Editor’s note: This letter is in response to the article “Disposal of Unused Opioid Medications: Aligning Patient Needs and Provider Expectations,” which was written by T.K. Miller, MD; Malek Bouzaher, BS, MS; Susan Giampalmo, BS; and Joseph T. Moskal, MD, and published in the February issue of AAOS Now.

In response to the opioid crisis, the state of Georgia has joined with other states in taking action. As of Jan. 1, 2018, every Georgia physician is required to document three or more hours of American Medical Association/American Osteopathic Association Physician’s Recognition Award Category 1 continuing medical education related to opioid prescribing in order to renew his or her Georgia medical license, and all prescribers must be registered for the Prescription Drug Monitoring Program. With only a few exceptions, prescribers must check the database and document the name of the person who checked, as well as note the date and time that the database was accessed. In addition, prescribers are required to provide patients with information on the drug’s addictive risks and available options for safe disposal of any unused medications.

As such, the Georgia Orthopaedic Society saw an opportunity to provide a service to assist Georgia orthopaedic surgeons in satisfying these requirements and provide a tool to help educate our patients. The public relations committee created a poster (see above image) that includes quick facts on opioid use and abuse, instructions regarding proper opioid disposal, and a place for the closest narcotic drop-off location. The society’s goal is to have at least one poster in every Georgia orthopaedic office. The posters were handed out at the Georgia Orthopaedic Society’s annual meeting and will be hand-delivered or mailed to practices throughout the state.

Although this does not obviate the need for one-on-one discussions with patients, it is felt to be a valuable educational tool.

Kelly Homlar, MD
Medical College of Georgia
Augusta, Ga.

J. Wendell Duncan, MD
Orthopaedic hand surgeon
Augusta, Ga.

References

1. Department of Health and Human Services: National Action Plan for Adverse Drug Event Prevention. Available at: http://www.health.gov/hcq/pdfs/ADE-Action-Plan-508c.pdf. Accessed August 20, 2019.
2. Centers for Disease Control and Prevention: Understanding the Epidemic. Available at: https://www.cdc.gov/drugoverdose/epidemic. Accessed August 20, 2019.
3. Jones CM: Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid pain relievers—United States, 2002-2004 and 2008-2010. Drug Alcohol Depend 2013;132:95-100.
4. Morris BJ, Mir HR: The opioid epidemic: impact on orthopaedic surgery. J Am Acad Orthop Surg 2015;23:267-71.
5. Bicket MC, Long JJ, Pronovost PJ, et al: Prescription opioid analgesics commonly unused after surgery: a systematic review. JAMA Surg 2017;152:1066-71.
6. Sabatino MJ, Kunkel ST, Ramkumar DB, et al: Excess opioid medication and variation in prescribing patterns following common orthopaedic procedures. J Bone Joint Surg Am 2018;100:180-8.
7. Volkow ND, McLellan TA, Cotto JH, et al: Characteristics of opioid prescriptions in 2009. JAMA 2011;305:1299-301.
8. Shah A, Hayes CJ, Martin BC: Characteristics of initial prescription episodes and likelihood of long-term opioid use—United States, 2006-2015. MMWR Morb Mortal Wkly Rep 2017;66:265-9.