Clinician Counseling and Patient Storage and Disposal Practices for Opioids Prescribed for Acute Pain: A Multicenter Prospective Cohort Study
- 1Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA
Abstract
BACKGROUND: Opioids prescribed for acute pain frequently remain unused, creating opportunities for unintended use, accidental ingestion, or diversion. Little is known about counseling patients receive from prescribers or pharmacists on storage and disposal of opioids. OBJECTIVE: To characterize clinician counseling on opioid disposal and patient-reported storage, use, and disposal practices among opioid-naive patients prescribed opioids for acute pain. DESIGN: Multicenter prospective cohort study with participant recruitment between September 2020 and March 2023. PARTICIPANTS: Opioid-naive patients prescribed opioids for acute pain in emergency departments, primary care or urgent care clinics, inpatient settings, and dental practices. MAIN MEASURES: Patient-reported receipt of counseling on the importance of opioid disposal and appropriate disposal methods; opioid storage practices; use and disposition of prescribed opioids; disposal methods; and reasons for keeping or disposing of leftover opioids. KEY RESULTS: Among 1708 participants, the median age was 38 years (IQR, 28-52); most were recruited from emergency departments (n=915; 53.6%) and primary care or urgent care clinics (n=307; 18.0%). Among 1233 participants who answered the question on counseling about the importance of opioid disposal, 811 (65.8%) reported receiving no counseling. Among 1220 participants who answered the question on counseling about appropriate disposal methods, 832 (68.2%) reported receiving no counseling. Among 812 participants who answered the question about storing opioids in a locked location, 610 (75.1%) reported never doing so. Among 929 participants providing information on opioid leftovers and disposition, 618 (66.5%) did not use all prescribed opioids. Among these 618 participants, 258 (42.8%) kept leftover opioids and 345 (57.2%) disposed of them. Among 256 participants who reported reasons for keeping leftover opioids, 159 (62.1%) wanted medication available for the same condition, 70 (27.3%) wanted medication available for a different condition, and 36 (14.1%) did not know how to properly dispose of the medication. CONCLUSIONS: Among opioid-naive patients prescribed opioids for acute pain, counseling about opioid disposal was uncommon, secure storage was infrequent, and leftover opioids were frequent, with many patients keeping leftover opioids for possible future use. These findings suggest opportunities to improve counseling on opioid storage and disposal and encourage safe disposal of unused opioids after acute pain treatment.
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BibTeX
@misc{taherifard2026clinician,
title = {{Clinician Counseling and Patient Storage and Disposal Practices for Opioids Prescribed for Acute Pain: A Multicenter Prospective Cohort Study}},
author = {E. Taherifard and M. Ahadpour and F. Bellolio and N. Chang and S. Allen and M.-C. Elie-Turenne and W. J. Fillmore and G. H. Gilbert and R. Heckmann and P. Koussis and C. Lee and H. Lipkind and C. Mallama and T. E. Meyer and T. K. Nuckols and J. D. Ritchie and M. A. Pacanowski and D. B. Page and M. Soukup and S. Tamang and S. Torbati and D. Wallace and L. Walter and Y. Zhao and N. D. Shah and J. S. Ross and M. M. Jeffery},
howpublished = {medRxiv},
year = {2026},
month = nov,
doi = {10.64898/2026.11.04.26367278},
url = {https://www.medrxiv.org/content/10.64898/2026.11.04.26367278v1},
note = {CC BY-NC},
}
RIS
TY - UNPB
TI - Clinician Counseling and Patient Storage and Disposal Practices for Opioids Prescribed for Acute Pain: A Multicenter Prospective Cohort Study
AU - E. Taherifard
AU - M. Ahadpour
AU - F. Bellolio
AU - N. Chang
AU - S. Allen
AU - M.-C. Elie-Turenne
AU - W. J. Fillmore
AU - G. H. Gilbert
AU - R. Heckmann
AU - P. Koussis
AU - C. Lee
AU - H. Lipkind
AU - C. Mallama
AU - T. E. Meyer
AU - T. K. Nuckols
AU - J. D. Ritchie
AU - M. A. Pacanowski
AU - D. B. Page
AU - M. Soukup
AU - S. Tamang
AU - S. Torbati
AU - D. Wallace
AU - L. Walter
AU - Y. Zhao
AU - N. D. Shah
AU - J. S. Ross
AU - M. M. Jeffery
PY - 2026
DA - 2026/11/04
PB - medRxiv
DO - 10.64898/2026.11.04.26367278
UR - https://www.medrxiv.org/content/10.64898/2026.11.04.26367278v1
AB - BACKGROUND: Opioids prescribed for acute pain frequently remain unused, creating opportunities for unintended use, accidental ingestion, or diversion. Little is known about counseling patients receive from prescribers or pharmacists on storage and disposal of opioids. OBJECTIVE: To characterize clinician counseling on opioid disposal and patient-reported storage, use, and disposal practices among opioid-naive patients prescribed opioids for acute pain. DESIGN: Multicenter prospective cohort study with participant recruitment between September 2020 and March 2023. PARTICIPANTS: Opioid-naive patients prescribed opioids for acute pain in emergency departments, primary care or urgent care clinics, inpatient settings, and dental practices. MAIN MEASURES: Patient-reported receipt of counseling on the importance of opioid disposal and appropriate disposal methods; opioid storage practices; use and disposition of prescribed opioids; disposal methods; and reasons for keeping or disposing of leftover opioids. KEY RESULTS: Among 1708 participants, the median age was 38 years (IQR, 28-52); most were recruited from emergency departments (n=915; 53.6%) and primary care or urgent care clinics (n=307; 18.0%). Among 1233 participants who answered the question on counseling about the importance of opioid disposal, 811 (65.8%) reported receiving no counseling. Among 1220 participants who answered the question on counseling about appropriate disposal methods, 832 (68.2%) reported receiving no counseling. Among 812 participants who answered the question about storing opioids in a locked location, 610 (75.1%) reported never doing so. Among 929 participants providing information on opioid leftovers and disposition, 618 (66.5%) did not use all prescribed opioids. Among these 618 participants, 258 (42.8%) kept leftover opioids and 345 (57.2%) disposed of them. Among 256 participants who reported reasons for keeping leftover opioids, 159 (62.1%) wanted medication available for the same condition, 70 (27.3%) wanted medication available for a different condition, and 36 (14.1%) did not know how to properly dispose of the medication. CONCLUSIONS: Among opioid-naive patients prescribed opioids for acute pain, counseling about opioid disposal was uncommon, secure storage was infrequent, and leftover opioids were frequent, with many patients keeping leftover opioids for possible future use. These findings suggest opportunities to improve counseling on opioid storage and disposal and encourage safe disposal of unused opioids after acute pain treatment.
ER -