About 100 million opioid pills prescribed after dental surgery are unused by people in the United States, increasing the risk of the opioid epidemic that has prevailed in the country for more than a decade.

In order to examine opioid use among people, researchers from the University of Pennsylvania (Penn) in Philadelphia conducted a study involving 79 patients who were prescribed opioid pills after dental impaction surgery. The investigators also studied whether giving a small financial incentive and imparting awareness on pharmacy-based drug disposal programs would influence patients to dispose of the unused pills properly.

It was found that about 24 hours after surgery, patients on medication experienced a pain level of 5 out of 10 on average. A score of 3 out of 10 was experienced by more than half the population on the second day, and five days after surgery about 80 percent of the patients reported very low pain.

Nearly 94 percent of patients were prescribed opioid painkillers, 82 percent of them were also given a nonsteroidal anti-inflammatory drug (NSAID) and 78 percent were prescribed antibiotics. The patients who didn't experience any kind of post-surgery complications (93 percent) were prescribed 28 opioid pills each.

It was found that around three weeks after their operation, patients had taken only 13 out of 28 pills on average, and about 1000 pills were left unused. Of all the patients involved in the study only five were found to have taken all the pills prescribed for them.

Dr. Elliot V. Hersh, the co-author of the study from Penn's School of Dental Medicine, said that five days after surgery most of the patients experienced only mild pain, but most of them had more than half of their opioid pills left.

When adequate information on the disposal of excess pills in addition to general instructions was given, a 22 percent increase in patients' willingness to dispose of the leftover pills was observed. The researchers concluded that limiting the prescription opioid painkillers to required amounts and making ample arrangements for the proper disposal of unconsumed opioid drugs would help prevent opioid abuse leading to the opioid epidemic.

"Given the increasing concern about prescription opioid abuse in the United States, all prescribers - including physicians, oral surgeons and dental clinicians - have a responsibility to limit opioid exposure, to explain the risks of opioid misuse, and educate patients on proper drug disposal," said lead author Dr. Brandon Maughan, an emergency physician and health services researcher at The Lewin Group, a health policy consulting firm, in a press release.

The study is published in the journal Drug and Alcohol Dependence.

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