Using an Environmentally Friendly Disposal Bag to Discard Leftover Opioids After Gynecologic Surgery

Abstract

OBJECTIVE: To evaluate the effects of an environmentally friendly drug deactivation bag on opioid disposal among patients undergoing gynecologic surgery. METHODS: This prospective cohort study included patients undergoing gynecologic procedures requiring an opioid prescription from March 2020 to December 2020. Patients were managed on a restrictive opioid prescribing algorithm and given an opioid disposal bag. The carbon drug deactivation bag neutralizes the opioid medication and can be discarded safely in the trash. Patients were educated about pain management goals and the disposal bag. Patients were surveyed at their postoperative visit to evaluate satisfaction, number of leftover pills, and disposal methods. Statistical analysis was performed using SPSS Statistics 26. RESULTS: Two hundred patients were asked to complete the survey, with a response rate of 78%. The most common procedures were exploratory laparotomy (50%) and minimally invasive hysterectomy (41%). Most patients (91%, 95% CI 91–97) filled their opioid prescription and 64 (41%, 95% CI 34–48) had leftover opioid pills. Most patients with leftover opioid pills (73%, 95% CI 67–79) discarded them; 78%, 95% CI 69–80 used the disposal bag. Patients undergoing an exploratory laparotomy most commonly used the disposal bag. All patients who used the disposal bag stated they would use it again. CONCLUSION: Despite a restrictive opioid prescribing algorithm, 41% of gynecologic surgical patients had leftover opioid pills. This study demonstrated that leftover opioid pills were safely discarded 73% of the time when patients were provided an opioid disposal bag and preoperative education.

Examining Age and Postoperative Opioid Use in the Urogynecology Population: A Prospective Study

“…A recent study published by Boitano et al 23 evaluated the effects of a DDDS on opioid disposal among patients undergoing benign and malignant gynecologic surgery. Patients were given the drug deactivation bag preoperatively as well as directions for use at home.…”

“…Furthermore, patients should be given the option of having zero opioids prescribed at the time of surgery especially with the ability of health care providers to electronically prescribe opioids postoperatively if needed. A recent study published by Boitano et al 23 evaluated the effects of a DDDS on opioid disposal among patients undergoing benign and malignant gynecologic surgery. Patients were given the drug deactivation bag preoperatively as well as directions for use at home.…”

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

“…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.…”

“…16 Yet, although 70% of prescribed opioids go unused after surgery, less than 10% are disposed of properly. 17 Interventions to enhance disposal of unused pills 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] and take-back programs. [33][34][35] These endeavors have shown mixed results in trials and are likely insufficient in isolation.…”

“…Interventions to enhance disposal of unused pills have focused on patient education,, 18–24 provision of drug disposal kits, 25–32 and take‐back programs 33–35 . These endeavors have shown mixed results in trials and are likely insufficient in isolation.…”