University of Toronto, Ontario, Canada.
The Hospital for Sick Children, Toronto, Ontario, Canada.
Hand (N Y). 2023 Jun;18(4):701-707. doi: 10.1177/15589447211063585. Epub 2021 Dec 28.
Despite increased public awareness to dispose of unused narcotics, opioids prescribed postoperatively are retained, which may lead to drug diversion and abuse. This study assessed retention of unused opioids among hand surgery patients and describes disposal methods and barriers.
Participants undergoing hand surgery were given an opioid disposal information sheet preoperatively (N = 222) and surveyed postoperatively to assess disposal or retention of unused opioids, disposal methods, and barriers to disposal. A binomial logistic regression was conducted to assess whether age, sex, pain intensity, and/or the type of procedure were predictors of opioid disposal.
There were 171 patients included in the analysis (n = 51 excluded; finished prescription or continued opioid use for pain control). Unused opioids were retained by 134 patients (78%) and disposal was reported by 37 patients (22%). Common disposal methods included returning opioids to a pharmacy (49%) or mixing them with an unwanted substance (24%). Reasons for retention included potential future use (54%), inconvenient disposal methods (21%), or keeping an unfilled prescription (9%). None of the patient factors analyzed (age, sex, type of procedure performed, or pain score) were predictors of disposal of unused narcotics ( > .05).
Most patients undergoing hand surgery retained prescribed opioids for future use or due to impractical disposal methods. The most common disposal methods included returning narcotics to a pharmacy or mixing opioids with unwanted substances. Identifying predictors of disposal may provide important information when developing strategies to increase opioid disposal.
尽管公众对处理未使用的麻醉药品的意识有所提高,但术后开的阿片类药物仍被保留,这可能导致药物转移和滥用。本研究评估了手外科患者未使用的阿片类药物的保留情况,并描述了处置方法和障碍。
术前向接受手外科手术的患者发放阿片类药物处置信息表(N=222),并在术后进行调查,以评估未使用的阿片类药物的处置或保留情况、处置方法以及处置障碍。采用二项逻辑回归分析评估年龄、性别、疼痛强度和/或手术类型是否是阿片类药物处置的预测因素。
共有 171 名患者纳入分析(n=51 人排除;完成处方或继续使用阿片类药物控制疼痛)。134 名患者(78%)保留了未使用的阿片类药物,37 名患者(22%)报告了处置情况。常见的处置方法包括将阿片类药物返还给药房(49%)或与不想要的物质混合(24%)。保留的原因包括潜在的未来用途(54%)、不方便的处置方法(21%)或保留未填写的处方(9%)。分析的患者因素(年龄、性别、手术类型或疼痛评分)均不能预测未使用的麻醉性镇痛药的处置(>.05)。
大多数接受手部手术的患者保留处方阿片类药物以备将来使用或由于处置方法不切实际。最常见的处置方法包括将麻醉性镇痛药归还药房或与不想要的物质混合。确定处置的预测因素可能在手外科患者中提供重要信息,有助于制定增加阿片类药物处置的策略。