Opportunity 

There is a risk that leftover opioids may be misused by the person they were prescribed to or by others. Interventions that encourage the safe disposal of leftover pills can help to mitigate this risk. 

Intervention  

We piloted a program in 2021 among patients undergoing orthopaedic or urologic procedures to assess whether mailing at-home disposal kits to patients might increase the rate of proper disposal of leftover opioids.  

Patients were randomly assigned to receive usual care or participate in the intervention. Participants in the usual care arm were texted instructions to dispose of any unused opioids along with a link detailing the locations of local safe disposal points. Intervention participants were mailed an at-home disposal kit timed to arrive four to seven days after their procedure when they were most likely to be finished taking opioids. Patients in both groups were prompted to self-report disposal via text message.

In 2022, we conducted a similar study in which we provided disposal kits to patients undergoing hip or knee arthroplasty upon discharge instead of mailing the kits.

Impact  

In the 2021 study, leftover opioids were disposed of properly by 60 percent of patients who received the mailed at-home disposal kit, compared with 43 percent of patients who received usual care.

Providing a kit upon hospital discharge was associated with an 11 percentage point rise in the fraction of patients disposing opioids as compared to our control group (similar patients at other hospitals without the intervention during this time period). We estimated that the fraction of opioid tablets disposed also increased by more than 10 percentage points. Although the absolute percentages of patients disposing opioids were much lower than in the first study, ranging from 21 percent to 32 percent, the results build on the evidence that providing kits to patients can be a simple and inexpensive way to improve disposal rates.