It’s no secret that the opioid crisis is one of the most pressing modern public health crises hitting communities nationwide.
While addiction to prescription pain medications leads to tens of thousands of deaths a year, a new study looked at the role people sharing their prescriptions with others may play in feeding this drug epidemic.
A second annual study commissioned by Stericycle, a medical and hazardous waste disposal company, asked 1,200 Americans about their prescription medication disposal habits.
While 75 percent reported they believed sharing or selling unused prescriptions contributed to the nation’s addiction epidemic, 1 in 10 admitted they have offered or given their meds to family members and friends for medical and recreational use.
Just how big of an impact does this have on the opioid crisis?
Dr. Joseph Ladapo, an internist at UCLA Health, told Healthline that this is a common but underreported reality of how Americans have been mishandling their prescription drugs.
“This sharing of medications goes underreported because people may have concerns about their privacy or of their activities being disclosed and potentially exposing themselves to risk. I do think it’s pretty common,” Ladapo said, who wasn’t affiliated with the new study.
“I’ve spoken with patients who have engaged in that activity. I’ve heard people say they have offered [these medications] out of kindness. I don’t think this is a problem of ill intent. I think many people probably mean well when they engage in this activity,” he added.
However, Ladapo stresses that this particular problem underscores an urgent need for better outreach and intervention efforts to quell the continued growth of the opioid epidemic.
A major crisis
The opioid crisis has been an expanding problem in the United States. In 2015, drug overdoses resulted in 52,404 deaths overall, according to the Centers for Disease Control and Prevention (CDC).
If you zero in on that number further, more than 63.1 percent — or 33,091 deaths — involved opioids.
Just two years later, the number of opioid-related deaths climbed to 47,600, or 67.8 percent of all drug overdose deaths, the CDC reports.
Just how much does sharing prescriptions contribute to this concerning trend?
Ladapo says it’s hard to quantify. There’s no conclusive research out there that addresses that specific question, but he says it’s safe to say it does play a major role.
“We do know that something like 2 out of 3 people who abuse opioids obtain them at some point from a friend or a family member, so in the face of that high prevalence, it’s really hard to reach another conclusion other than that it is certainly not helping,” he said.
Like Ladapo, Josanne Pagel, MPAS, PA-C, MDiv, DFAAPA, executive director of physician assistant services at the Cleveland Clinic Health System, told Healthline she suspects the number of people who go past official — and safe — healthcare channels to share opioids with others is probably much higher than these statistics.
“I have a higher personal experience as a provider, hearing from patients [it] happens more commonly than not,” Pagel said, who also wasn’t affiliated with this study.
“First and foremost, a lot of these people want to help their family member, help their friend. No one wants to see anyone in pain. Sometimes it might take a long time to get a physician or a provider, and some people don’t feel there is any harm in giving one pill to alleviate someone’s pain,” she said.
She added, “It also might be some peer pressure among friends. It’s ‘cool’ to share leftover prescriptions, and some people are explicitly using them to get a little buzz.”
Essentially, Pagel says it’s a multifaceted, complicated problem. There’s no single reason why people misuse opioids and share them with others.
But while this behavior does help fuel the opioid crisis, Pagel believes it’s “secondary to overprescribing.”
“The first component is providers need to be more responsible in how they prescribe. They need to be thinking twice about whether this is the best recourse for treatment. That being said, I think yes, the second major cause of the crisis is sharing,” she said.
A nationwide issue we need to address from multiple angles’
A lack of education is a big part of the problem.
Cindy Miller, president and CEO-elect of Stericycle Inc., said the most striking thing to her about the study was the high number of people — 86 percent — who said they felt comfortable asking their doctor or pharmacist about ways to dispose of these drugs, but that two-thirds said they don’t know if their pharmacy allows them to return unused prescriptions.
“This shows an apparent gap between people who want to identify opportunities to help curb the opioid epidemic and those who already have made the effort,” she wrote in an email to Healthline. “It’s clear there is still room for improvement in education around disposing of unused prescriptions, including opioids, and that consumers will be receptive to this education.”
Pagel says a lot of people throw their medications in the trash, which might sound innocuous but actually isn’t. She says many people looking for their fix go through others’ trash.
“Just tossing it out is contributing to sustaining the crisis. It’s not helping people to stop the addiction,” she explained. “We have a lot of unused medications that are just floating around there.”
Miller wrote that educational outreach needs to improve to correct the misinformation out there about the do’s and don’ts of disposing opioids.
“It is critical that education come from a variety of sources and is inclusive of multiple topic areas. These topics should include the impact on the environment — i.e. informing consumers of the issues with flushing opioids — as well as how to keep opioids out of the wrong hands (i.e. providing more information on where consumers can properly dispose of opioids),” she wrote.
“This education can go beyond healthcare. For example, some HR departments at organizations are offering items such as mail-back envelopes for unused prescriptions to their employees to help fight the opioid epidemic and contribute to education on proper disposal solutions. This truly is a nationwide issue we need to address from multiple angles,” Miller wrote.
Changing public awareness
Ladapo adds that he does think public awareness campaigns about the opioid crisis have broken through.
From his own experience as a physician, he’s noticed patients expressing trepidation about using opioids. He says now, more than in his early career, people are declining opioids and asking about other kinds of treatment.
“Doctors have also evolved in the course of my career. Doctors are being more sensitive to really communicating with patients about the risk of opioids,” Ladapo said.
“That being said, most of that communication is about the patient’s risk of taking these drugs. Most doctors don’t talk about the risk associated with sharing,” he said.
Pagel stresses that more providers need to give people clear disposal instructions along with prescriptions.
She says there are “two lines of defense” that should be emphasized: Prescribers and pharmacists should hand out disposal bags and instructions for how to get rid of these drugs when no longer needed, and there needs to be more community-specific education efforts about what to do with opioids.
“I think this is a big call to arms to inform community leaders, to inform family members, to inform patients receiving these prescriptions, to store them and properly dispose of them with ease,” she said.
Miller echoed those thoughts. While the new study doesn’t touch on why so many people share these medications, it offers an important reminder that things need to change.
“We do know this is a very dangerous habit due to the addictive properties of many of these drugs, including opioids,” she wrote. “It’s important to make sure friends and family only receive prescription medication from a prescribing physician, and that consumers properly dispose of any unused medication to make sure they don’t fall into the wrong hands.”