Opioid use and disposal at 2 weeks post-surgery: Brief communication regarding excess opioids and disposal habits

Authors

DOI:

https://doi.org/10.5055/jom.0854

Keywords:

orthopedic, opioid epidemic, opioid education, surgery, opioid use

Abstract

Objective: To measure the number of unused prescription opioids and disposal habits of patients following orthopedic shoulder surgery.

Design: A prospective observational study.

Setting: Academic orthopedic sports medicine department.

Patients: Sixty-seven patients undergoing shoulder surgery.

Interventions: Nine-question opioid use questionnaire.

Main outcome measures: Responses to an opioid use questionnaire were collected at 2 weeks post-surgery. Outcomes of interest included the amount of initial opioid prescription used and the disposal of excess opioids.

Results: Sixty-seven patients completed the opioid use questionnaire. Forty-six (68.7 percent) patients reported having excess opioids at 2 weeks. Of the 46 patients with excess opioids, 57 percent disposed of the excess, and 43 percent planned to keep their opioids.

Conclusion: Two-thirds of the patients reported having excess opioids, highlighting the issue of an overabundance of unused prescription opioids in America. Utilization of opioid-free pain management strategies and drug disposal kits should be explored to reduce the number of unused and improperly disposed opioids.

Author Biographies

Henry Kuechly, BS

Department of Orthopaedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati, Ohio

Sarah Kurkowski, MD

Department of Orthopaedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati, Ohio

John Bonamer, BS

Department of Orthopaedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati, Ohio

Brian Newyear, BS

Toledo College of Medicine, Toledo, Ohio

Brian Johnson, MD

Department of Orthopaedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati, Ohio

Brian Grawe, MD

Department of Orthopaedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati, Ohio

References

Clarke H, Soneji N, Ko DT, et al.: Rates and risk factors for prolonged opioid use after major surgery: Population based cohort study. BMJ. 2014; 348(3): g1251-g1251.

Centers for Disease Control and Prevention: Wide-ranging online data for epidemiologic research (WONDER). 2017. Available at https://healthdata.gov/dataset/wide-ranging-online-dataepidemiologic-research-wonder. Accessed October 1, 2023.

Sheth U, Mehta M, Huyke F, et al.: Opioid use after common sports medicine procedures: A systematic review. Sports Health. 2020; 12(3): 225-233.

Cheesman Q, DeFrance M, Stenson J, et al.: The effect of preoperative education on opioid consumption in patients undergoing arthroscopic rotator cuff repair: A prospective, randomized clinical trial-2-year follow-up. J Shoulder Elbow Surg. 2020; 29(9): 1743-1750.

Farley KX, Anastasio AT, Kumar A, et al.: Association between quantity of opioids prescribed after surgery or preoperative opioid use education with opioid consumption. JAMA. 2019; 321(24): 2465.

Rucinski K, Cook JL: Effects of preoperative opioid education on postoperative opioid use and pain management in orthopaedics: A systematic review. J Orthop. 2020; 20: 154-159.

Syed UAM, Aleem AW, Wowkanech C, et al.: Neer award 2018: The effect of preoperative education on opioid consumption in patients undergoing arthroscopic rotator cuff repair: A prospective, randomized clinical trial. J Shoulder Elbow Surg. 2018; 27(6): 962-967.

Sabesan VJ, Chatha K, Koen S, et al.: Innovative patient education and pain management protocols to achieve opioid-free shoulder arthroplasty. JSES Int. 2020; 4(2): 362-365.

Rodgers J, Cunningham K, Fitzgerald K, et al.: Opioid consumption following outpatient upper extremity surgery. J Hand Surg Am. 2012; 37(4): 645-650.

Bates C, Laciak R, Southwick A, et al.: Over-prescription of postoperative narcotics: A look at postoperative pain medication delivery, consumption and disposal in urological practice. J Urol. 2011; 185(2): 551-555.

Cabo J, Hsi RS, Scarpato KR: Postoperative opiate use in urological patients: A quality improvement study aimed at improving opiate disposal practices. J Urol. 2019; 201(2): 371-376.

Bicket MC, Long JJ, Pronovost PJ, et al.: Prescription opioid analgesics commonly unused after surgery: A systematic review. JAMA Surg. 2017; 152(11): 1066-1071.

Lawrence AE, Carsel AJ, Leonhart KL, et al.: Effect of drug disposal bag provision on proper disposal of unused opioids by families of pediatric surgical patients: A randomized clinical trial. JAMA Pediatr. 2019; 173(8): e191695.

Dwyer CL, Soong M, Hunter A, et al.: Prospective evaluation of an opioid reduction protocol in hand surgery. J Hand Surg. 2018; 43(6): 516-522.e1.

Hasak JM, Roth Bettlach CL, Santosa KB, et al.: Empowering post-surgical patients to improve opioid disposal: A before and after quality improvement study. J Am Coll Surg. 2018; 226(3): 235-240.e3.

Kumar K, Gulotta LV, Dines JS, et al.: Unused opioid pills after outpatient shoulder surgeries given current perioperative prescribing habits. Am J Sports Med. 2017; 45(3): 636-641.

Bartels K, Mayes LM, Dingmann C, et al.: Opioid use and storage patterns by patients after hospital discharge following surgery. PLoS One. 2016; 11(1): e0147972.

Finger A, Teunis T, Hageman MG, et al.: Association between opioid intake and disability after surgical management of ankle fractures. J Am Acad Orthop Surg. 2017; 25(7): 519-526.

Wyles CC, Thiels CA, Hevesi M, et al.: Patient opioid requirements are often far less than their discharge prescription after orthopaedic surgery: The results of a prospective multicenter survey. J Am Acad Orthop Surg. 2021; 29(7): e345-e353.

US Department of Health and Human Services: Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings. Rockville, MD: US Department of Health and Human Services, 2011.

Chapman CG, Hudspeth J, Floyd SB, et al.: Increased opioid use following rotator cuff repair associated with prior opioid use and surgeon prescription patterns. J Shoulder Elbow Surg. 2020; 29(7s): S115-S125.

Sethi PM, Brameier DT, Mandava NK, et al.: Liposomal bupivacaine reduces opiate consumption after rotator cuff repair in a randomized controlled trial. J Shoulder Elbow Surg. 2019; 28(5): 819-827.

Lamplot JD, Premkumar A, James EW, et al.: Postoperative disposal of unused opioids: A systematic review. HSS J. 2021; 17(2): 235-243.

Stokes SM, Kim RY, Jacobs A, et al.: Home disposal kits for leftover opioid medications after surgery: Do they work? J Surg Res. 2020; 245: 396-402.

Published

04/01/2024

How to Cite

Kuechly, H., S. Kurkowski, J. Bonamer, B. Newyear, B. Johnson, and B. Grawe. “Opioid Use and Disposal at 2 Weeks Post-Surgery: Brief Communication Regarding Excess Opioids and Disposal Habits”. Journal of Opioid Management, vol. 20, no. 2, Apr. 2024, pp. 103-7, doi:10.5055/jom.0854.

Issue

Section

Brief Communication

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