title: Frequency of unsafe storage, use, and disposal practices of opioids among cancer patients presenting to the emergency department.
abstract: Approximately 75% of prescription opioid abusers obtain the drug from an acquaintance, which may be a consequence of improper opioid storage, use, disposal, and lack of patient education. We aimed to determine the opioid storage, use, and disposal patterns in patients presenting to the emergency department (ED) of a comprehensive cancer center.
  
  
  
  We surveyed 113 patients receiving opioids for at least 2 months upon presenting to the ED and collected information regarding opioid use, storage, and disposal. Unsafe storage was defined as storing opioids in plain sight, and unsafe use was defined as sharing or losing opioids.
  
  
  
  The median age was 53 years, 55% were female, 64% were white, and 86% had advanced cancer. Of those surveyed, 36% stored opioids in plain sight, 53% kept them hidden but unlocked, and only 15% locked their opioids. However, 73% agreed that they would use a lockbox if given one. Patients who reported that others had asked them for their pain medications (p = 0.004) and those who would use a lockbox if given one (p = 0.019) were more likely to keep them locked. Some 13 patients (12%) used opioids unsafely by either sharing (5%) or losing (8%) them. Patients who reported being prescribed more pain pills than required (p = 0.032) were more likely to practice unsafe use. Most (78%) were unaware of proper opioid disposal methods, 6% believed they were prescribed more medication than required, and 67% had unused opioids at home. Only 13% previously received education about safe disposal of opioids. Overall, 77% (87) of patients reported unsafe storage, unsafe use, or possessed unused opioids at home.
  
  
  
  Many cancer patients presenting to the ED improperly and unsafely store, use, or dispose of opioids, thus highlighting a need to investigate the impact of patient education on such practices.
authors.affiliation: Department of Emergency Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.
authors.forename: Julio
authors.initials: J
authors.lastname: Silvestre
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.
authors.forename: Akhila
authors.initials: A
authors.lastname: Reddy
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.
authors.forename: Maxine
authors.initials: M
authors.lastname: de la Cruz
authors.affiliation: Department of Biostatistics,The University of Texas MD Anderson Cancer Center,Houston,Texas.
authors.forename: Jimin
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Biostatistics,The University of Texas MD Anderson Cancer Center,Houston,Texas.
authors.forename: Diane
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bruera
authors.affiliation: Department of Emergency Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.
authors.forename: Knox H
authors.initials: KH
authors.lastname: Todd
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000009:adverse effects* / Q000627:therapeutic use; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005260:Female; D006801:Humans; D008297:Male; D017744:Medical Waste Disposal / Q000379:methods / Q000592:standards*; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy / Q000523:psychology*; D010146:Pain / Q000188:drug therapy
chemical_list: D000701:Analgesics, Opioid; D017744:Medical Waste Disposal
keywords: Accidental opioid poisoning; Cancer patients; Emergency center; Opioid Disposal; Opioid diversion; Opioid storage; Prescription opioid abuse