In a review of half a dozen published studies in which patients self-reported use of opioids prescribed to them after surgery, researchers at Johns Hopkins report that a substantial majority of patients used only some or none of the pills, and more than 90 percent failed to dispose of the leftovers in recommended ways.
A summary of the review, published August 2 in JAMA Surgery, highlights the need for more personalized pain management to avoid overprescribing opioids and reduce risks linked to improperly stored opioids in the home.
“Physicians write a lot of prescriptions for patients to fill for home use after they have inpatient or outpatient surgery, but our review suggests that there’s a lot we don’t know about how much pain medication people really need or use after common operations,” says Mark Bicket, M.D., an assistant professor of anesthesiology and critical care at the Johns Hopkins University School of Medicine and the paper’s first author.
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The review he and his team published found that 67 to 92 percent of a total of 810 patients in the six studies did not use their entire opioid prescription, yet still held onto them, increasing the risk of misuse, says Bicket. Opioid abuse and misuse rates have been rising in the U.S., adding to what public health officials are calling an epidemic of opioid deaths and overdoses.
Commonly, Bicket notes, prescriptions for opioid pills permit patient discretion for dosing, such as taking one pill every four hours “as needed” for pain. Instead of a one-size-fits-all approach, Bicket says, clinicians need to do a better job of personalizing prescriptions and dosing for each patient.