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Frequency of unsafe storage, use, and disposal practices of opioids among cancer patients presenting to the emergency department

Published online by Cambridge University Press:  13 April 2016

Julio Silvestre ,
Akhila Reddy ,
Maxine de la Cruz ,
Jimin Wu ,
Diane Liu ,
Eduardo Bruera  and
Knox H. Todd
Julio Silvestre
Affiliation:
Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas Department of Medicine, Geriatrics, and Palliative Care, University of Virginia Health System, Charlottesville, Virginia
Akhila Reddy*
Affiliation:
Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
Maxine de la Cruz
Affiliation:
Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
Jimin Wu
Affiliation:
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
Diane Liu
Affiliation:
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
Eduardo Bruera
Affiliation:
Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
Knox H. Todd
Affiliation:
Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
*
Address correspondence and reprint requests to: Akhila Reddy, Department of Palliative Care and Rehabilitation Medicine, Unit 1414, The University of Texas MD Anderson Cancer, 1515 Holcombe Boulevard, Houston, Texas 77030. E-mail: asreddy@mdanderson.org.
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Abstract

Objective:

Approximately 75% of prescription opioid abusers obtain the drug from an acquaintance, which may be a consequence of improper opioid storage, use, disposal, and lack of patient education. We aimed to determine the opioid storage, use, and disposal patterns in patients presenting to the emergency department (ED) of a comprehensive cancer center.

Method:

We surveyed 113 patients receiving opioids for at least 2 months upon presenting to the ED and collected information regarding opioid use, storage, and disposal. Unsafe storage was defined as storing opioids in plain sight, and unsafe use was defined as sharing or losing opioids.

Results:

The median age was 53 years, 55% were female, 64% were white, and 86% had advanced cancer. Of those surveyed, 36% stored opioids in plain sight, 53% kept them hidden but unlocked, and only 15% locked their opioids. However, 73% agreed that they would use a lockbox if given one. Patients who reported that others had asked them for their pain medications (p = 0.004) and those who would use a lockbox if given one (p = 0.019) were more likely to keep them locked. Some 13 patients (12%) used opioids unsafely by either sharing (5%) or losing (8%) them. Patients who reported being prescribed more pain pills than required (p = 0.032) were more likely to practice unsafe use. Most (78%) were unaware of proper opioid disposal methods, 6% believed they were prescribed more medication than required, and 67% had unused opioids at home. Only 13% previously received education about safe disposal of opioids. Overall, 77% (87) of patients reported unsafe storage, unsafe use, or possessed unused opioids at home.

Significance of Results:

Many cancer patients presenting to the ED improperly and unsafely store, use, or dispose of opioids, thus highlighting a need to investigate the impact of patient education on such practices.

Keywords

Cancer patientsOpioid storageOpioid DisposalPrescription opioid abuseOpioid diversionAccidental opioid poisoningEmergency center
Type
Original Articles
Information
Palliative & Supportive Care , Volume 15 , Issue 6 , December 2017 , pp. 638 - 643
Copyright
Copyright © Cambridge University Press 2016 

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Footnotes

*

These authors contributed equally to the work of the study.

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