Guidelines & Recommendations

Hospice care nurses, doctors and assistants provide care at the most difficult and challenging time in their patient’s lives. The most important part of their job is ensuring that their patient is comfortable, which includes administering medications like opioids to give relief from pain and other symptoms. When the medications are no longer needed, it is critical that they are safely disposed of so they do not fall into the wrong hands.

Safe Disposal Can Save Lives

We are all aware of the opioid crisis that is affecting our country. In the United States, overdose of opioids is the cause of death for tens of thousands of people each year. According to experts, millions of prescribed opioids go unused by the patient and are either left in the medicine cabinet or disposed of improperly—leading to misuse and overdose by others, often family or friends of the patient. One of the key ways to help prevent opioid addiction and overdose is proper disposal.

Guidelines for Hospice Care Workers

While there has been legislation put into place regarding opioid use and disposal, the rules vary from state-to-state. For hospice care professionals, it is crucial that you understand and abide by the regulations in your state. When a patient dies, it is important to ensure that any and all medications that fall into the opioid category are treated as medical waste that can potentially harm others. In states that do not have drug disposal requirements for hospice care, the Support for Patients and Communities Act that was established in 2018, provides several guidelines:

• Training and documentation of training of the proper disposal of opioids are required by Hospice staff, including responsible disposal to prevent abuse, misuse and diversion.

• Nurses, doctors, caregivers and other hospice care workers of qualified hospice organizations are authorized to dispose of patient’s lawfully prescribed medications upon the death of the patient, expiration of medications or a change in the care plan that no longer includes the medication.

• Hospice organization must have written policies and procedures in regards to the disposal of opioids or other controlled substances. These policies and procedures must be effectively communicated and documented to the patient, patient representative and family members when the medication is prescribed.

• After disposal of opioids or other controlled substances, Hospice staff must document the details of disposal, including the amount disposed of, date, time and method of disposal. This information, including the dosage prescribed, the type of opioid and the route of administration must be documented in the patient’s medical records.

Disposal Recommendations

Depending on where the hospice organization is located and the rules set forth in the organization itself, disposal can be managed in several ways. Caregivers should follow the requirements of the hospice organization. In addition, the EPA and other agencies have put forth several recommendations for the safe disposal of opioids including: 

• Do not flush opioids down the toilet
• Do not place in regular trash
• Return unused medications via a secure mail-back program
• Utilize secure drug collection community kiosks
• Bring unused medications to drug take-back events

Proper disposal of opioids and other controlled substances is extremely important to protect others and to prevent misuse and overdose. As a hospice care worker, it is crucial that you follow the guidelines set forth by your organization and any state or federal mandates.

All Points Medical Waste is a family-owned and operated company in Stuart, Florida. We provide medical waste disposal to hospitals, clinics, treatment and diagnostic centers, funeral homes, veterinarians, dental practices and more throughout South Florida. Give us a call today or fill out this form to learn more.