What to Do – and Not Do – with Leftover Opioid Meds

Keeping unused opioid medications could have very dangerous outcomes.

Update: October 27, 2018 is national DEA Prescription Drug Take Back Day - get your leftovers ready to return!

If your physician has prescribed opioids for your pain, chances are you store them in your bathroom medicine cabinet. And if you find that you don’t finish all the medication, you may be thinking that the medicine cabinet is the best place to keep the pills in case you need them in the future. Experts, however, say you should reconsider where you keep these medicines, and they recommend disposing of any unused medication.

For starters, “If you are on chronic opioids, you should have lockable storage, such as a safe, and that is where they should be,” says Lawrence W. Epstein, MD, FIPP, director of outpatient services in the Pain Management Division, Department of Anesthesiology at Mount Sinai Medical Center in New York City. This will help avoid any diversion, that is, letting the medication fall into the hands of a family member or friend.

Unused OpioidsLearn how to properly dispose of leftover opioid medication. (Source: 123RF)

The Problem with Leftovers

Almost one-third of older Americans filled a prescription for opioids in the past two years, but many didn’t receive adequate counseling on the risks of taking them, how to reduce their use, and what to do with unused pills, according to a University of Michigan poll.

About half (49%) of the adults had leftover medication and 86% of these individuals said they kept the pills in case their pain returned. Approximately 9% threw the pills in the trash or flushed them down the toilet, while just 13% took them to an approved disposal facility (see below).

Diversion of unused opioids to a teenager or child can have fatal consequences, Dr. Epstein warns. “The problem with young adults, in particular, is that they see a prescription medicine and may have an inherent belief in its safety because it is a prescription drug,” Dr. Epstein explains. “It’s logical for them to assume that it must be safe because a doctor gave it to his/her parents.”

Individuals on chronic opioid therapy should also ask their doctor about take-home naloxone, an emergency overdose medication that can be used if an opioid-related accident should occur.

Dispose of Leftover Opioids Appropriately

If you have unused opioid medication, don’t flush it down the toilet or toss it in the trash. Instead, find out if your pharmacy or your police station has a “give back” program. Some states do, so learn whether yours is on the list. Your pharmacy is not obligated to take back the medication but it is possible they will—so be sure to call ahead.

The National Association of Boards of Pharmacy (NABP) offers an online search tool titled: “Looking for a permanent drug disposal site?” You can enter your zip code and see how many miles the nearest disposal site exists.

If you cannot locate a give-back program, you may render the medication unusable, Dr. Epstein says. You can then crush the pills, mix them with coffee grounds or cat litter, and place them into the trash, he advises.

Avoid Saving Leftover Opioids for Anticipated Future Pain

Saving unused opioids that have been prescribed to you is not recommended, Dr. Epstein says. If you should decide to use them at a future time, you need to consider the consequences of how they might interact with whatever other medications you take, he says.

Individuals who are seeing several doctors for various conditions and are on multiple medications need to ensure that all their doctors know each and every medication they’re taking. Respiratory depression, which is extremely dangerous, can result from mixing certain drugs, explains Michael Genovese, MD, JD, chief medical officer at Acadia Healthcare and Medical director of the Officer Safety and Wellness Committee of the FBI National Academy Associates. “If you are getting Valium from one doctor for anxiety and then you are prescribed opioids for pain, this could be very dangerous,” he says.

While most states have prescription drug monitoring programs to monitor potential interactions, it’s best to play it safe, Dr. Genovese says. “No system is foolproof,” he says. “Your doctor should take a good history before prescribing opioids, and you should be really open with your doctor about what other medications you are taking.”

Updated on: 10/24/18
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