Controlled Substance Disposal Practices of Oral and Maxillofacial Surgeons

The goal of this study was to examine the medication wasting and disposal practices of oral and maxillofacial surgeons (OMSs) who deliver outpatient anesthesia using controlled substances, and to determine what factors, if any, influence those practices.

The investigators composed an anonymous online survey that was emailed to OMSs currently practicing in the United States. Participants were questioned about their length of practice experience, drug disposal training, specific methods employed for medication disposal, and the use of a witness during the disposal process. Descriptive and bivariate statistics were computed. The P value was set at 0.05.

A total of 5,551 surveys were sent, yielding 719 responses (13%) and 656 completed surveys. The most common disposal methods reported were pouring the unused medications into an absorbent (n = 207, 32.4%), pouring into the sink (n = 196, 30.7%), placing into the sharps container (n = 141, 22.1%), and pouring into the trash (n = 32, 5%). Most respondents (n = 543, 84.7%) utilize a witness during the drug inactivation process. There was a statistically significant negative relationship between years of practice experience and receiving formal training in guidelines for the disposal of controlled substances during residency (P < .001). Those OMSs who received formal training regarding drug inactivation were more likely to standardize medication disposal methods (P < .001) and to utilize witnesses during the process (P = .013). OMSs who employed a standard method for drug disposal were more likely to involve witness confirmation during the process (P < .001).

Medication disposal practices vary widely among OMSs who deliver outpatient anesthesia using controlled substances. Formal training in this area is associated with a greater likelihood of maintaining a standardized disposal method that utilizes a witness during drug disposal but is not associated with rendering the medications nonretrievable during the process. Further educational opportunities among OMSs and residents may help to improve compliance with drug disposal regulations.