While prescription drug disposal programs are growing and are popular with the public, government policies concerning the handling of these products are still a significant barrier to more successful disposal efforts, a dilemma examined by a Senate committee hearing this week.
In convening the hearing, U.S. Senate Aging Committee Chairman Herb Kohl (D-Wisc.) lamented the contradicting federal disposal guidelines for consumers from federal agencies like the Drug Enforcement Administration (DEA), Food and Drug Administration, and Environmental Protection Agency. And he urged the DEA to update its rules to allow easier disposal of controlled substances, such as OxyContin or Vicodin, through takeback programs.
“I will be working with my colleagues to develop a comprehensive package of legislative reforms that reduce waste and ensure safe disposal,” Kohl pledged.
NCPA is working constructively with Senator Kohl’s staff and others to ensure community pharmacists’ views are incorporated. In the weeks leading up to the hearing we told the committee about NCPA’s Dispose My Meds effort. It builds on the Iowa Pharmacy Association’s successful program and now nearly 1,000 local pharmacies are voluntarily helping patients safely get rid of their unused or expired medication, with the exception of controlled substances. Participating pharmacies can be found at www.disposemymeds.org.
The committee’s lead witness, R. Gil Kerlikowske, Dierctor of the White House Office of National Drug Policy Control, summed up the controlled substance challenge:
“If an individual has been prescribed a controlled substance, he or she cannot legally transfer the controlled substance to a pharmacist or to another non-law enforcement person for any reason, even if the person intends to dispose of the drug. Consumers, therefore, often retain unused controlled substances in their homes, which can lead to diversion and abuse of the prescription drug. … Among 12th graders surveyed, 7 of the top 10 drugs abused by youth were prescription drugs, with a majority of the youth surveyed saying that they had obtained the drug from a friend of relative.”
A DEA official said the agency is planning a national takeback day that is currently under internal discussion and about which he couldn’t divulge further details.
Bernie Strain, a Philadelphia father, recounted the tragic loss of his son, putting a human face on the disposal problem and highlighting why prescription drugs shouldn’t be shared in the same way certain over-the-counter products can be:
“Our third son, Timothy Michael Strain was 18 years of age at the time of his untimely and tragic death. Tim was soon to attend College. Early in August 2009, while working to put money away for college he severely burned his hand on a lawn mower, after touching the muffler. He was treated by a doctor and then was seen at Saint Christopher’s Hospital at the Philadelphia burn unit. He was prescribed pain medication and was scheduled for skin grafts. Time went by and while at his girlfriend’s mother’s home, he complained of continuing severe pain in his hand. The mother, who was arrested for this act, gave him medication (methadone) from her own medicine cabinet. The mixture of drugs that were in his system killed our son that night.”
NCPA officials continue to talk to and meet with Congress and others designing such disposal programs. We’ve suggested the following guidelines to policymakers (also featured in an NCPA article published at The Hill.com):
- 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 allowed to operate year-round 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.