Tanabe Paula, Paice Judith A, Stancati Jennifer, Fleming Michael
Duke University School of Nursing, Durham, NC, USA.
J Emerg Nurs. 2012 May;38(3):273-9. doi: 10.1016/j.jen.2011.09.023. Epub 2011 Dec 26.
Opioid abuse and overdose have increased drastically in recent years. Diversion of opioids used to treat pain, either through theft or sharing, is increasing and may contribute to this misuse. Based on these trends, we designed a study to investigate opioid storage and disposal practices of patients who were prescribed these agents in the emergency department.
A prospective cohort pilot study was conducted. All adults (aged ≥18 years) with a chief complaint of either minor musculoskeletal trauma, renal colic, or acute back pain who were discharged home with an opioid prescription were eligible for inclusion; persons with chronic pain were excluded. Patients were asked to participate in two home interviews in which the research assistant viewed the storage location of the opioid prescription. Safe storage was defined as being stored in a locked container or cabinet. Safe disposal was defined as returning the drugs to a designated location or mixing unused pills with an undesirable substance, placing in a sealable container, and then in the trash. Patients self-reported disposal methods. Feasibility of study methods evaluated the ability to conduct home interviews after the ED visit. Descriptive statistics were used to analyze the data.
Twenty-five subjects consented to participate; 20 patients completed both home interviews. None of the medications were safely stored. Only 1 patient disposed of the medication, yet did so improperly.
This pilot study revealed widespread improper storage and disposal of opioids. The study has major implications for education for ED physicians, nurses, and residents.
近年来，阿片类药物滥用及过量使用情况急剧增加。用于治疗疼痛的阿片类药物通过盗窃或共享等方式被转移的现象日益增多，这可能助长了此类药物的滥用。基于这些趋势，我们设计了一项研究，以调查在急诊科开具此类药物处方的患者的阿片类药物储存和处置情况。
开展了一项前瞻性队列试点研究。所有因轻微肌肉骨骼创伤、肾绞痛或急性背痛为主诉而开具阿片类药物处方并出院回家的成年人（年龄≥18岁）均符合纳入条件；慢性疼痛患者被排除在外。患者被要求参加两次家庭访谈，研究助理在访谈中查看阿片类药物处方的储存位置。安全储存定义为存放在上锁的容器或柜子中。安全处置定义为将药物返还至指定地点，或将未使用的药片与有害物质混合，放入可密封容器，然后丢弃。患者自行报告处置方法。研究方法的可行性评估了急诊就诊后进行家庭访谈的能力。采用描述性统计方法分析数据。
25名受试者同意参与；20名患者完成了两次家庭访谈。所有药物均未安全储存。只有1名患者处置了药物，但处置方式不当。
这项试点研究揭示了阿片类药物广泛存在的储存和处置不当问题。该研究对急诊科医生、护士和住院医师的教育具有重要意义。
