Package inserts for opioid analgesics may not consistently provide information regarding safe drug storage and/or disposal, according to a brief research report by investigators at the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, and Vanderbilt University Medical Center, Nashville, Tennessee.
Misuse of prescription opioids represents the main source of diversion of medication, presumably in part because of insufficient knowledge regarding safe storage and disposal practices by patients.
Although evidence supports the notion that appropriate information by drug providers (eg, on the drug package insert) may effectively improve risky behaviors, it is not clear how or whether such information is conveyed.
The investigators assessed information on package inserts of a random selection of 10% of products identified using DailyMed, a National Library of Medicine database of prescription drug labeling information, that contain 1 or more of the most commonly misused opioid analgesics (hydrocodone, oxycodone, fentanyl, morphine, hydromorphone, and tramadol).
Disposal and safe storage information present on package inserts was coded by 1 of the investigators. Among the 98 products selected, 1 message was found regarding storage (to prevent theft through secure storage) and 3 messages were found regarding disposal (discard, n=31; flush, n=34; consult provider for safe disposal, n=28).
Of all selected products, oxycodone- and morphine-containing medications had the most safe storage and disposal messages (storage: n=16 and n=8 of 35 products, respectively; disposal: n=47 and n=24 of 93 products, respectively).
“Although we found promising information on safe storage and disposal in package inserts, the messaging was inconsistent across pain reliever types and infrequent or absent for some products. This finding was disappointing, because consistent and explicit messaging is an important component of effective education,” noted the study authors.
“Providers are uniquely positioned to promote safe storage and disposal behaviors in patients, and appropriate education may decrease medication diversion and unintentional poisonings,” they added, emphasizing the need for effective policies to support this goal.
Doucette ML, Sterling Haring R, Frattaroli S. Storing and disposing of opioid analgesics: What does our medicine tell us? [published online April 16,2018]. Ann Intern Med. doi: 10.7326/M17-3381