Disposal of Unused Postoperative Opioids: A Real-World Demonstration of Surgeon-initiated Strategies Using an Activated Charcoal Bag System

Madhuri V Nishtala; Aos S Karim; David Melnick; Therese Delarwelle; Elise Lawson; Caprice C Greenberg; Tudor Borza

doi:10.1097/AS9.0000000000000313

Disposal of Unused Postoperative Opioids: A Real-World Demonstration of Surgeon-initiated Strategies Using an Activated Charcoal Bag System

Ann Surg Open. 2023 Aug 17;4(3):e313. doi: 10.1097/AS9.0000000000000313. eCollection 2023 Sep.

Authors

Madhuri V Nishtala¹, Aos S Karim¹, David Melnick¹, Therese Delarwelle², Elise Lawson^{1

3}, Caprice C Greenberg⁴, Tudor Borza^{1

3

5}

Affiliations

¹ From the Department of Surgery), University of Wisconsin, Madison, WI.
² Door County Medical Center, Sturgeon Bay, Wisconsin.
³ Wisconsin Surgical Outcomes Research Program (WISOR), University of Wisconsin, Madison, WI.
⁴ Department of General Surgery, University of North Carolina, Chapel Hill, NC.
⁵ Department of Urology, University of Wisconsin, Madison, WI.

Abstract

Excessive opioid prescribing following surgery creates a reservoir of unused medications available for diversion and abuse. We conducted a cohort study examining the impact of clinic-based, surgeon-initiated strategies using an activated charcoal bag (ACB) system on disposal of unused opioids. Among patients undergoing a variety of general surgery procedures, 67% of those with unused opioids disposed of them using the ACB. Our findings demonstrate practical ways to incorporate opioid disposal into surgical practice as a complement to judicious opioid prescribing.

Keywords: opioid disposal; opioid stewardship; surgery.

Grants and funding

K08 HS028474/HS/AHRQ HHS/United States