Program issuing mailed kits doubles rate of leftover opioids disposal

A Penn study finds that patients of orthopaedic and urologic procedures were more likely to dispose of their extra opioid tablets when they received kits in the mail to do so.

Mailed opioid disposal kits led to 60% of patients who had leftover opioid pain pills properly disposing of them after surgeries, according to a new study by researchers at the Perelman School of Medicine. Just 43% of patients in this study who didn’t receive the kits disposed of their opioids, but when compared to national studies, the mailed kit group in this research appeared to double or even triple the previously seen rates of safe disposal. Pointing to a potentially effective method for cutting down on a source of illicit opioids, this study was published in JAMA Network Open.

Many empty prescription pill bottles, some with caps removed.

“I was pleased to see that such a simple, ‘snail mail’ approach could change behavior and promote self-reported disposal,” says the study’s lead author, Anish Agarwal, an assistant professor of emergency medicine and chief wellness officer of the Department of Emergency Medicine at Penn Medicine. “The opioid epidemic clearly continues to be front and center for patients, and the concerns with opioid use and misuse are becoming a real part of the conversation between physicians and patients. I think patients are more aware of the risks and consequences of using opioids and storing them in their homes.”

Leftover opioid medications are a concern for their potential to be misused, either by the person they were prescribed to or someone else taking them. But just throwing leftover pills into the trash may not be the best option.

“Throwing them in the trash can be dangerous if tabs are ingested by kids or animals, and there are environmental concerns,” says the study’s senior author, M. Kit Delgado, an assistant professor of emergency medicine and epidemiology and deputy director of the Penn Medicine Nudge Unit. “When safe disposal site are not available, the FDA recommends that certain high-risk medications, including opioids, be flushed down the toilet due to their high-risk nature. However, there are also environmental concerns with doing this.”

While safe disposal sites, like certain pharmacies, are the best option, patients often don’t use them because they may not be easily accessible or it takes extra effort. So Agarwal, Delgado, and colleagues decided to test whether an added layer of convenience—mailing safe disposal kits—might make a difference.

This story is by Frank Otto. Read more at Penn Medicine News.