More Than Half Of Opioids Prescribed To Kids Aren't Taken

By Paul Gaita 04/27/18

According to a new study, only 19% of families said they were given clear instructions on how to dispose of leftover opioids.

Pediatrician giving young patient medicine

Children, like adults, may experience moderate to severe pain after undergoing surgery or a serious illness. In these cases, physicians may prescribe opioids to alleviate such symptoms.

But as a recent study found, more than half of the opioids prescribed to children were not taken, which left thousands of prescription painkiller tablets in households.

More troubling was the fact that when faced with this surplus of potentially dangerous and dependency-inducing medication, less than a quarter of families were told how to dispose of them, and less than 5% actually did.

The study suggests that such practices could contribute to a vast amount of unaccounted-for prescription pain medication in communities already under siege from the national opioid epidemic.

According to an article published on US News and World Report by study lead author Constance L. Monitto, MD, from the Johns Hopkins University School of Medicine in Baltimore, Maryland, the research focused on 343 pediatric patients at Johns Hopkins, of which 98% were postoperative patients, and all of whom were experiencing acute pain.

The children's parents were interviewed twice by researchers—the first within 48 hours of being discharged, and then 10 to 14 days after discharge—and were asked questions in regard to how many opioids had been prescribed to and consumed by their child, and what had been done with the unused medication.

The researchers found that 58% of the medication prescribed to patients was not taken, which left more than 3,000 oxycodone and 1,000 hydromorphone tablets in homes.

When asked how they dealt with the leftover medication, only 19% of families said that they were given clear instructions on how to dispose of them, and of that number only 4% followed those directions.

As Monitto noted, several factors could provide a solution to this excess of unused medication.

Greater research into pediatric pain could assist physicians on how to focus prescriptions to address specific situations within that age group and by circumstance (type of surgery, medical condition).

Expanded use of electronic or telephone refills—which is allowed but not mandated in all 50 states—could eliminate excessive prescriptions. And while limiting opioid prescriptions to a period of three to seven days may prove useful in some cases, it does not directly address each patient's exact condition and level of pain.

Until these issues are clarified or resolved, Monitto and her co-authors recommend that physicians provide patients and their families with clear instructions on how to dispose of the medication they do not use.

The Food and Drug Administration (FDA) has a list of approved methods of disposal, which include take-back options, throwing the medication in the trash or flushing them down the toilet, though the latter is a controversial suggestion. Unused medications can also be taken to some pharmacies, hospitals and/or clinics. 

The study's authors conclude that their recommendations are mere suggestions, and clearly defined and proven answers to the problem of unused medication remain elusive.

But expanded access to and information about disposal can provide, as the feature states, "important and achievable first steps that can make a significant difference today."

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Paul Gaita lives in Los Angeles. He has contributed to the Los Angeles Times, Variety, LA Weekly, and The Los Angeles Beat, among many other publications and websites.