University of Utah Health Sciences Center, Salt Lake City, Utah, USA.
J Urol. 2011 Feb;185(2):551-5. doi: 10.1016/j.juro.2010.09.088. Epub 2010 Dec 18.
Prescription narcotic abuse is a significant social problem. Surplus medication following surgery is 1 source of prescription diversion. We assessed prescribing practices, consumption and disposal of prescribed narcotics after urological surgery.
Surveys were administered to a 3-month consecutive sample of adult patients who underwent surgery performed by full and adjunct University of Utah Urology faculty. Surveys were performed 2 to 4 weeks postoperatively. With the exception of the investigators, prescribing physicians had no prior knowledge of the study. Data collected included perception of pain control, type and quantity of medication prescribed, quantity of leftover medication, refills needed, disposal instructions and surplus medication disposition.
Overall 47% of 586 patients participated in the study. Hydrocodone was prescribed most commonly (63%), followed by oxycodone (35%), and 86% of the patients were satisfied with pain control. Of the dispensed narcotics 58% was consumed and 12% of patients requested refills. A total of 67% of patients had surplus medication from the initial prescription and 92% received no disposal instructions for surplus medication. Of those patients with leftover medication 91% kept the medication at home while 6% threw it in the trash, 2% flushed it down the toilet and less than 1% returned it to a pharmacy.
Overprescription of narcotics is common and retained surplus medication presents a readily available source of opioid diversion. It appears that no entity on the prescribing or dispensing ends of prescription opioid delivery is fulfilling the responsibility to accurately educate patients on proper surplus medication disposal. Surgeons should analyze prescribing practices and consider decreasing the quantity of postoperative narcotics prescribed.
处方类麻醉药物滥用是一个严重的社会问题。手术后剩余的药物是处方类麻醉药物滥用的一个来源。我们评估了泌尿外科手术后的处方开具习惯、麻醉药物使用和处置情况。
对连续三个月内接受了由犹他大学泌尿科全职和兼职医生进行的手术的成年患者进行问卷调查。调查在术后 2 至 4 周进行。除了调查人员，开处方的医生对这项研究一无所知。收集的数据包括对疼痛控制的感知、开具的药物类型和数量、剩余药物的数量、所需的续药、处置说明和剩余药物处置情况。
共有 586 名患者中的 47%（279 名）参与了这项研究。最常开的是氢可酮（63%），其次是羟考酮（35%），86%的患者对疼痛控制满意。在开出的麻醉药物中，58%被使用，12%的患者要求续药。初始处方中有 67%的患者有剩余药物，92%的患者没有收到剩余药物的处置说明。在有剩余药物的患者中，91%将药物留在家中，6%将药物扔进垃圾桶，2%将药物冲进厕所，不到 1%的患者将药物退还给药店。
麻醉药物的过度开具很常见，保留的剩余药物是阿片类药物滥用的一个现成来源。在开具或分发麻醉药物的过程中，似乎没有任何机构承担起准确教育患者正确处置剩余药物的责任。外科医生应该分析处方开具习惯，并考虑减少术后开具的麻醉药物数量。
