Introduction: At-home opioid disposal systems have been shown to increase proper opioid disposal following cessation of acute post-operative pain. As part of our Opioid Stewardship Initiative, we sought to improve proper opioid disposal by providing an at-home medication disposal product to all patients prescribed opioids for at home use. Methods: From May 2019 to May 2020, patients prescribed opioids for acute at-home post-operative pain were given a packet of an at-home disposal product and an educational flyer describing safe at-home storage and disposal methods. Instructions regarding disposal were further iterated by an anesthesiologist during the preoperative. Families with unused opioids at the conclusion of the first post-operative meeting were encouraged to dispose of these opioids and given a reminder call two weeks after following up on opioid disposal. Results: 452 packets of the at-home disposal product were distributed. There were 355 encounters with unused opioids who were followed up. Of these 338 (95%) ultimately disposed of their unused opioid. All but 10 families used the at-home disposal product (328, 92%) as provided. A total of 97 were excluded from final analysis due to surgery cancellation (20), failure to follow-up (39), never filled prescription (21) and used all of the prescribed medication (17). Discussion and Conclusion: Providing an at-home disposal product is a viable method of ensuring proper disposal of unused opioids. The combined cost of the disposal packet plus the instructional flyer was $1.90 per patient. Additional efforts are being undertaken to evaluate whether follow-up reminder calls at 2 weeks can be simplified to be included in the post-operative follow-up call to increase parent/guardian adherence.
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