(Reuters Health) – Patients who talk with their physicians about the risks of prescription opioid addiction are less likely to hoard their medications for later use, researchers report.
“We believe these findings add support for Centers for Disease Control and Prevention (CDC) guidelines regarding educating patients of the addictive risks of prescription painkillers, but they are by no means definitive and many questions remain,” said Joachim O. Hero from Harvard University in Boston.
“We hope that our findings help spur direct efforts to measure how patients respond to information on prescription painkillers from their providers, and on how the content and delivery of that information can be shaped to maximize effectiveness,” Hero told Reuters Health by email.
While the CDC recommends that clinicians discuss the known risks and benefits of opioid therapy with their patients, its guidelines note that no evidence exists to evaluate the effectiveness of patient education or any other risk-mitigation strategy for prescription opioids.
Hero and colleagues used two surveys – one national, one in Massachusetts – to evaluate whether patient education efforts as currently practiced might influence behavior regarding prescription opioid use.
Among individuals prescribed “strong painkillers,” 61% nationally and 36% in Massachusetts recalled talking about the risk of prescription drug addiction with their physicians, the researchers report in Annals of Family Medicine on November 14.
Massachusetts residents were more likely than national respondents to say they saved pills for later use (30% vs. 17% nationally). The authors estimated that 20% of national respondents who did not remember discussing addiction risk reported saving pills for later, compared with only 8% who did remember discussing addiction risk.
For Massachusetts, an estimated 26% of respondents who did not discuss the risk of addiction reported saving pills for later, compared with only 12% of those who did.
“We found a clear association between patients recalling a conversation with their physician about the addictive risks of prescription painkillers and risky pill-saving behavior, even after adjustment for sociodemographic differences between these populations,” Hero said.
Dr. Mellar Davis, an expert in palliative medicine at Geisinger Medical Center in Danville, Pennsylvania, told Reuters Health by email, “One of the large missing pieces in this whole affair of education is how do I get rid of unused medications, particularly opioids.”
“In the past it was common to flush them down toilets but this pollutes water sources,” said Dr. Davis, who was not involved in the surveys. “Grinding them in cat litter or pouring bleach over them are other ways. It would be helpful if there was a universal policy and procedure to dispose of unused opioids. Recycling them to proper use would be ideal but would take some doing in changing policy and procedure and doing it safely.”