American Society of Regional Anesthesia and Pain Medicine August 2016 - 7
Table 1: Results from three opioid recovery drives to date.
Total No. of people
349
Pills
Estimated weight of pills
181.6 lb
Estimated total No. of pills
139,658.5
Opioid pills
13,784
Most common - Hydrocodone
5,714
Other medications of interest
REDUCING LEFTOVER OPIOIDS IN OUR COMMUNITY
Several years ago, our research team created a mission statement
and guiding principles, including service to our community. We have
and continue to proudly work with an incredibly well-organized local
food pantry; however, we recognized the opportunity to create a
new volunteer initiative that was closer to the work that we do every
day. Although our group does not specifically study opioid abuse,
we do have interest in the efficacy of opioids postoperatively,11
persistent use after surgery,12 opioid-induced hyperalgesia,13 and
the behavioral factors associated with persistent use despite a
lack of efficacy.14 As a group of anesthesiologists, psychologists,
surgeons, and pain researchers, the opportunity to reduce the
amount of opioids in our local community seemed like a natural
fit for our group. The idea for an opioid recovery drive followed a
lecture by Joseph Rannazzisi (deputy assistant administrator, Office
of Diversion Control, Drug Enforcement Administration) at the ASRA
13th Annual Pain Medicine Meeting in 2014. Mr Rannazzisi described
our current problems with opioids as being worse than the crack
cocaine epidemic of the 1980s. We could see that immediate action
was needed to reduce access to leftover opioids for adolescents and
teens in our community.
To date, we have held three Saturday morning opioid drives. In just
12 hours, we have made a tremendous impact by reducing the
number of opioids in our community. Combined, we have thus far
collected ~140,000 pills, including more than 13,000 opioid pills
and patches (Table 1). Following the first drive, we began tracking
the dose of the opioid pills to quantify the opioids collected. In the
last two drives, we collected more than 100,000 oral morphine
equivalents. Surgery was the most common reason for the opioid
prescriptions. Additionally, we have collected approximately 15,000
antidepressants, benzodiazepines, sleep aids, muscle relaxants, and
antiepileptics. The total weight of just the pills and patches (not the
bottles) from one 4-hour drive was almost 97 pounds. Amazingly,
some of the prescriptions had been sitting in a medicine cabinet
unused since the 1980s and early 1990s. Most importantly, we
have drawn attention to the problem and created dialogue among
healthcare providers, parents, teachers, police, and policy makers.
Benzodiazepines and sedatives
3,002
Antidepressants
6,401
Stimulants
623
Muscle relaxants
565
Antiepileptics
4,156
Additional information
Oldest opioid date (by year)
1981
Second oldest opioid (different person)
1985
Most common reason for opioid
Surgery
HOW CAN YOU START AN OPIOID RECOVERY DRIVE IN YOUR
COMMUNITY?
Starting an opioid recovery drive is a terrific way to give
back to your community while also enhancing the sense of
community within your team. We have created a website with
some information necessary to begin. Although this information
is intended to help get you started, you should involve your
community's law enforcement early to ensure compliance.
Communication and advertising are keys to success. Please let us
know about your experience and share anything you learn along
the way.
CONCLUSIONS
Our group remains committed to providing a safe place for patients
to dispose of unused opioids. Ultimately, we believe that disposing
of unused opioids should be much easier, and we will continue
to push our politicians and policy makers to fix this issue. We are
hopeful that our group will soon need to find a new community
service effort when disposing becomes as easy as filling an opioid
prescription. Until that time, we will continue to partner with the
police and our community to reduce the potential for opioid misuse
and abuse.
ACKNOWLEDGMENTS
We sincerely appreciate the City of Ann Arbor Police Department,
specifically, Sergeant Thomas Hickey, Lieutenant Matthew Lige,
and Officers Renee Bondy and Rebecca Provancher for their
American Society of Regional Anesthesia and Pain Medicine
2016
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