Expand Prescription Drug Take-back & Disposal Program

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Safe Disposal of Medicine

WHY

Accidental Exposure:

• When medicines are no longer needed or have expired, it is important to properly dispose of them to reduce harm from accidental exposure or intentional misuse. Throwing drugs in the garbage also is a bad idea, because they can accidentally be taken by kids or pets.

Intentional Misuse:

• A majority of abused prescription drugs are obtained from family and friends, including from the home medicine cabinet.
• SAMHSA’s 2009 National Survey on Drug Use and Health found that over 70 percent of people who used prescription pain relievers non-medically got them from friends or relatives, while approximately 5 percent got them from a drug dealer or from the Internet.
• Getting hooked on prescription opioids is directly responsible for over 60% of subsequent heroin addictions as addicts turn to this less expensive alternative.
• Prescription drugs involved in overdoses are almost all originally prescribed by physicians

Environmental Concerns:

• Some people propose flushing or pouring unused medications down the drain, however medications flushed into the waste stream can end up in water supplies.
• Since the drugs in take-back programs are incinerated, take-back programs are the safest way to get rid of the chemicals and to stop them from getting into drinking water and watersheds as well as in the hands of those at risk.

 

State Legislation Requiring Disposal Kits be Given with Prescriptions

The Kentucky State Senate passed in March 2018 a bill that requires opioids and other abused drugs to be dispensed along with a method to permanently sequester and dispose of any leftover pills. If passed by the house and signed, it will be the first state passing such a bill.DisposeRx will be a popular choice to be given out along with prescription. 
 
  If no take-back programs are readily available, it is still important to dispose of the medications quickly and appropriately. Some prescriptions include instructions on how to dispose of the drug. The U.S. Food & Drug Administration (FDA) provides the safest ways of disposing of these medications at home here. The FDA also recommends that certain drugs be flushed immediately such as fentanyl patches, Oxycontin, and Percocet. A full list can be found on this page.
 
 

Special Populations

Senior Citizens

Senior citizens have a disproportionate number of medications in their homes. Helping seniors understand how to properly dispose of medications can make a big difference in the success of your program.
 

Nursing Homes

Individual patients aside, one study estimated the nation’s nursing homes discard anywhere from $73 million to $378 million worth of drugs a year. Some are incinerated, but many are flushed.
 

Hospice Programs

Hospice programs can help family members understand how to properly handle the medications they inherit when a loved one passes away.
 
 

Take-back Events

DEA National Drug Take-Back Day Initiative

The National Prescription Drug Take Back Day Initiative addresses a crucial public safety and public health issue by providing an opportunity for Americans to prevent drug addiction and overdose deaths. As of May 2017, the DEA has promoted 13 national take-back days and they continue to collect more and more drugs each time.

Program Successes

• Over 4,200 law enforcement and community partners and 5,500 sites across the country.
• Since September 2010, these events have altogether collected 8,103,363 pounds (4,052 tons) of prescription drugs.
• The last National Take-back Day collected more than 900,386 pounds (450 tons).

To promote your local Rx Take Back Day, the DEA provides a partnership toolkit featuring promotional materials for associated partners.

The next National Take-back Day is ___!!
See Tools & Resources for more DEA take-back resources and other ideas on how to implement a local take-back day.

State Level Drug Take Back Programs

See below for inspiration from current state efforts:
 

• Pennsylvania
• Indiana
• Oregon
• Arkansas
• Washington
• Georgia

Local Disposal Drop Boxes

Disposal Locations

Medication Disposal Locators

Use the following links to find drug disposal locations

• DEA's Disposal Locator - Find locations in your ZIP code. These collectors are registered with the DEA and pass unused medicine on to the agency to disposed.
• Rx Drop Box
• Dispose My Meds
• National Association of Boards of Pharmacy
• The American Medicine Chest Challenge
• Walgreens Safe Medication Disposal Program

Drug Drop-Boxes

The NADDI prescription drug dropbox website is an important resource to find locations of drop boxes, buy boxes, apply for grants, and other information about drop boxes.

Grants

With the help of the of the National Association of Drug Diversion Investigators, communities can apply for grants to receive a drop box that will hold old opioids to prevent abuse. These boxes have resulted in multiple cities and communities to be safer, and reduce the risk of opioid addiction. Boxes are to be located in close proximity to law enforcement agencies so nothing happens to them. Multiple boxes have been placed in the State of Minnesota, and after reaching out to one town in specific, Fridley , they told us that they have seen a positive response to the drop-box. They have discarded pounds of prescription opioids that came from an at-risk community. This is becoming a great option for communities, and it assures that opioids are removed safely, and efficiently.

In-Home Disposal

Drug Deactivation Pouch Systems

These pouches render opioids ineffective for misuse and safe for disposal and the environment, are another cost-efficient way to safely dispose of opioids.

