Study Says Majority of Postoperative Opioid Prescriptions Go Unused

Prescription opioids, intended for post-surgery utilization, often go unused and undisposed, leading to the nonmedical use of opioids that could have harmful consequences.

A study recently published by JAMA Surgery used MEDLINE, EMBASE, and Cochrane Register of Controlled Trials to search for studies that evaluate opioid oversupply for adults following a surgical procedure. This oversupply, or primary outcome, was categorized as the number of patients with filled but unused opioid prescriptions or unfilled opioid prescriptions.

“Prescriptions may go unfilled for several reasons, including adequate pain control after surgery,” the authors wrote. There are also instances where patients fill the prescription, but do not finish the medication, “leading to a reservoir of pills that can potentially contribute to the nonmedical use of opioids.”

From the database search, the researchers found 6 studies that reported a total of 810 patients who experienced 7 different types of surgical procedures. Among all of the studies considered, 67% to 92% of patients reported not using their opioid prescription; among all opioid tablets obtained by surgical patients, 42% to 71% were unused.

The majority of patients stopped using or did not use opioids once their pain was controlled. However, 16% to 29% of patients had reported adverse effects that were a result of their opioid utilization.

The research also considered the safety of how patients were storing their unused opioids. Of the studies reviewed, 2 evaluated storage safety and found that 73% to 77% of patients reported that they did not store their opioids in locked storage containers. This ultimately can contribute to opioid use by those who were not prescribed the drug originally.

Additionally, all of the observed studies had reported low rates of anticipated or actual disposal, but, no study had reported the use of the FDA recommended disposal method in more than 9% of patients. This, again, demonstrating the lack of prevention for those without a medical need to have access to the drug.

“Postoperative prescription opioids often go unused, unlocked, and undisposed, suggesting an important reservoir of opioids contributing to nonmedical use of these products, which could cause injuries or even deaths,” the authors concluded.