tivate discarded medications to eliminate the possibility of staff
diverting trace amounts of leftover substances.
If you're prescribing opioids, are you accounting for what happens
to those opioids after patients bring them home, especially in terms of
what happens to leftover medications?
Studies estimate that 75% of opioids prescribed after surgery go
unused, and most of the unused medications are not disposed of proper-
ly, leaving open the possibility that a patient's relative "tries just one"
when he see leftover pills in the medicine cabinets. Like many physi-
cians earlier this decade, surgeons at Rush University Medical Center in
Chicago, Ill., were prescribing opioids to patients. Furthermore, there
wasn't a process in place to educate patients about how to safely get rid
of extra pills.
"We weren't addressing opioid disposal at all," says Charles Hannon,
MD, resident physician at Rush's department of orthopedic surgery. "If
you look at the literature, an overwhelming majority of physicians and
practices do not educate patients on proper opioid disposal methods."
As the national epidemic grew worse, Rush decided to take correc-
tive action. They began with a randomized trial. Dr. Hannon and his
team tested 2 patient educational methods. One involved handing
patients a simple pamphlet, which described FDA-approved opioid
disposal methods, such as bringing them to medication takeback
boxes at local pharmacies, hospitals, and fire and police stations or,
failing that, flushing them down the toilet. The team gave each patient
the pamphlet on 3 occasions: pre-operatively, 3 weeks post-op and 6
weeks post-op. The second method consisted of giving patients the
same pamphlet, but and also sending them text message reminders
about proper disposal methods.
The result? About 38% of the text/pamphlet group disposed of their
pills properly, while about 33% of those with just the pamphlet did. Of
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