The environmental impact can also be significant. An estimated 250 million
pounds of unused medications are improperly disposed of each year. A 2008
Associated Press investigation discovered a wide array of pharmaceuticals
detected in the drinking water supplies of 24 major metropolitan areas,
affecting at least 41 million Americans.
Consumers can be excused for not knowing what to do with their expired or
unused prescription drugs. For years, people were advised to flush their unused
medications down the toilet. More recently, the recommendation shifted to
combining the medicine with undesirable substances, like kitty litter or coffee
grounds, and throwing it in the trash. But that led to concerns that
water contamination could still occur as sensitive material theoretically
leaches out of landfills and enters underground water tables.
Balancing law enforcement and anti-drug abuse needs on the one hand with public
health and environmental concerns in the other has been no easy task for
Congress, the Drug Enforcement Administration and other state and local
officials. As a result, local pharmacists and others trying to do the right
thing encounter a wall of seemingly conflicting laws and regulations.
We’re proud of the hundreds of independent community pharmacies stepping
up voluntarily to make the Dispose My Meds program a success. And we’re
continuing to encourage more pharmacies to join the program and give patients
additional disposal options (and hopefully a new appreciation for their local
pharmacy).
While drug disposal drives at community centers like fire or police stations
are welcome, pharmacies are the optimal setting. That’s because it
enables direct, real-time pharmacists counseling of patients regarding unused
medications.
But we also recognize that this is only a start. We need a comprehensive
approach to ensure appropriate medication use and disposal to keep patients
healthier and communities safer.
Governments at all levels are increasingly getting into the act. Last year the
D.C. City Council enacted legislation sponsored by Council members David
Catania, Mary Cheh and Tommy Wells that requires the city’s Board of
Pharmacy to develop a prescription drug disposal program with drop-off and
mail-in options. The National Conference of State Legislatures says Maine and
12 other states have enacted or are considering legislation affecting
pharmaceutical collection or disposal, according to the Associated Press. At
the federal level, several bills have been introduced thanks to the leadership
of notables like Senators Dianne Feinstein (D-CA), Charles Grassley (R-IA), Amy
Klobuchar (D-MN), and Patty Murray (D-WA) and Representatives Earl Blumenauer
(D-OR), Jay Inslee (D-WA), Jim Moran (D-VA), Lamar Smith (R-TX) and Bart Stupak
(D-MI).
Community
pharmacists want to be constructive partners in designing such programs.
We’ve suggested to policymakers that they follow this approach:
• Make it easy on consumers –
Patients need viable, convenient solutions when seeking to dispose of their
unused medications. That means allowing for drop off at collection sites under
the supervision of a licensed pharmacist as well pre-paid shipping envelopes.
• Make the rules consistent,
practical — Current laws allow pharmacists to dispense controlled substances
and to counsel patients about them, but criminalize the pharmacist who would
take the drugs back for disposal. Guidance for patients can be just as counterintuitive.
Authorities say flush some drugs down the toilet, but not others. The lack of
clarity undermines safe and effective drug disposal.
• Don’t overburden small
pharmacies – Take-back programs should be voluntary for community
pharmacies and there should be reasonable liability protections in place for
participating pharmacies.
• Identify new funding –While
many pharmacists have admirably stepped up to voluntarily be part of the new
Dispose My Meds campaign, they should not be required to finance a
comprehensive, national program.
• Effective outreach to consumers,
stakeholders – The ambiguity and uncertainty described above makes
effective education critical to ensuring maximum participation by all.
These are the building blocks to enable local pharmacists to help patients get
the most out of their medications while making our communities safer and
protecting the environment.