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Elder Services in Your Town - Follow Up

DEA Allows Return of Unused Prescription Drugs

Once or twice a year in my town there is a day when residents can turn in leftover prescription drugs that are then disposed of properly rather than flushing them down the toilet to enter streams and rivers or be found in medicine cabinets by children or grandchildren.

The problem has now been addressed by the federal Drug Enforcement Administration (DEA). Beginning next month, the agency will

”...permit consumers to return [certain] unused prescription medications...to pharmacies,” reports The New York Times and others...

“The new regulation, which will go into effect in a month, covers drugs designated as controlled substances. Those include opioid painkillers like OxyContin, stimulants like Adderall and depressants like Ativan.

“Until now, these drugs could not legally be returned to pharmacies. The Controlled Substances Act allowed patients only to dispose of the drugs themselves or to surrender them to law enforcement.”

What I didn't understand until reading about this new regulation is that the “take back” days are a national event organized by the DEA. The next one is on Saturday 27 September.

”In the past four years, these events have removed from circulation 4.1 million pounds of prescription medications,” reports The Times.

But that's only a drop in the bucket compared to how many drugs are in circulation:

“'The [take back days] only removed an infinitesimal fraction of the reservoir of unused drugs that are out there,' said Dr. Nathaniel Katz, an assistant professor of anesthesia at Tufts University School of Medicine in Boston who studies opioid abuse. 'It’s like trying to eliminate malaria in Africa by killing a dozen mosquitoes.'

“Dr. Katz is optimistic that the D.E.A.’s decision could have a powerful impact. Putting drop-off receptacles for controlled substances in pharmacies will mean consumers have year-round access to disposal services.”

The new regulation is voluntary and does not require pharmacies to have drop off receptacles so it is unknown at this point how many will participate.

It seems such an obviously important service – especially for elders who use more prescription drugs than younger people - that it is amazing it's never been thought of before. You can read the entire story here.


At The Elder Storytelling Place today, Joanne Zimmermann: Worldwide Music Man

Comments

Great idea. But if we are not going to be reimbursed for the unused pills, what's in it for us. It's easier just to flush them down the toilet and let the fish get high.

I would come a lot closer to returning unused pills to my pharmacist than turning them in to the sheriff's office, which is how they have done these events in the past in my locale. Despite saying it is anonymous, they have required people to give their names and addresses.

Why would I care, you say? Well, around here the police authorities are zealots for doing drug busts. I don't want to be added to some secret list because I had a (prescribed) opiate they didn't like. Or an allegy pill you can make meth out of. Sheesh.

So where does all this stuff go? These collection sites will be a convenience, like the sharps disposal containers at the regional VA clinic my husband visits a few times a year. We have difficulty disposing, otherwise, of the several syringes he uses for his multiple daily injections of insulin. But where does all this stuff go? How is it disposed of that is a safer alternative to flushing down the toilet? Why is so much medication going unused, and how is this calculated?

I also wanted to say that I hope you're feeling much better, Ronni, and that the medication you were recently prescribed has served you well.

Cathy...
As the Times story explains, in the take-back programs, the drugs were incinerated.

The new regulation does not name the type of disposal but flushing is not a good idea as the drugs enter streams and rivers polluting the environment.

This is not a perfect regulation but it is a good beginning that can be improved over time now that it exists.

And, as to "what's in it for you", Bruce, I'm guessing you've never heard of the greater good.

When my good friend died and I was responsible for cleaning out her house, I asked the nursing home where she had died what to do with 15 bottles of her meds sitting on the dining room table. This was 3 years ago. They told me to return the drugs to the pharmacy where they were purchased.

I bagged those drugs, it was a BIG bag, and hauled them to CVS where they were purchased. Handed over the bag and told them the patient had died, here was the unused drugs. They just looked at me like I was crazy. I turned and walked away.

Later I found out that drug stores have to pay to have the drugs destroyed. I didn't really care, but did find it odd that the drug stores really don't want the drugs turned in. I just knew I had been told not to flush them down the toilet or throw them in the trash.

Thanks for this. We use all our meds, darn it.

This is good to hear. Anyone can drop off unused prescription drugs to the police station here in Denton, Tx. But that is a lot less convenient than dropping them off at the pharmacy we frequent far more often the police station, although there was a time when I was inside one more times than I like to mention. Picking up friends and relatives of course who needed bailing out. :-)

Where I live, we can take unused drugs to any police station and in the lobbies are big cast iron mailboxes where we can leave drugs. The only rule is we have to black out the patient's name on the bottles. It' part of a program to keep drugs off the streets where our kids can buy and sell them.

I would never, ever put them in the toilet or down the drains where they can and do eventually work their back into our food chain. If you don't have a take-back program in your area, call around to find the safest way to dispose of them. Where I live the suggested second best way is to put them in a glass jar with a little water and throw them in the trash.

This is such a challenging question. For example, I have a nearly-full bottle of codeine in a medicine chest in the bathroom.

It was prescribed by an ER doctor I saw in Seattle two months ago. It worked well for the few days I needed to take it, but what do I do with the rest of it?

Seattle Public Utilities --which picks up recycling, food & yard waste, and garbage--seems to indicate in its public information that the leftover drug is prohibited from any of those categories.

Then there are my used lancets from testing my blood-glucose levels. They go into a container marked Biohazard which says "Please dispose in accordance with all state and local regulations." I have no idea what that means.

The full story in the NYT also leaves a lot of questions unanswered. For example, incinerators are generally sizable structures which create their own problems, including lengthy licensing processes, significant expense, and possible toxic emissions.

Fortunately, neither The Engineer or I take meds for any longer than we need to. I guess we'll just keep doing what we've been doing.

Our garbage dump/landfill takes needles and lancets for free. You do have to bundle them in a heavy plastic container (old bleach bottle etc.) Mark them as to content and tape them shut. But its free. Getting to the landfill is easy here not like a big city. But if you don't drive it becomes problematic. Sometimes our doctor will take them and dispose of them with the office sharps just out of good will.

Before getting the information on a drug disposal site I had to get rid of 2 large containers of a medication that had expired. It was recommended to fill the container with oil or some non-edible liquid and thrown them in the garbage. I didn't have any cooking oil so I filled the containers with water.

We have a drug disposal day, but you have to take them to the site that collects them.

I think taking them to your pharmacy is a better solution.

When I said I would flush them down the toilet, I was just making a joke. I would dispose of them in a proper manner. But really, I paid good money for those pills. maybe a discount on something would be in order. Criminals who turn in firearms get a couple of hundred bucks, and I'm no criminal.

I had been told a relatively safe way of disposing of drugs is to grind them and place them in used coffee grounds or used kitty litter before placing them in the trash. My police department now offers a secure receptacle for disposal of unwanted meds.

I believe that there are ways we could reduce this surplus of unwanted meds. One way would be for a doctor to prescribe a trial amount of a new medication as so often, the medication isn't tolerated or the dose needs to be adjusted. The key would be for the copay to cost less than it would for a full month's worth, so the patient isn't financially penalized. Another source of excess meds is the result of some pharmacies automatically sending out monthly refills. Pharmacies often don't know a medication has been discontinued by the prescriber. The end result is also that it is easy for patients to get confused about which meds they are supposed to be taking, leading to over-medicated seniors. Some prescribers automatically write for 11 refills of a medication. This means their office staff won't be frequently contacted for refills, but also means there may be more confusion for elders or their caretakers.

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