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Poll: Seniors need counseling on opioid risks, safe disposal

Nearly a third of older adults have received an opioid pain prescription medicine in the past two years, but many of them didn't get enough counseling about the risks posed by these drugs, how to decrease their use, when to seek a non-opioid option, or what they should do with pills that they no longer need, according to a new National Poll on Healthy Aging, conducted by the University of Michigan Institute for Healthcare Policy and Innovation, and sponsored by AARP and Michigan Medicine, U-M's academic medical center.

The poll, which was conducted among 2,013 adults between the ages of 50 and 80, also found that almost three-quarters of older adults give thumbs up to limiting how many opioid pills a doctor could prescribe at on time.

"We know that unused opioid medications that linger in homes are one of the primary pathways to diversion, misuse, abuse and dependence. As prescribers, we must find opportunities to discuss safe opioid use, storage and disposal with our patients," Michigan Opioid Prescribing Engagement Network (Michigan OPEN) co-director and an associate professor of surgery at Michigan Medicine, Jennifer Waljee said. "It is critically important to provide a detailed plan for patients who get opioids for pain management and resources for disposal."

Dr. Waljee worked with NPHA director and U-M professor Preeti Malani and IHPI National Clinician Scholar Calista Harbaugh to design the poll.

Arthritis pain, back pain, surgery and an injury were the most common ailments that led to most of the 589 older adults receiving an opioid prescription in the previous two years. Although the majority of those adults recalled their physician, pharmacist or another health care provider discussed how to take the drug, the percentage who said they'd talked with any provider about other opioid issues was much lower.

Less than half indicated that they were counseled about addiction or overdose risks. Just over a quarter said their pharmacist had counseled them. Slightly more individuals mentioned that doctors and pharmacists brought up options to decrease the amount of opioids they were taking.

Thirty seven percent of respondents said their doctor had talked with them about what to do with leftover opioid pills, while 25% said their pharmacist had discussed this. Half of those who had been prescribed an opioid said they had had pills left over, and 86% said they saved these pills for later potential use.

"The fact that so many older adults report having leftover opioid pills is a big problem, given the risk of abuse and addiction with these medications," AARP senior vice president of research Alison Bryant said. "Having unused opioids in the house, often stored in unlocked medicine cabinets, is a big risk to other family members, as well. These findings highlight the importance of improving older adults' awareness and access to services that will help them safely dispose of unused opioid medications."

Among respondents who didn’t have medication left over, and respondents who hadn’t been prescribed an opioid in the past two years, two-thirds said they would save remaining opioids for future use, more than one quarter (27%) said they would dispose of them at home, and over one-third (36%) said they would bring opioids to an approved disposal facility.
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