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.