Storage and Disposal Information on Opioid Package Inserts Insufficient
The lack of information regarding storage and disposal on drug package inserts may contribute to increased access to opioids by individuals not prescribed these medications.
Oxycodone and morphine are more likely to contain messaging on package inserts describing safe storage and disposal methods compared with other commonly used and misused opioid analgesics, according to a report published in the Annals of Internal Medicine. These findings indicate that the lack of information regarding storage and disposal on drug inserts may contribute to increased access to opioids by individuals not prescribed these medications.
A total of 6 opioid analgesics that are often prescribed and have a high risk for misuse (ie, hydrocodone, hydromorphone, tramadol, fentanyl, morphine, and oxycodone) were analyzed. The investigators randomly selected a 10% sample and analyzed package insert information (n=98 products). An investigator assessed package inserts, identified messages/phrases on safe storage and disposal methods of the products, and recorded which packages contained safe storage and disposal messaging.
The investigators identified 1 safe storage message, which contained educational information on securing the stored medication to prevent theft. Of the 35 package inserts with this message, 16 were for oxycodone and 8 were for morphine medications. Safe disposal messages with information on discarding unused medications or flushing any unused medications down the toilet were present on 31 and 34 packages, respectively. The majority of safe disposal messages were for morphine (n=24) and oxycodone (n=47) products. Investigators found no messages for storage or disposal on tramadol package inserts and only 1 insert on hydrocodone products included messaging on safe storage and disposal methods.
Limitations of this analysis include its small sample size and the lack of data on other sources used by physicians for education on storage and disposal strategies for opioid medications.
The investigators noted that “increasing the consistency and frequency of information on safe storage and disposal in package inserts may reduce diversion of opioid analgesics and should be explored further by researchers and policymakers.”
Doucette ML, Shields WC, Haring RS, Frattaroli S. Storing and disposing of opioid analgesics: What does our medicine tell us? [published online April 17, 2018] Ann Intern Med. doi:10.7326/M17-3381