Storing and Disposing of Opioid Analgesics: What Does Our Medicine Tell Us?
Authors: Mitchell L. Doucette, Wendy C. Shields, R. Sterling Haring, Shannon Frattaroli
Journal: Annals of Internal Medicine (2018)

Letters7 August 2018Storing and Disposing of Opioid Analgesics: What Does Our Medicine Tell Us?Mitchell L. Doucette, PhD, MS, Wendy C. Shields, MPH, R. Sterling Haring, DO, MPH, and Shannon Frattaroli, PhD, MPHMitchell L. Doucette, PhD, MSThe Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (M.L.D., W.C.S., S.F.), Wendy C. Shields, MPHThe Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (M.L.D., W.C.S., S.F.), R. Sterling Haring, DO, MPHVanderbilt University Medical Center, Nashville, Tennessee (R.S.H.), and Shannon Frattaroli, PhD, MPHThe Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (M.L.D., W.C.S., S.F.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-3381 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Medication diversion represents the largest source of misused opioid analgesics (1). Unused opioid analgesics are seldom safely stored or disposed of (1–3), creating a large supply for diversion. Most patients lack knowledge about safe storage and disposal of opioids (4). Recent reports call for clear and consistent messages about safe practices (5). Providers rarely counsel patients on safe storage and disposal despite promising evidence supporting such interventions as an effective mechanism to improve patient behaviors (4). Drug package inserts include prescribing information for providers (6) and are an avenue for conveying information on safe storage and disposal. How medication ...References1. Bicket MC, Long JJ, Pronovost PJ, Alexander GC, Wu CL. Prescription opioid analgesics commonly unused after surgery: a systematic review. JAMA Surg. 2017;152:1066-71. [PMID: 28768328] doi:10.1001/jamasurg.2017.0831 CrossrefMedlineGoogle Scholar2. Frattaroli S, Shields W, Omaki E, Molloy M, Gielen AC. How are prescription medications stored in urban homes where children live? Opportunities for poisoning prevention. Clin Pediatr (Phila). 2017;56:678-81. [PMID: 27629434] doi:10.1177/0009922816668631 CrossrefMedlineGoogle Scholar3. Kennedy-Hendricks A, Gielen A, McDonald E, McGinty EE, Shields W, Barry CL. Medication sharing, storage, and disposal practices for opioid medications among US adults. JAMA Intern Med. 2016;176:1027-9. [PMID: 27295629] doi:10.1001/jamainternmed.2016.2543 CrossrefMedlineGoogle Scholar4. McCauley JL, Back SE, Brady KT. Pilot of a brief, Web-based educational intervention targeting safe storage and disposal of prescription opioids. Addict Behav. 2013;38:2230-5. [PMID: 23501140] doi:10.1016/j.addbeh.2013.01.019 CrossrefMedlineGoogle Scholar5. Alexander GC, Frattaroli S, Gielen AC, eds. The Opioid Epidemic: From Evidence to Impact. Baltimore: The Johns Hopkins Bloomberg School of Public Health; 2017. Accessed at www.jhsph.edu/events/2017/americas-opioid-epidemic/report/2017-JohnsHopkins-Opioid-digital.pdf on 18 November 2017. Google Scholar6. Watson KT, Barash PG. The new Food and Drug Administration drug package insert: implications for patient safety and clinical care. Anesth Analg. 2009;108:211-8. [PMID: 19095852] doi:10.1213/ane.0b013e31818c1b27 CrossrefMedlineGoogle Scholar7. Dart RC, Surratt HL, Cicero TJ, Parrino MW, Severtson SG, Bucher-Bartelson B, et al. Trends in opioid analgesic abuse and mortality in the United States. N Engl J Med. 2015;372:241-8. [PMID: 25587948] doi:10.1056/NEJMsa1406143 CrossrefMedlineGoogle Scholar8. U.S. National Library of Medicine. DailyMed. Bethesda: U.S. National Library of Medicine; 2005 on 3 April 2018. Google Scholar Author, Article, and Disclosure InformationAffiliations: The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (M.L.D., W.C.S., S.F.)Vanderbilt University Medical Center, Nashville, Tennessee (R.S.H.)Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-3381.Reproducible Research Statement:Study protocol and statistical code: Not available. Data set: A list of included opioid analgesics' National Drug Codes is available through written agreement from Dr. Doucette (e-mail, [email protected]edu).This article was published at Annals.org on 17 April 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoStorage and Disposal of Opioid Analgesics Mitchell L. Doucette , Wendy C. Shields , R. Sterling Haring , and Shannon Frattaroli Storage and Disposal of Opioid Analgesics Mark A. Liberatore , Judith A. Racoosin , and Douglas C. Throckmorton Metrics Cited byOpioids in advanced cancer: use, storage and disposal in the homePostoperative Disposal of Unused Opioids: A Systematic ReviewStorage and Disposal of Opioid AnalgesicsMark A. Liberatore, PharmD, RAC, Judith A. Racoosin, MD, MPH, and Douglas C. Throckmorton, MD 7 August 2018Volume 169, Issue 3Page: 198-199KeywordsAnalgesicsBehaviorDisclosureDrug informationDrugsMorphineOpioidsOxycodonePoisoningTheft ePublished: 17 April 2018 Issue Published: 7 August 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...