Leftover Opioids Present a Quandary for Many California Pharmacies

Sarasota, FL (WorkersCompensation.com) – Unfinished opioid prescriptions have been cited as one of the biggest contributors to the opioid epidemic. But a new study shows pharmacy employees in California either don’t know or don’t share information on proper disposal of opioids with customers – especially on the weekends.

During a two-month period in 2018, researchers from the University of California at San Francisco posed as parents of children who had recently had surgery and phoned pharmacies to find out what to do with leftover medications. In addition to an antibiotic was liquid Hycet (hydrocodone-acetaminophen), a pain reliever containing an opioid compound.

Fewer than half the pharmacies responded with answers that adhered to the U.S. Food and Drug Administration guidelines.

“The FDA has specific instructions on how to dispose of these medications, and the American Pharmacists Association has adopted this as their standard,” said Hillary Copp, an associate professor of urology at UCSF and the senior author of the study. “Yet it’s not being given to the consumer correctly the majority of the time.”

Drug disposal or ‘takeback’ programs are the ideal way to dispose of unused medications, the FDA says. Short of that, the agency recommends that opioids be flushed down the toilet, while antibiotics should be mixed with coffee grinds or kitty litter, sealed in a container and thrown in the garbage.

While 47 percent of the nearly 900 pharmacies surveyed gave correct instructions for disposing of antibiotics, only 19 percent had the right answer for leftover opioids. Additionally, just 82 pharmacies, or 11 percent of those surveyed said they had a take-back program for opioids.

The findings, reported in the Annals of Internal Medicine, also showed correct information was provided more often on weekdays. “For opioids, correct information was given 20 percent of the time on a weekday call and 7 percent of the time on a weekend call,” the authors wrote. “Our findings suggest that differences may exist in how often accurate information is provided according to whether the inquiry was made on a weekday or weekend. This variability warrants further investigation and may present an opportunity for quality improvement.”

The fact that consumers do not know what to do with unused medication is “disturbing,” said Teresa Bartlett, MD, SVP, Senior Medical Officer at Sedgwick. “Some large pharmacy chains have Pharmacy Drop-Off boxes at their locations and are able to communicate that and share the information,” she said.

“We have seen a trend emerging where employers and retailers are growing more concerned about this issue and offering solutions with prescriptions where a disposal bag is provided with, or immediately following the prescription that allows the patient to mail the unused medication at no cost to a facility where the drugs are closed incinerated,” she added. “One particular retailer has a patent on a product formulation of a disposal bag where, when the medication is added to the container, it is rendered inert.”

Improving disposal practices must be a collaborative effort. Bartlett pointed out that local law enforcement is another way people can easily and safely dispose of medications. Additionally, more education is needed – for consumers and those who advise them.

“A pharmacy is a place where medications are dispensed so it is natural for people to look to this same location for advice on how to dispose of unused medications” Copp said. However, “pharmacies should not be solely responsible for providing proper disposal information. Managing leftover medications is a complex problem that should be addressed from multiple angles.”

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