More than half of patients who get a prescription for opioid painkillers have leftover pills and keep them to use later, a practice that could potentially exacerbate the United States’ epidemic of painkiller addiction and overdoses.
Researchers reporting in JAMA Internal Medicine also found that nearly half of those surveyed reported receiving no information on how to safely store their medications to keep them from children who could accidentally ingest them or from someone looking to get high.
One in five respondents said they had shared their medication with another person, many saying they gave them to someone with pain. Nearly 14 percent said they were likely to share their prescription painkillers with a family member in the future and nearly 8 percent said they would share with a close friend.
“The fact that people are sharing their leftover prescription painkillers at such high rates is a big concern,” says Colleen L. Barry, who directs Johns Hopkins University’s Center for Mental Health and Addiction Policy Research. “It’s fine to give a friend a Tylenol if they’re having pain, but it’s not fine to give your OxyContin to someone without a prescription.”
Over the past decade, there has been a sharp increase in prescription painkiller addiction rates and overdose deaths. Drug overdoses—the majority of which involve opioid pain relievers—were the leading cause of injury death in 2014 among people between 25 and 64. Prescription opioids include hydrocodone (sold as Vicodin), oxycodone (OxyContin, Percocet), morphine and codeine, the National Institutes of Health say.
“These painkillers are much riskier than has been understood and the volume of prescribing and use has contributed to an opioid epidemic in this country,” says study leader Alene Kennedy-Hendricks, assistant scientist in health policy and management at Johns Hopkins’ Bloomberg School of Public Health.
Many patients in the study said they were not given information on how to safely dispose of unused medication. Fewer than 7 percent of people with extra pills reported taking advantage of “take back” programs that enable patients to turn in unused pain medication to pharmacies, police departments or the Drug Enforcement Administration for disposal.
“It’s not clear why so many of our survey respondents reported having leftover medication, but it could be that they were prescribed more medication than they needed,” Kennedy-Hendricks says.
In March, the US Centers for Disease Control and Prevention urged doctors to avoid prescribing powerful opioid painkillers for patients with chronic pain, saying the risks from such drugs outweigh the benefits for most people. Prolonged use can lead to addiction, putting people at much higher risk for overdose. Abusers may also turn to illegal heroin, also an opioid.
The new survey involved 1,032 US adults who had used prescription painkillers in the previous year. Among those no longer using prescription pain relievers at the time of survey (592 respondents), 60.6 percent reported having leftover pills and 61.3 percent of those with leftover pills said they had kept them for future use rather than disposing of them.
Fewer than 10 percent said they kept their opioid pain medication in a locked location. Nearly half said they weren’t given information on safe storage or proper disposal of leftover medication. More than 69 percent of those who got instructions said they had received information about turning over the remaining medication to a pharmacist or a “take back” program, but few actually did. Fewer than 10 percent reported throwing leftover medication out in the trash after mixing it with something inedible like used coffee grounds, a safe method for disposing of medication.
Physicians should, when prescribing these medications, discuss the inappropriateness of sharing and how to safely store and dispose of them, Kennedy-Henricks says.
“We don’t make it easy for people to get rid of these medications. We need to do a better job so that we can reduce the risks not only to patients but to their family members.”
“If we don’t change our approach, we are going to continue to see the epidemic grow,” Barry says.
The study, a collaboration between Johns Hopkins’ Center for Mental Health and Addiction Policy Research and its Center for Injury Research and Policy, was funded by an unrestricted research grant from the AIG.
Source: Johns Hopkins University