500 ARE WE CONTRIBUTING TO PRESCRIPTION DRUG ABUSE? A LOOK AT POST-OPERATIVE PAIN MEDICATION DELIVERY, CONSUMPTION, AND DISPOSAL IN UROLOGIC PRACTICE

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Practice Patterns, Cost Effectiveness II1 Apr 2010500 ARE WE CONTRIBUTING TO PRESCRIPTION DRUG ABUSE? A LOOK AT POST-OPERATIVE PAIN MEDICATION DELIVERY, CONSUMPTION, AND DISPOSAL IN UROLOGIC PRACTICE Cory Bates, Jay Bishoff, Sarah Cano, Megan Mills, Greg Stoddard, Neal Oberg, and Molly McFadden Cory BatesCory Bates More articles by this author , Jay BishoffJay Bishoff More articles by this author , Sarah CanoSarah Cano More articles by this author , Megan MillsMegan Mills More articles by this author , Greg StoddardGreg Stoddard More articles by this author , Neal ObergNeal Oberg More articles by this author , and Molly McFaddenMolly McFadden More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2430AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Prescription narcotic abuse is a significant social problem and one source of opioids is surplus medication following surgery. We sought to assess prescribing practices, consumption, and disposal of prescribed narcotics after urological surgery. METHODS Over a 3-month period, phone or mail surveys were administered 2-4 weeks after surgery. Surgeries were categorized by level of invasiveness into cystoscopic/endoscopic, minor open, major lap, and major open. Except for the investigators, prescribing physicians had no knowledge of the study. Data collected included: perception of pain control, type and quantity of medication prescribed, quantity leftover, refills needed, disposal instructions, and the disposition of surplus medication. RESULTS 47% of 586 patients participated in the study. Hydrocodone was prescribed most commonly (63%), followed by oxycodone (35%). Overall, 84% of patients were satisfied with their pain control. Only 58% of dispensed narcotics were consumed and only 12% of patients requested refills. 67% had surplus medication from their initial prescription and 92% received no disposal instructions for surplus medication. Of those with leftover medication, 89% kept the medication at home, while 6% threw it in the trash, 2% flushed it down the toilet, and <1% returned it to the pharmacy. There was statistically significant variability in the prescribing practices of individual physicians for surgeries of the same category. The mean and median number of tablets used in each category were: cysto/endo (14.1,14), minor open (10.8,10), major lap (14.9,14.5), major open (15.9, 14). The proportion of patients using their entire prescription in each category was 38%, 33%, 33%, and 19% respectively. CONCLUSIONS Prescription narcotic abuse is a grave social problem. Prescription opioids can serve as gateway drugs leading to addiction and use of illicit drugs such as heroin, especially in adolescents. Our study shows that over-prescribing prescription narcotics is common and retained surplus medication presents a readily available source of opioid diversion. At this point, it appears no entity on either the prescribing or dispensing ends of opioid delivery is fulfilling the responsibility to accurately educate patients on proper surplus medication disposal. As over 40% of narcotics are unused and 2/3 of patients are left with surplus medication, urologists should consider decreasing the quantity of narcotics prescribed for a given procedure. SLC, UT© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e197-e198 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Cory Bates More articles by this author Jay Bishoff More articles by this author Sarah Cano More articles by this author Megan Mills More articles by this author Greg Stoddard More articles by this author Neal Oberg More articles by this author Molly McFadden More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...