Article Text

Download PDFPDF
Opioids in advanced cancer: use, storage and disposal in the home
  1. Sebastiano Mercadante1,
  2. Lucia Adamoli2,
  3. Giuseppe Bellavia2,
  4. Luisa Castellana2,
  5. Tommaso Favara2,
  6. Lavinia Insalaco2,
  7. Marco Mauceri2,
  8. Carla Scibilia2,
  9. Mario Lo Mauro2,
  10. Alessio Lo Cascio3 and
  11. Alessandra Casuccio4,5
  1. 1Pain Relief and Supportive Care, Private Hospital La Maddalena, Palermo, Italy
  2. 2Società Assistenza Malato Oncologico Terminale, Palermo, Italy
  3. 3Private Hospital La Maddalena, Palermo, Italy
  4. 4Università degli Studi di Palermo Scuola di Medicina e Chirurgia, Palermo, Italy
  5. 5Hygiene, Università degli Studi di Palermo Facoltà di Medicina e Chirurgia, Palermo, Italy
  1. Correspondence to Dr Sebastiano Mercadante, Pain Relief and Supportive Care, Private Hospital La Maddalena, Palermo, Italy; terapiadeldolore{at}


Objectives To determine the patterns of storing, using and disposing of opioids among patients with advanced cancer followed at home.

Methods Patients who were prescribed opioids were selected. Prescribed opioids and their doses used for background pain and breakthrough pain were collected, as well as CAGE (cut down, annoyed, guilty and eye opener) for alcohol and drugs, smoking and history of illicit substance use. Questions regarding the opioid use, storage and disposal were posed.

Results 100 patients were surveyed. Fifty-one patients had unused opioids at home, 25 patients did not throw away the drugs, 40 patients saved opioids for future use and 35 patients were unaware of proper opioid disposal methods. A total of 28 patients reported unsafe use by sharing or losing their opioids; 12 patients were unaware that their opioid could be fatal when taken by others. Most patients acknowledged that pain medications could be dangerous when taken by others. Patients with a partner and who were married were more likely to keep their opioids locked (p=0.028 and p=0.025, respectively).

Conclusion A large number of patients with advanced cancer followed at home do not store, use and dispose of opioids safely. Patient education programmes should be incorporated to decrease the availability of opioids at home for abuse, diversion, and accidental poisoning.

  • home care
  • pain
  • supportive care
  • symptoms and symptom management

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Twitter @#sebmercadante

  • Contributors Conception/design—SM and GB. Provision of study material or patients—LA, GB, LC, TF, LI, MM, CS and MLM. Collection and/or assembly of data—SM and ALC. Data analysis and interpretation—SM and AC. Manuscript writing—SM. Final approval of the manuscript—all.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.