Since 1999, overdose deaths from opioids - including prescription painkillers and heroin - have nearly quadrupled in the United States. In the thick of what is being termed an opioid epidemic in the U.S., a new study finds that more than 50 percent of patients with prescribed opioids have leftover tablets, and many save them to share or use later.

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A national sample of U.S. adults who have used prescribed opioids in the last year reveals that 20 percent have shared them with family or friends.

The study, published in JAMA Internal Medicine, was conducted by researchers from the Johns Hopkins Bloomberg School of Public Health in Baltimore, MD.

"These painkillers are much riskier than has been understood, and the volume of prescribing and use has contributed to an opioid epidemic in this country," says study leader Alene Kennedy-Hendricks, Ph.D., from the Department of Health Policy and Management at the Bloomberg School.

According to the Centers for Disease Control and Prevention (CDC), more than 3 out of 5 overdose deaths involve an opioid.

Opioids work on the nervous system or specific brain receptors to reduce pain intensity. In March of this year, the CDC released guidelines for prescribing opioid medications for chronic pain.

The organization advised doctors to avoid prescribing powerful opioid painkillers for patients with chronic pain, noting that the risks far outweigh the benefits for most people.

Officials say prolonged use of these medications leads to addiction and puts people at higher risk for overdose, raising the risk of heroin use, which is a cheaper alternative.

Over 60 percent of respondents had leftover pills

To further investigate the extent to which prescribed opioids fall into the hands of those without a prescription, the researchers constructed a national sample of 1,032 adults in the U.S. who had used prescription painkillers in the previous year.

In February and March of 2015, the participants completed a survey. In total, 592 participants were no longer using prescription pain relievers at the time of the survey. However, 60.6 percent of them reported having leftover pills.

Furthermore, 61.3 percent of those with leftover pills said they held onto them for future use rather than getting rid of them.

Perhaps most distressing is the finding that 20 percent of the respondents reported that they had shared their medication with another person; the majority of these people had shared their medication with someone who needed them for pain.

Other findings revealed:

  • Almost 14 percent of participants said they were likely to share their prescription opioids with a family member
  • 8 percent said they would share them with a friend
  • Fewer than 10 percent kept their opioids in a locked location
  • Almost 50 percent were not given information on safe storage or proper disposal of leftovers
  • Fewer than 10 percent threw out leftover medication in the trash after mixing it with something inedible - such as used coffee grounds - which is a safe method of medication disposal.

"It's not clear why so many of our survey respondents reported having leftover medication," says Kennedy-Hendricks, "but it could be that they were prescribed more medication than they needed."


"The fact that people are sharing their leftover prescription painkillers at such high rates is a big concern. It's fine to give a friend a Tylenol if they're having pain, but it's not fine to give your OxyContin to someone without a prescription."

Prof. Colleen L. Barry, Ph.D., senior study author

'Approach needs to change'

Although the study's findings are significant, the authors point to some limitations. Firstly, the use of self-reported data could be subject to social desirability bias; the researchers note, however, that using a web-based panel survey reduces this risk.

Additionally, because there is no census of adults with past-year opioid medication use, the authors cannot verify that their study is representative of all U.S. adults who have recently used opioid medication.

Still, the authors say their findings should be a wake-up call to physicians, who should, when prescribing them, discuss the appropriateness of sharing these medications and how to store and dispose them.

"We don't make it easy for people to get rid of these medications," says Kennedy-Hendricks. "We need to do a better job so that we can reduce the risks not only to patients but to their family members."

Prof. Barry puts it more succinctly: "If we don't change our approach, we are going to continue to see the epidemic grow."

Read about a study that suggests opioids might worsen chronic pain.