Communication of Recommendations for the Disposal of Unused Prescription Opioid Medications by Stakeholders in the News Media

Abstract

Objective The opioid epidemic is a national public health emergency that requires a comprehensive approach to reduce opioid-related deaths. Proper and timely disposal of unused prescription opioids is one method to deter improper use of these medications and prevent overdose. The objective of this study was to understand how recommendations for disposing of unused prescription opioids, including both take-back programs and toilet disposal, are communicated to the public. Methods Two hundred sixty-three US newspaper articles published between January 1, 2014, and June 30, 2017, containing information on opioids and take-back programs were found using LexisNexis. Using content analysis, articles were coded for the presentation of and recommendation for opioid disposal practices, beliefs about environmental harm from toilet disposal, and additional strategies to reduce opioid supply. The entity responsible for the statement was also captured. Results Take-back programs were presented as a recommended disposal strategy for unused prescription opioids in 88.6% of coded articles. Toilet disposal was presented as a recommended disposal strategy for unused prescription opioids in 3.4% of articles and as harmful to the environment in 16.0% of articles. Individuals from health care, government, and law enforcement were primarily involved in discussing opioid disposal practices. Conclusions Although toilet disposal is recommended by the US Food and Drug Administration (FDA) for disposal of unused prescription opioids when a take-back program is not readily available, it was infrequently presented or recommended in news media articles. These results highlight the importance of improving communication of FDA guidelines for opioid disposal in the media, particularly by health care providers, government employees, and law enforcement officials.

Efficacy of a password‐protected, pill‐dispensing device with mail return capacity to enhance disposal of unused opioids after cancer surgery

“…The substantial quantity of unused pills observed in our study (70% of prescribed pills) is consistent with other published reports 14,17,39–45 . Although there is agreement about the need for disposal of unused pills, the optimal method is uncertain 21,46 . Published interventions have focused on patient education, 18–24 provision of drug disposal kits, 25–32,47 and take‐back programs 33–35 .…”

“…14,17,[39][40][41][42][43][44][45] Although there is agreement about the need for disposal of unused pills, the optimal method is uncertain. 21,46 Published interventions have focused on patient education, [18][19][20][21][22][23][24] provision of drug disposal kits, [25][26][27][28][29][30][31][32]47 and take-back programs. [33][34][35] These initiatives have shown mixed results in trials and generally rely on patient self-report without a mechanism to directly verify opioid removal from the home.…”

Opioids and Public Health: The Prescription Opioid Ecosystem and Need for Improved Management

“…Contrasting recommendations, even within and between U.S. federal and state agencies (Drug Enforcement Administration; Environmental Protection Agency, Washington., D.C.; state boards of pharmacy; individual state agencies) can be confusing to patients. 155 The U.S. Food and Drug Administration (Silver Spring, Maryland) recommends flushing some drugs down the sink or toilet, while recommending that others should be mixed with used coffee grounds, dirt, or cat litter, placed in a closed unmarked container, and thrown in the garbage. 156 In contrast, the U.S. Environmental Protection Agency advises against flushing unwanted drugs down the toilet.…”

“…U.S. news media articles rarely cover flushing as an option, and often present it as environmentally harmful. 155 Some state guidelines contradict federal guidelines. 157,158…”

“…U.S. news media articles rarely cover flushing as an option, and often present it as environmentally harmful. 155 Some state guidelines contradict federal guidelines. 157,158 In contrast to the United States, Health Canada (Ottawa, Canada) recommends that unused drugs be returned to local pharmacies or municipal waste disposal centers and discourages other forms of disposal (flushing, pouring down the drain, or throwing in the trash).…”