among those who were no longer using the prescriptions, 60.6% said they had leftovers, and 61.3% of those with leftovers kept them for future use rather than disposing of them.
Also, one in 5 of all the respondents said that they had shared their medication with another person, with many saying they gave them to someone who needed them for pain. Nearly 14% said they were likely to share their prescription painkillers with a family member in the future, and nearly 8% said they would share with a close friend.
Fewer than 10% said they kept their opioids in a locked location. Nearly half said they weren’t given information on safe storage or proper disposal of leftovers. More than 69% of those who got instructions said they received information about “take back” programs, but few actually did. And, fewer than 10% reported throwing leftovers in the trash after mixing it with something inedible like used coffee grounds, which is considered a safe disposal method.
Kennedy-Hendricks said that physicians should discuss the inappropriateness of sharing and how to safely share and dispose of these medications when they are prescribed.
“We don’t make it easy for people to get rid of these medications,” she said. “We need to do a better job so that we can reduce the risks not only to patients but to their family members.”
“We’re at a watershed moment,” said Barry. “Until recently, we have treated these medications like they’re not dangerous. But the public, the medical community, and policymakers are now beginning to understand that these are dangerous medications and need to be treated as such. If we don’t change our approach, we are going to continue to see the epidemic grow.”
The study, “Medication Sharing, Storage, and Disposal Practice Among U.S. Adults with Recent Opioid Medication Use,” was supported by an unrestricted research grant from AIG and published by JAMA Internal Medicine.