Los Angeles Times

After surgery, prescripti­on pills go unused

Many patients who went under the knife wound up with unused opioids, report finds.

- KAREN KAPLAN karen.kaplan@latimes.com Twitter: @LATkarenka­plan

Amid opioid crisis in U.S., report finds that many patients wind up with a surplus of painkiller­s.

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 an prescripti­on for opioids, more than twothirds 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% 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% of generalsur­gery patients had excess pain medication, the researcher­s found.

In fact, in five of the seven surgical categories, more than 80% of patients had surplus opioids at their disposal. These included thoracic surgery (81%), dermatolog­ic surgery (89%), caesarean sections (90%) and dental surgery (91%), in addition to general surgery.

The only category besides urologic surgery to miss the 80% mark was orthopedic surgery (77%).

The researcher­s also sorted the patients based on whether their surgeries required a hospital stay. Between 67% and 90% 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% to 92% 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% to 83% 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% acknowledg­ed that this was a concern.

Two of the underlying studies queried patients about where they kept their medication. About threequart­ers 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% of cases, patients said they hadn’t given the situation any thought at all. Only 4% to 9% used — or even considered using — a disposal method endorsed by the Food and Drug Administra­tion. (These include bringing unused medicine to a “take-back” event or mixing it with kitty litter in a sealable bag and throwing it away.)

“The combinatio­n of unused opioids, poor storage practices, and lack of disposal sets the stage for the diversion of opioids for nonmedical use,” the study authors explained. “These findings are important because of the magnitude of injuries and deaths attributab­le to the nonmedical use of prescripti­on opioids.”

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