• Kevin Madden, Akhila S Reddy, Maxine J De La Cruz, Diane D Liu, and Eduardo Bruera.
• Department of Palliative, Rehabilitation and Integrative Medicine, University of Texas, M.D. Anderson Cancer Center, Houston, Texas, USA. Electronic address: kmadden@mdanderson.org.
• J Pain Symptom Manage. 2020 Feb 1; 59 (2): 320-326.

ContextMultiple studies have demonstrated that adults do not store prescription opioids safely. Increased prescription opioid rates have led to an increased incidence of opioid poisonings in children and adolescents.ObjectivesWe investigated whether parents practiced safe storage, use, and disposal techniques of opioids that were prescribed to their child with cancer-related pain.MethodsWe conducted a prospective cross-sectional survey of parents whose children were prescribed opioids and asked them about their patterns of storage, use, and disposal of prescription opioids.ResultsVirtually, all parents (106 of 109; 97%) completed the survey. Most parents (95 of 106; 90%) did not store opioids safely. Six of 106 parents (6%) gave their child's opioid pain medication to someone else with pain, and three of 106 parents (3%) personally took some of their child's opioid. Parents who personally took their child's opioid (P = 0.01) or gave it to another person (P < 0.001) were more likely to use opioids unsafely with their child. A minority of parents (22 of 106; 21%) did not use opioids safely in their child. A small number of parents (3 of 22; 14%) did not dispose of opioids safely.ConclusionUniversal education about the safe use and disposal of opioids should be adopted when prescribing opioids. Pediatricians need to maintain vigilance about the nonmedical use of prescription opioid use by parents of children.Copyright © 2019 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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