medically-aided dying: are leftover/unused meds a documented problem?

One group voicing their opposition to legalized medical aid in dying is concerned about this aspect of it:

OK, so there are documented cases of a few hundred unused bottles of Seconal lying around over the past couple of decades. The all-important question is whether there are documented instances of any of these pills having been ingested by third parties, either one at a time[sup]*[/sup] for recreational purposes or en masse as a suicide attempt. Anyone know?

*“One at a time” may not be possible. There may be pharmacies that provide the Seconal as a bottle of intact capsules, but in the one instance I was involved with, the pharmacist emptied all 100 capsules to provide a bottle of loose powder.

No instances that I’ve heard of though it is of course possible.
Even if it has happened this would be a tough one to document. Most people are not forthcoming about what they took much less where they got it. I think it would take a bottle being found (with a label) next to a body. Even then, you would have to prove it was an accident.

People do take medicines that are not prescribed to them, all the time. Some die. In the absence of a suicide note, intent is difficult to ascertain. Seconal is rarely prescribed anymore in my experience, though I believe it is still used in animal euthanasia.

I would call BS on this as a valid argument against assisted suicide.

So 554 unused prescriptions are possibly sitting around (highly doubtful), literally 10s of thousands of opiate prescriptions are in common use. Those bottles are killing people, every day.

Doesn’t seem a whole lot different from nursing Granny to her death in your home. Regardless of her illness, come to the end there are most likely to be some pretty heavy pain meds, in use. Often scripts are changed up pretty quickly near the end. Often opioids and other heavily restricted meds.

Now that Gran is gone, you’re still left with a shelf full of meds that could easily present the same dangers. Yet how many cases have you read about those falling into the wrong hands, being misused, or costing lives?

I don’t think this is really a thing. It looks like manufactured outrage to me.

Well, if it works like hospice, the nurse is pretty aggressive in disposing of any leftover medications.

I was present for an elderly relative passing in in-home hospice, and the nurse had gotten rid of all of the prescriptions the relative had been prescribed within 10 minutes of the death.

I can’t imagine any reason that the protocol would be less strict in medically-aided dying than in hospice.

My mother died in hospital. When we cleared her house, she had a large drawer full of unused meds. Most of it was non-lethal asthma inhalers, some way out of date, but she had a good supply of painkillers, up to and including morphine. At the bottom of the drawer, we found a bottle containing 100 50 grain ephedrine which had been dispensed at least ten years earlier.

We put it all in a black bag and took it to the pharmacy so they could dispose of it. I guess, if anyone had been criminally inclined, there were drugs worth a considerable amount on the open market (ie - the pub)

Wouldn’t the Seconal be present in the blood? It’s not like it’s a recreational drug that you might take every once in awhile and the body filters out eventually. You take it, and then, you die, no filtering by liver/kidneys. Sure, you’ll probably void yourself, but, that won’t be before any filtering.

So, unless the surviving family decided to not have an autopsy performed, one would be, with a drug/tox screen, which probably would have picked up the Seconal. I only say probably as I’m not 100% sure, but I’d say I’m 98% sure.

I’d also like to think that the people who had the Seconal, and had second thoughts, would have disposed of it.

Some people get the prescription and keep it around in case the pain gets to be too much or something like that. A psychological security blanket. They sometimes end up not using it.

As far as an autopsy, probably rarely done. The person with the prescription has been diagnosed with an incurable disease with less than 6 months life expectancy. And if they take the drug, the cause of death put on the death certificate is supposed to be whatever disease they had, not suicide or drug overdose. At least that’s the law here in Oregon and I think all the other states copied that part of our law. (Oregon was the first to have physician-assisted suicide/death with dignity/whatever you call it. Most other states that have it copied our law with minor modifications.) So it’s unlikely anyone will be asking for an autopsy.

I think electronbee was referring to the situation of a third party stealing and ingesting the Seconal that was prescribed to the terminally ill patient (after the latter had died of natural causes). Upthread, steatopygia had suggested that it might be challenging to identify instances in which this had happened.

My mother died, at home, under hospice care. Nobody from hospice was there when she died, but we called them and they showed up within 30 minutes. We had a bottle of liquid morphine we’d been giving her for pain.

Literally the first thing one of the hospice workers did when they arrived was to take that bottle and not only measure what was left against her recommended dosage, but also put something in it to presumably test that nobody’d refilled the bottle with something other than morphine. I remember it was a little lab experiment going on in the corner. Once they verified that everything was a-ok, they took the rest of the bottle when they left.

I understand, but in my example it wasn’t hospice assisted. Which happens a lot.

(Happened in my home. We did her care for six years and to the very end, ourselves. And the last ten weeks saw a lot of meds stepped up, scripts replaced swiftly, as her condition shifted. When it was over we had enough meds to open a pharmacy, I swear. The Dr did the death certificate in my home and he simply reminded us to not flush them and the pharmacy will destroy them.)