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Use, Abuse, Misuse & Disposal of Prescription Pain Medication Patient Guide
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Not Following Medication Directions is Risky Business

Pain relievers help people in pain live well. There are many kinds of pain relievers. Some like acetaminophen (Tylenol), ibuprofen (Advil), or aspirin are bought over-the-counter. This means without a prescription. Others require a prescription from your doctor. The prescription lets a pharmacist sell you a medicine that needs to be monitored by your doctor who wrote the prescription. This medicine is only for you. It should not be shared, given away, or sold. Never try to treat yourself or another. Drugs needs to be taken as directed—the way the instructions or your doctor told you to. Your health and safety could be at risk if you do not follow the directions. Some drugs are known to have abuse potential and some people taking these drugs can develop an addiction. These drugs are called a "controlled substance.” It is illegal for anyone but you to use a controlled substance or medication that has been prescribed specifically for you. It is important to take these medications according to the prescription, and discuss any changes you think reasonable or needed with your doctor.

What is a controlled substance?
A controlled substance is a drug whose general availability is restricted. Possession and use are controlled by law. These drugs are known to have abuse and addiction potential and are often abused. You must have a prescription to get a controlled substance because of the danger of addiction or abuse. These drugs tend to have immediate and desirable effects that either slow down or speed up the nervous system. They can be very dangerous and even fatal if taken incorrectly. Opioids are controlled substances. Opioids are often used to treat pain. Another name for these drugs is narcotics.

Prescription drug misuse/abuse is growing
Most people take prescription drugs correctly. But some do not. The numbers of people not taking medication correctly is on the rise. About 7 million people misuse/abuse prescription drugs every month. Some people just misuse their drugs. Maybe they take too much. Maybe they mix drugs with alcohol. Maybe they misunderstand the directions. Other people abuse drugs. These people purposely take drugs to "get high.”

Is it addiction?
Sometimes a person taking pain relievers becomes unintentionally addicted to them. Addiction is characterized by the 4C’s:

  • Control over drug use is lacking
  • Compulsive use is occurring
  • Continued use occurs despite harm
  • Craving drugs is a focus

If you think this might be a problem for you, there is help. Use the checklist below to see if you should talk to your doctor.

1. In the last 3 months, have you felt you should cut down on using your drugs?

2. In the last 3 months, has anyone annoyed you or gotten on your nerves by telling you to cut down on using these drugs?

3. In the last 3 months, have you felt guilty or bad about how much you use your drugs?

4. In the last 3 months, have you been waking up wanting to use drugs?

If you answered, yes to two or more questions make an appointment to talk to your doctor today.

Or is it need?
Know that just because you take pain medication everyday does not mean you are addicted. You may depend on your medication for pain relief. Your body may need this medication. Don’t ever stop taking medication without talking to your doctor first. Always be sure you are taking you medication exactly the way you were told. If you forgot or have questions, call your doctor.

Where should I keep my drugs?
It is important to safely store your drugs. You should not keep any drug beyond their expiration date without discussing it with your doctor or pharmacist. You will want to keep them safe from children, teens and strangers. Do not tell others about the medicines you take. This could make you a target for theft, even from people in your family and others you normally trust. Make sure all medications cannot be reached by small children and that drug packaging/bottles cannot be opened by small children.

To protect drugs from going bad:

  • Store in a cool dry place
  • Don’t store in the bathroom
  • Don’t store in the refrigerator, unless told to do so
  • Safely dispose of expired drugs (See below)

To safeguard drugs:

  • Organize them and keep track of them
  • Keep them separate from other family members’ drugs
  • Keep them under lock and key
    • This is especially important for "controlled substances” (OxyContin®, Dilaudid®, Percocet®, Vicodin®, Xanax®)
  • Do not share drugs

To safeguard you:

  • Immediately discuss with your doctor and pharmacist any concerns you have about taking the medication, or any side effects you think strange or unusual
  • Make sure you fully understand how the medication is to be taken
  • Keep a list of ALL medications; include anything you take that is "over-the-counter,” or herbal (not prescribed) as well as all medications prescribed by any doctor
  • Ask your doctor or pharmacist to check for drug interactions that may be present between ALL medications you currently take
  • Whenever reasonable, ask if there are medications that might not be needed, or if it is possible to simplify the medication schedule
  • Keep a "personal health record” that can be shared with your doctor
  • Have a system you develop with your doctor or pharmacist so that all medications are taken on time in a way easy for you to remember
  • Keep medicine in the bottle it came in
  • Always check you are taking the right drug
  • Double check the dose
  • Never take medicine in the dark
  • Put drugs away after taking them
  • Never mix medications together
  • Never take multiple medications unless told to do so
  • Never increase or change the dose by yourself, always work with your doctor

I don’t need this medication anymore. What now?
When your pain is gone or you switch to another medication you need to safely dispose of unused drugs. Some communities have a "take-back” program. Call your local trash or recycling service; they may know about a "take-back” program or proper disposal procedure. Ask your doctor or pharmacist how to properly dispose of unused medications.


  • Don’t flush drugs down the toilet unless found on the FDA list at this website:
  • Don’t give drugs away; this is illegal for controlled substances
  • Don’t take drugs back to the pharmacy


  • Remove the drugs from the bottle
  • Scratch off name and address
  • Throw empty bottle away
  • For most drugs, mix unused drugs with cat litter, used coffee grounds, garbage, or other undesirable item
  • Put this mixture in a sealed bag or container
  • Throw into trash

The Bottom Line
We may all benefit from the use of a controlled substance at some point. It is important to respect the potential for abuse of these drugs. For your safety, take medicine as directed. Do not take more than you need. Do not mix drugs with alcohol. Do not take drugs to get "high.” Do not share or sell drugs. Prescription drug abuse is on the rise. Safeguard yourself. Safeguard others. Safeguard your community.

Click here to download a printable version of Use, Abuse, Misuse, and Disposal of Prescription Pain Medication: A Guide for Patients.

For other information and useful links, visit the American College of Preventive Medicine website at www.acpm.org.

Purdue PharmaThe American College of Preventive Medicine acknowledges Purdue Pharma L.P. for its support of this resource through an unrestricted educational grant.

Copyright 2011. American College of Preventive Medicine. All Rights Reserved.

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