• Eleanor T Lewis, Michael A Cucciare, and Jodie A Trafton.
• *Center for Innovation to Implementation, Veterans Affairs-Palo Alto Health Care System, Menlo Park §Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA †Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System ‡Department of Psychiatry and Behavioral Sciences, University of Arkansas for Medical Sciences, Little Rock, AR.
• Clin J Pain. 2014 Aug 1; 30 (8): 654-62.

ObjectivesThe volume of opioid medications being prescribed in the United States is increasing rapidly. Problems associated with the misuse of opioid medications are also increasing, in part because of medication diversion from legitimate prescriptions. However, little is known about what patients do with any unused opioid medications. This paper uses a qualitative analysis of patients' self-report of medication storage and retention habits to begin to address this gap.MethodsWe analyzed responses to the Prescription Drug Use Questionnaire in conjunction with other data on prescription opioid use in a sample of 191 Veteran patients (83% of whom had a preexisting factor associated with higher rates of opioid misuse) who received one or more opioid prescriptions in the previous 12 months.ResultsOnly 6.3% of participants disposed of extra medications and 24.1% reported having no extra opioids. A total of 65.4% of participants reported retaining some or all opioids even if they ceased taking the medication, and some participants accumulated large amounts of medication. A total of 34.0% of participants described engaging in sharing or diversion of opioids at least once, most often receiving them from a family member or a friend.DiscussionA majority of patients retain unused opioids, and medication sharing is common. Interventions to improve monitoring of patient experience with opioid medication, educate patients about the dangers of opioid use by nonprescribed others, and increase information about medication disposal options could decrease the supply of opioid medications available for misuse.

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