Hanging on to Old Opioids? No Judgment—We Are Too.

By Maggie Gorini

Based on an informal poll of 9 staff members, 4 of us admitted to having an old bottle of unfinished opioids on the shelf at home, gathering maybe its 10th year of dust. But how could that be? Aren’t we all knowledgeable health advocates that follow every single up-to-date health recommendation? We try, but we’re also human. Folks over here are just as guilty of breaking the Don’t Keep Your Old Meds rule, when we know all too well why they should be disposed of promptly once no longer needed.

How did we end up getting these pills in the first place, anyway? For many, that first opioid prescription is given to mitigate pain from wisdom teeth extractions, a procedure which about 5 million patients undergo each year. There are some signals that prescribing trends are changing, however. As recent as 2018, adjustments made by health professionals reflect lower numbers of opioid painkillers prescribed for routine surgeries like teeth extractions. Specifically, oral health professionals out of Johns Hopkins are rethinking their standard practices, and some have adapted to new evidence that supports initial prescriptions for nonsteroidal anti-inflammatory drugs (NSAIDs) after many dental surgeries, like the 3rd molar extraction (wisdom teeth), and following up with opioid medication only when necessary. 

In addition to the roles played by opioid manufacturers and prescribers in creating an opioid epidemic, many tragic outcomes tied to opioid use can be caused by other increasingly popular pain medications such as gabapentinoids (e.g. Lyrica). These types of medications are often prescribed to manage seizures, fibromyalgia, pain from spinal cord injury, specific types of nerve damage, and pain commonly associated with shingles.

Admittedly, getting rid of old medications is not the most clear process, and not every pharmacy even takes unused medications. So we asked the question, where do you dispose of old medication, and how can the process be made easier? 

The FDA lists some environmentally-unfriendly options, such as flushing them, which is currently the safest option for 15 drugs (check the table halfway down the page), or mixing them (not crushing them) in with coffee grounds before tossing them in the garbage. It’s not great for Mother Earth, but the risk to your mother is likely higher

The FDA lists several methods of drug disposal that are not environmentally friendly.

The agency also suggests taking advantage of medicine take-back events hosted periodically by the Drug Enforcement Administration (DEA), one of which is National Prescription Drug Take Back Day, on October 26, 2019 from 10am-2pm. You can also find local sites that are available year round. If you call the DEA Office of Diversion Control’s Registration Call Center at 1-800-882-9539 or use their search engine, you can find a nearby “authorized collector” licensed to take back the drug you have in hand. Those authorized collectors will sometimes offer ways to mail in your medications for convenience.

Ideally, we would like to see state legislatures require that all pharmacies become authorized collectors in order to operate. That would mean more residents could drop off old medications at their convenience, and the task wouldn’t throw a wrench in their already busy schedules. Here’s to hoping our policymakers catch up to the times, and make it easier for us all to say goodbye to our medicine cabinet clutter.

 

Maggie Gorini is the NWHN Policy Fellow