Sur­gi­cal pa­tients end up with left­over opi­oids

Three-quar­ters of re­spon­dents to study say they don’t lock up the sur­plus

The Denver Post - - NEWS - By Karen Ka­plan

Amer­ica’s opi­oid cri­sis is fu­eled by pre­scrip­tion painkillers. Med­i­ca­tions such as oxy­codone, fen­tanyl and mor­phine were re­spon­si­ble for nearly half of the 33,000 over­dose deaths recorded in 2015, ac­cord­ing to the Cen­ters for Dis­ease Con­trol and Preven­tion.

How did Amer­i­cans get their hands on so many opi­oid pills? A new study sug­gests that sur­gi­cal pa­tients have plenty go to around.

Among 810 peo­ple who were op­er­ated on and sent home with a pre­scrip­tion for opi­oids, more than two-thirds wound up with un­used painkillers in the weeks af­ter their pro­ce­dures, ac­cord­ing to a re­port pub­lished Wed­nes­day in the jour­nal JAMA Surgery.

The re­searchers, from Johns Hopkins Univer­sity, ex­am­ined data from six pre­vi­ously pub­lished stud­ies and or­ga­nized it into seven cat­e­gories ac­cord­ing to the type of surgery the pa­tients had.

At the low end of the spec­trum, 67 per­cent of pa­tients who went un­der the knife to treat kid­ney stones, prostate cancer or other uro­logic con­di­tions had un­filled pre­scrip­tions or left­over pills from pre­scrip­tions that were filled. On the high end, 92 per­cent of gen­eral-surgery pa­tients had ex­cess pain med­i­ca­tion, the re­searchers found.

In fact, in five of the seven sur­gi­cal cat­e­gories, more than 80 per­cent of pa­tients had sur­plus opi­oids at their dis­posal.

The re­searchers also sorted the pa­tients based on whether their surg­eries re­quired a hos­pi­tal stay. Between 67 per­cent and 90 per­cent of those who were checked into a hos­pi­tal had ex­tra pre­scrip­tion painkillers weeks af­ter they’d gone home. Among those who had out­pa­tient pro­ce­dures, 77 per­cent to 92 per­cent had sur­plus opi­oids, the re­searchers found.

When pa­tients were asked why they hadn’t used all of their pre­scrip­tion pills, the most com­mon an­swer — given 71 per­cent to 83 per­cent of the time — was that their pain was al­ready un­der con­trol. One study specif­i­cally asked pa­tients if they were wor­ried that the opi­oid pills would be­come ad­dic­tive; 8 per­cent ac­knowl­edged that this was a con­cern.

Two of the un­der­ly­ing stud­ies queried pa­tients about where they kept their med­i­ca­tion. About three-quar­ters of those who an­swered said it was stored in an un­locked com­part­ment such as a medicine cab­i­net, cup­board or dresser.

Pa­tients in five of the stud­ies were asked about their plans for left­over pills. In 70 per­cent of cases, pa­tients said they hadn’t given the sit­u­a­tion any thought at all. Only 4 per­cent to 9 per­cent used — or even con­sid­ered us­ing — a dis­posal method en­dorsed by the Food and Drug Ad­min­is­tra­tion.

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