• Terri Voepel-Lewis, Carol J Boyd, Alan R Tait, Sean Esteban McCabe, and Brian J Zikmund-Fisher.
• School of Nursing, University of Michigan, Ann Arbor, Michigan; Department of Anesthesiology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan; Center for the Study of Drugs, Alcohol, Smoking and Health (DASH Center), University of Michigan, Ann Arbor, Michigan. Electronic address: terriv@umich.edu.
• Am J Prev Med. 2022 Oct 1; 63 (4): 564573564-573.

IntroductionRetaining leftover prescription opioids poses the risks of diversion, misuse, overdose, and death for youth and other family members. This study examined whether a new educational program would enhance risk perceptions and disposal intentions among parents and decrease their retention of leftover prescription opioids.Study DesignThis study is an RCT (NCT03287622).Setting/ParticipantsA total of 648 parents whose children were prescribed opioid analgesics were recruited from a Midwestern, academic pediatric hospital between 2017 and 2019. Parents were randomized to receive routine information (control) with or without Scenario-Tailored Opioid Messaging Program intervention.InterventionThe intervention provided opioid risk and mitigation advice using interactive decisional feedback.Main Outcome MeasuresThe main outcome measures were parents' perceptions of the riskiness of keeping/sharing opioids and child misuse measured at baseline, Days 3 and 14, their intention to dispose of leftover opioids, and their final retention decisions after the child's use (at or around Day 14).ResultsPerceived riskiness of child misuse and keeping/sharing opioids increased from baseline through Day 14 only for parents in the intervention group (p≤0.006). However, there were no significant differences in risk perceptions between groups and no intervention effect on disposal intentions at either follow-up. Despite these findings, the intervention reduced the likelihood of parents' opioid retention when adjusted for important parent and child covariates (AOR=0.48; 95% CI=0.25, 0.93; p=0.028). Parents who reported past opioid misuse also showed higher retention behavior (AOR=4.78; 95% CI=2.05, 11.10; p<0.001).ConclusionsA scenario-specific educational intervention emphasizing the potential risks that leftover opioids pose to children and that provided risk mitigation advice decreased parents' retention of their child's leftover opioid medication. Removing leftover prescription drugs from homes with children may be an important step to reducing diversion, accidental poisoning, and misuse among youth.Trial RegistrationThis study is registered at www.Clinicaltrialsgov NCT03287622.Copyright © 2022 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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