Drug-Disposal Bag Helps Families Properly Dispose of Unused Opioids After Kid’s Surgery

By Will Boggs MD

June 26, 2019

NEW YORK (Reuters Health) - Providing drug-disposal bags increases the likelihood that families will properly dispose of unused opioids after their children's surgery, researchers report.

"Although patient and caregiver education and the reduction of excess opioid prescribing are critical steps to reducing opioid misuse, our findings suggest that providing a simple tool to enable families to safely dispose of their children's' leftover opioids in the home garbage significantly increases proper postoperative opioid disposal," Dr. Jennifer N. Cooper from the Research Institute at Nationwide Children's Hospital, in Columbus, Ohio, told Reuters Health by email.

Opioids are commonly prescribed for postoperative pain management, and reported rates of proper disposal of unused opioids are below 10% among both adults and children. Education regarding proper drug disposal has not consistently improved proper excess opioid disposal in earlier studies.

Dr. Cooper and colleagues randomly assigned 202 families of children having outpatient surgery to receive a drug-disposal bag containing activated charcoal or to standard care.

Nearly all children were prescribed liquid opioid medication. Clinicians did not prescribe opioids to seven patients, and the parents of two patients, both of whom had received a drug-disposal bag, refused an opioid prescription.

Significantly more families receiving the bags reported properly disposing of their child's leftover opioids (71.7% vs. 56.2%, P=0.03), the researchers report in JAMA Pediatrics, online June 24.

Results were similar among only those families who filled an opioid prescription and had leftover opioids after resolution of their child's pain (85.7% vs. 64.9%, respectively).

Significantly fewer families in the disposal-bag group (91.3%) than in the standard care group (98.9%) actually filled their child's opioid prescription.

"This could indicate that the provision of a drug-disposal bag increased some parents' fears about the risks of opioids, prompting them to forgo filling their child's opioid prescription altogether," Dr. Cooper said. "There was, however, no difference in parent-reported pain control between groups."

Most parents in both groups reported that their child's postoperative pain control was good, and the groups did not differ in the number of days that opioids were used and the total number of doses taken and left over.

Among parents reporting disposal, 89.6% of those in the disposal-bag group used it for opioid disposal, whereas 63.0% of those in the standard care group reported pouring the leftover drugs in the toilet or sink.

"Physicians should consider providing drug-disposal products to their patients at the time opioids are prescribed or refer their patients to pharmacies where such products are available," Dr. Cooper said. "Drug-disposal bags and pouches are available for purchase online and at many large retailers, and many pharmacies and health systems now provide these bags at no cost to patients filling opioid prescriptions."

SOURCE: https://bit.ly/2XC4rqu

JAMA Pediatr 2019.