Drug Takebacks Aim to Prevent Abuse, Protect Environment

By Tucker, Charlotte | The Nation's Health, March 2011 | Go to article overview

Drug Takebacks Aim to Prevent Abuse, Protect Environment


Tucker, Charlotte, The Nation's Health


THESE DAYS, DOCTORS can prescribe medications that can cure or treat a range of illnesses. But estimates say that one-third of prescription and over-the-counter medicines go unused or expire, creating questions on how to safely dispose of them.

A new federal law signed by President Barack Obama in October will allow states to create takeback programs for prescription and over-the-counter medications, allowing for their safe and legal disposal.

The need for such programs is clear. Americans use more prescription drugs than a decade ago, with one out of 10 people using five or more, according to the National Center for Health Statistics.

To address the growing problem, the Department of Justice's Drug Enforcement Administration held its first National Prescription Drug Take Back day on Sept. 25, 2010. Approximately 3,000 state and local law enforcement agencies across the United States participated, and they collected more than 121 tons of drugs. The effort was so successful that DEA will hold another national takeback day on April 30.

The public health problem of drug disposal is threefold, said Margaret Shield, PhD, a policy liaison with the King County, Wash., Hazardous Waste Management System. More than 7 million Americans abuse prescription drugs, sometimes taking them from medicine cabinets where the unused drugs are being stored. In 17 states, overdose is the leading cause of accidental death, Shield said.

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Second, unused prescription drugs pose a poisoning hazard to children if left unsecured. In 2009, more than 30 percent of the accidental poisoning deaths among children involved the ingestion of prescription or over-the-counter medications, according to the American Association of Poison Control Centers.

And finally, recent studies have detected trace amounts of many common prescription drugs in drinking water. The drugs likely enter the water system two ways: after being expelled by the body and when people flush unused or expired medications down the toilet. Though the amount of drugs in drinking water is small, public health experts say it is not clear what effect ingestion of those drugs could be having on the public.

"Prescription drugs are an emerging pollutant of concern," Shield told The Nation's Health. "The old advice of flushing medicine you don't need just ends up sending medicine out into the environment."

The Environmental Protection Agency advises against flushing medication unless the label specifically recommends it. Instead, to make the drugs unpalatable to illicit users and young children, EPA and the President's Office of National Drug Control Policy recommend mixing the drugs with cat litter or coffee grounds and then placing the mixture into a sealed container or bag before disposing of it in the trash.

But Shield said that method also has problems, because drugs can leach out into the environment over time.

The best solution for prescription and over-the-counter drug disposal is incineration, Shield said. Hospitals and pharmacies send their unused and expired drugs to be incinerated, but only recently have residents in some states had the same opportunity.

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Another problem, up until Obama signed the Secure and Responsible Drug Disposal Act Oct. 12, was that it was illegal under the Controlled Substances Act to transfer prescription drugs from one person to another, even for disposal. The law removes that barrier and opens the door for states or other groups to create takeback programs, Shield said.

In about a year, DEA is expected to write regulations governing the collection of controlled substances. The way such regulations are written could greatly expand states' ability to run takeback programs, said Jeanie Jaramillo, PharmD, of the Texas Panhandle Poison Control Center.

Her group has sponsored six takeback events since 2009, at which it has collected about a ton of unused or expired drugs, Jaramillo said. …

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