Storage and Disposal of Unused Prescription Opioids for Acute Pain After Emergency Department Discharge.
7 affiliations
- 1Department of Emergency Medicine, Research Centre, Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) du Nord-de-l'Île-de-Montréal, Hôpital Sacré-Coeur, Montréal, Québec, Canada.
- 2Département de Médecine Familiale et Médecine d'Urgence, Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada.
- 3Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (CIUSSS du Nord-de-l'Île-de-Montréal), Montréal, Québec, Canada.
- 4Faculté de Pharmacie, Université de Montréal, Montréal, Québec, Canada.
- 5Acute Care Research Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
- 6Division of Emergency Medicine, Department of Medicine, Western University, London Health Sciences Centre, London, Ontario, Canada.
- 7Department of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Abstract
Importance
Opioid misuse is a major public health concern, and unused prescription opioids can contribute to this problem.Objective
To estimate the proportion of unused opioids among patients discharged from the emergency department (ED) for acute pain, evaluate opioid storage and disposal practices, and identify factors that may motivate patients to return unused opioids.Design, setting, and participants
This cohort study, which was a preplanned substudy of a Canadian multicenter prospective cohort study (Quantity of Opioids for Acute Pain and Limit Unused Medication Group [OPUM] study, with recruitment beginning in May 2019 and follow-up ending in January 2024), included consecutive patients aged 18 years or older discharged from the EDs of 7 hospitals in Québec and Ontario with an opioid prescription for an acute pain condition. Participants were followed up at 2 weeks and 3 months.Exposure
Opioid prescription for acute pain at ED discharge.Main outcomes and measures
The main outcomes were the proportion of participants with unused opioids at 2 weeks and 3 months after ED discharge, opioid storage practices at 2 weeks, and opioid disposal practices at 3 months.Results
Of 2590 enrolled participants in the cohort, 2047 (79.0%) completed the 2-week follow-up and 1835 (70.8%) completed the 3-month follow-up. Among participants who completed the 3-month follow-up, mean (SD) age was 51.3 (15.4) years, 947 (51.6%) were male, and mean pain intensity score at triage was 7.1 (2.3) out of 10. At 2 weeks, 1521 of 1811 participants (84.0%; 95% CI, 82.2%-85.6%) reported unused opioids; 102 of 1525 (6.7%; 95% CI, 5.5%-8.1%) stored their opioids in a locked area and 393 of 1525 (25.8%; 95% CI, 23.6%-28.0%) out of reach of children or teenagers. At 3 months, 926 of 1495 (61.9%; 95% CI, 59.4%-64.4%) reported unused opioids, kept mostly for possible future pain (534 [57.7%; 95% CI, 54.4%-60.9%]) or because participants forgot or lacked time to return them (262 [28.3%; 95% CI, 25.4%-31.3%]). Only 614 of 1835 participants (33.5%; 95% CI, 31.3%-35.7%) indicated they would voluntarily return opioids to the pharmacy if prompted, while 479 (26.1%; 95% CI, 24.1%-28.2%) would not return them regardless of incentive offered.Conclusions and relevance
In this cohort study, 3 months after their ED visit, many participants kept unused prescription opioids at home under suboptimal storage conditions; only one-third were willing to return their opioids to a pharmacy, while more than one-fourth were not. These findings support tailoring opioid prescriptions to individual patient needs to reduce unused medication, alongside strengthening take-back networks and enhancing patient education on safe use, storage, and disposal of opioids.
Related
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BibTeX
@article{daoust2026storage,
title = {{Storage and Disposal of Unused Prescription Opioids for Acute Pain After Emergency Department Discharge.}},
author = {Raoul Daoust and David Williamson and Vérilibe Huard and Jeffrey J Perry and Justin W Yan and Eddy Lang and Alexis Cournoyer and Quantity of Opioids for Acute Pain and Limit Unused Medication Group (OPUM), on behalf of the Network of Canadian Emergency Researchers},
journal = {JAMA network open},
year = {2026},
month = oct,
doi = {10.1001/jamanetworkopen.2026.39607},
url = {https://europepmc.org/article/MED/42900472},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Storage and Disposal of Unused Prescription Opioids for Acute Pain After Emergency Department Discharge.
AU - Raoul Daoust
AU - David Williamson
AU - Vérilibe Huard
AU - Jeffrey J Perry
AU - Justin W Yan
AU - Eddy Lang
AU - Alexis Cournoyer
AU - Quantity of Opioids for Acute Pain and Limit Unused Medication Group (OPUM), on behalf of the Network of Canadian Emergency Researchers
PY - 2026
DA - 2026/10/01
JO - JAMA network open
DO - 10.1001/jamanetworkopen.2026.39607
UR - https://europepmc.org/article/MED/42900472
AB - Importance Opioid misuse is a major public health concern, and unused prescription opioids can contribute to this problem.Objective To estimate the proportion of unused opioids among patients discharged from the emergency department (ED) for acute pain, evaluate opioid storage and disposal practices, and identify factors that may motivate patients to return unused opioids.Design, setting, and participants This cohort study, which was a preplanned substudy of a Canadian multicenter prospective cohort study (Quantity of Opioids for Acute Pain and Limit Unused Medication Group [OPUM] study, with recruitment beginning in May 2019 and follow-up ending in January 2024), included consecutive patients aged 18 years or older discharged from the EDs of 7 hospitals in Québec and Ontario with an opioid prescription for an acute pain condition. Participants were followed up at 2 weeks and 3 months.Exposure Opioid prescription for acute pain at ED discharge.Main outcomes and measures The main outcomes were the proportion of participants with unused opioids at 2 weeks and 3 months after ED discharge, opioid storage practices at 2 weeks, and opioid disposal practices at 3 months.Results Of 2590 enrolled participants in the cohort, 2047 (79.0%) completed the 2-week follow-up and 1835 (70.8%) completed the 3-month follow-up. Among participants who completed the 3-month follow-up, mean (SD) age was 51.3 (15.4) years, 947 (51.6%) were male, and mean pain intensity score at triage was 7.1 (2.3) out of 10. At 2 weeks, 1521 of 1811 participants (84.0%; 95% CI, 82.2%-85.6%) reported unused opioids; 102 of 1525 (6.7%; 95% CI, 5.5%-8.1%) stored their opioids in a locked area and 393 of 1525 (25.8%; 95% CI, 23.6%-28.0%) out of reach of children or teenagers. At 3 months, 926 of 1495 (61.9%; 95% CI, 59.4%-64.4%) reported unused opioids, kept mostly for possible future pain (534 [57.7%; 95% CI, 54.4%-60.9%]) or because participants forgot or lacked time to return them (262 [28.3%; 95% CI, 25.4%-31.3%]). Only 614 of 1835 participants (33.5%; 95% CI, 31.3%-35.7%) indicated they would voluntarily return opioids to the pharmacy if prompted, while 479 (26.1%; 95% CI, 24.1%-28.2%) would not return them regardless of incentive offered.Conclusions and relevance In this cohort study, 3 months after their ED visit, many participants kept unused prescription opioids at home under suboptimal storage conditions; only one-third were willing to return their opioids to a pharmacy, while more than one-fourth were not. These findings support tailoring opioid prescriptions to individual patient needs to reduce unused medication, alongside strengthening take-back networks and enhancing patient education on safe use, storage, and disposal of opioids.
SN - 2574-3805
ER -