What Happens To Leftover Prescription Opioids?

By Paul Gaita 09/22/17

Less than 10% of the participants in a recent study reported proper disposal of leftover medications.

young woman pours the pills out of the bottle and into her hand.

While recent federal statistics have shown that the number of opioid prescriptions written in the United States over the previous decade has dropped, a new study suggests that very few of the individuals who receive such prescriptions today are finishing or disposing of the unused pills in the proper manner.  

The study found that up to 92% of patients did not finish their entire prescription and less than 10% get rid of the remaining drugs, which can lead to instances of abuse among people with unrestricted access to improperly stored or secured prescription medication.

A report from CNBC noted that while there are many ways to dispose of prescriptions drugs—including the upcoming National Prescription Drug Take Back Day, which takes place on October 28—such events have not reached their full potential among the American public.

The study, published in the August edition of the journal JAMA Surgery, reviewed data from six studies which involved 810 patients who underwent one of seven different forms of surgery—from general procedures to more specified work, including orthopedic or obstetric surgeries.

The researchers, from Johns Hopkins University School of Medicine and Bloomberg School of Public Health, found that between 67% and 92% of these patients reported having unused opioids. The patients reported that the majority of the painkillers prescribed to them—between 42% and 71%—went unused because the pain caused by the procedure had stopped, while 16% to 29% reported that they had stopped using the opioids due to "adverse side effects."

Two studies reviewed by the authors found that between 73% and 77% of patients reported that their prescriptions were not stored in a locked container of some kind. Additionally, all six studies showed that less than 9% of patients have used disposal methods recommended by the Food and Drug Administration (FDA) to dispose of medication. These include flushing certain medicines down the sink or toilet—the FDA's approved list of such drugs can be found here—though there is a chance that such medication can contaminate water supplies. Disposing them in household trash after mixing the uncrushed capsules or tablets with an inedible substance like dirt or used coffee grounds is another option supported by the FDA.

The availability of unsecured prescription drugs can lead to misuse, according to the National Survey on Drug Use and Health, which reported that 60% of adult respondents to the survey who stated that they misused opioids did not have a prescription, and of that number 41% got the drugs from friends or a relative. And with death rates from opioid overdose increasing among teenagers, there would appear to be good reason to secure or dispose of leftover prescription opioids.

If flushing or throwing away medications is of concern, individuals can also take unused prescription drugs to some pharmacies, including CVS, as well as hospitals and clinics. National efforts like the Prescription Drug Take Back Day—which is conducted twice annually—have proven effective, with 450 tons of prescription medication received at the last collection on April 2017.

Keith Humphreys, professor of psychiatry and behavioral sciences at Stanford University and a former member of the White House Commission on Drug Free Communities, believes that such events should be held more regularly in order to increase their efficacy. "We need to force it into a cultural habit so it is not a special event," he noted, adding that a recycling program like that for bottles and cans that comes with a cash reward might help increase its profile. "People return bottles because of the deposit," he said. 

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