Patients Keep Unused Opioids Pills In Case of Future Pain

Many patients keep their unused prescribed opioid pills in anticipation of future pain needs, according to a new AHRQ study published in Pain Medicine. Of 235 participants discharged from a large Chicago emergency department between 2015 and 2017, 117 planned to keep their hydrocodone-acetaminophen, and 100 planned to dispose of it. Researchers found patients described their plans for the unused opioids in four primary categories: keep “just in case” of recurrence of a specific medical condition; keep “just in case” of an unspecified condition or emergency; keep for now but will discard “after they expire” or “when my shoulder heals”; and had no identified plans but are keeping them anyway. Notably absent from patients’ responses were intentions to share, abuse or sell their opioid pills. These findings confirm existing literature that patients regularly keep their medications. Access the abstract.

2019 Mar 21. pii: pnz025. doi: 10.1093/pm/pnz025. [Epub ahead of print]

Who Is Keeping Their Unused Opioids and Why?

Neill LA1, Kim HS1, Cameron KA2, Lank PM1, Patel DA3, Hur SI3, Opsasnick LA3, Curtis LM3, Eifler MR3, Courtney DM1, Wolf MS2,3, McCarthy DM1.

Author information

Abstract

OBJECTIVE:

To better understand patients' reasoning for keeping unused opioid pills.

METHODS:

As part of a larger study, patients were asked their plans for their unused opioids. Responses were categorized as "dispose," "keep," and "don't know." Baseline characteristics were compared between the "keep" and "dispose" groups. Verbatim responses categorized as "keep" were analyzed qualitatively using a team-based inductive approach with constant comparison across cases.

RESULTS:

One hundred patients planned to dispose of their pills; 117 planned to keep them. There were no differences in demographics between the groups. Among patients who planned to keep their pills, the mean age was 43 years and 47% were male. Analysis revealed four categories of patient responses: 1) plans to keep their pills "just in case," with reference to a medical condition (e.g., kidney stone); 2) plans to keep pills "just in case" without reference to any medical condition; 3) plans to dispose in delayed fashion (e.g., after pill expiration) or unsure of how to dispose; and 4) no identified plans, yet intended to keep pills. In this sample, there were no differences in characteristics of those reporting planning to keep vs dispose of pills; however, there were diverse reasons for keeping opioids.

CONCLUSIONS:

This manuscript describes a sample of patients who kept their unused opioids and presents qualitative data detailing their personal reasoning for keeping the unused pills. Awareness of the range of motivations underpinning this behavior may inform the development of tailored education and risk communication messages to improve opioid disposal.