St. Louis, MO—Persuading more patients to safely dispose of leftover prescription opioids might be as straightforward as informing them of the importance of doing so and describing how to accomplish it.

That’s according to a new article published ahead of print by the Journal of the American College of Surgeons. Background information in the report points out that unused painkillers kept at home are a major source of drugs fueling the nation’s opioid epidemic.

Researchers from the Washington University School of Medicine and Barnes Jewish Hospital, both in St. Louis, found that supplying patients with a brochure that describes safe disposal practices can help.

The study, conducted from February through September 2017, reports that adult patients provided the educational information were twice as likely to dispose of their opioids properly compared with those who did not receive the brochure.

“There is strong data indicating that prescription opioid use is a risk for heroin use,” study coauthor Katherine B. Santosa, MD, said, citing a 2012 study that found that 86% of IV drug users reported having misused opioid pain relievers before using heroin. 

“Initiation of misuse occurred through three main sources: family, friends, or personal prescriptions.”

The study recruited eligible surgery patients from an upper extremity/peripheral nerve clinic. The brochure was provided to 170 patients after surgery who were compared to 164 patients who did not receive the brochure.

Results indicate that, after dissemination of the brochure, the proportion of patients who disposed of their unused opioids (11% vs. 22%, P = .02) increased significantly. Of those who disposed of their opioids, however, there was no significant difference in the proportion of patients from each group who disposed in a manner that was recommended by the brochure (43% vs. 64%, P = .19).

The educational brochure was designed by a team including attending surgeons, a clinical fellow, a nurse practitioner, a research nurse coordinator, and patient service and education administrators. Using FDA guidelines and published medical reports, the brochure describes the opioid epidemic and the problem with unsafe disposal and then provides step-by-step instructions for proper disposal in the trash, including discarding the empty bottle, as well as identifying websites that provide lists of drug take-back locations.

Lead author Jessica Hasak said the self-disposal method detailed in the brochure is mixing unused opioid medications with undesirable household substances such as coffee grounds, soil, kitty litter, or dish detergent in a plastic food storage bag and putting it in the trash. 

“We were encouraged by our findings and have now designed and are testing an even more straightforward one-page brochure to see if disposal will be even more efficient,” Hasak said. “Our thought was that the simpler and easier for the patient the instructions and disposal method can be, the more likely we as medical practitioners will be to empower them to do something about the problem.”
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