Deterra

Minneapolis based company Verde Technologies has created a product called Deterra® System which deactivates prescription drugs.

Each patented Deterra® pouch contains a water-soluble inner pod containing MAT12® activated carbon. Once the pharmaceuticals are placed in the pouch, warm water is then added, which dissolves the inner pod releasing the activated carbon. The warm water also dissolves prescription pills, patches and liquids, allowing them to be adsorbed by the carbon, rendering them inert and non-retrievable.

For more information on how to use Deterra®, view this How-to video
 

Current Efforts to Promote In-Home Disposal

The state of Pennsylvania has a goal of distributing Deterra® Drug Deactivation and Disposal pouches alongside 10% of all opioid prescriptions.

[File:http://www.wikispaces.com/i/mime/32/application/pdf.png PA AG case study.pdf]

PA AG case study.pdf

• Details
• Download
• 433 KB

 

[[file/view/7.11.17 Attorney General Shapiro Unveils Plan to Distribute 300,000 Drug Disposal Pouches in 12 counties[5].pdf/615588959/7.11.17 Attorney General Shapiro Unveils Plan to Distribute 300,000 Drug Disposal Pouches in 12 counties[5].pdf|[File:http://www.wikispaces.com/i/mime/32/application/pdf.png 7.11.17 Attorney General Shapiro Unveils Plan to Distribute 300,000 Drug Disposal Pouches in 12 counties[5].pdf]]]

[[file/view/7.11.17 Attorney General Shapiro Unveils Plan to Distribute 300,000 Drug Disposal Pouches in 12 counties[5].pdf/615588959/7.11.17 Attorney General Shapiro Unveils Plan to Distribute 300,000 Drug Disposal Pouches in 12 counties[5].pdf|7.11.17 Attorney General Shapiro Unveils Plan to Distribute 300,000 Drug Disposal Pouches in 12 counties[5].pdf]]

• [[file/detail/7.11.17 Attorney General Shapiro Unveils Plan to Distribute 300,000 Drug Disposal Pouches in 12 counties[5].pdf|Details]]
• [[file/view/7.11.17 Attorney General Shapiro Unveils Plan to Distribute 300,000 Drug Disposal Pouches in 12 counties[5].pdf/615588959/7.11.17 Attorney General Shapiro Unveils Plan to Distribute 300,000 Drug Disposal Pouches in 12 counties[5].pdf|Download]]
• 135 KB

 

Case Studies

Inspira Health Network (New Jersey) distributed the Deterra® pouch throughout their network.
Case Study
 

Benefits

• Inexpensive - Costs $7 per pouch
• Can encourage people to connect with law enforcement - People can pick up free (if already given to law enforcement) pouches from station and dispose of them at home and save any potential embarrassment
• Improve overall water quality - with the majority of people flushing unused medication down the toilet, only water treatment facilities remove less than half of the prescription drugs found in sewage

DisposeRx

Dispose Rx is "a patented (pending) blend of solidifying materials that provides a solution for the safe disposal of unwanted or expired prescription drugs. Dedicated to environmentally friendly and safe non-toxic disposal solutions, DisposeRx is spearheading programs of educating communities with practical and safe medication disposing solutions, thus preventing the cycle of environmental pollution, addiction, overdose, and death." Prescription drugs can be rendered safe for disposal (and impossible to misuse) by adding powder from a packet directly into the pill bottle and shaking the bottle.
DisposeRX.jpg

• Very Inexpensive - Costs about $1.50 per packet (and Walmart gives the packets away free with a prescription or possibly a request)
• Packets can attached to prescriptions with a rubber band (much like flower fertilizer is attached to fresh-cut flowers)
• Well-suited to campaigns with community partners (like clinics, churches, barbershops or hair salons) to increase distribution to diverse populations.

See Tools & Resources for more information.

Funding

Legislation & Drug Companies

Currently several West Coast counties, the city of San Francisco and the state of Massachusetts have issued legislature that require drug companies to fund drug take-back programs. On a national level, however, only 2.5 percent of eligible take-back organizations are participating, according to the Government Accountability Office. The primary barrier seems to be financial: Maintaining the safe-like prescription drop-off container, training staff to follow the relevant regulations, and destroying the returned medication costs money. As a potential solution, writing policy that mandates opioid manufacturers to pay patients for their returned bottles of pills, along with subsidizing drop off location operators, could offset the costs and be what is needed to make returning leftover medication an automatic habit for consumers.



The Product Stewardship Institute, a nonprofit that supports drug take-back programs, calculated that at least a dozen other local governments around the country are considering similar legislation, including several California counties.

In Minnesota, pharmaceutical company Mallinckrodt donated 30,000 disposal pouch systems to be distributed.

Tools & Resources

TR - Expand Prescription Drug Take-back & Disposal Programs

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