Thought Leadership

Make home disposal of leftover medications as common as seat belts

If a drug disposal method was automatically included with prescriptions, retail pharmacies could help reduce opioid diversion and childhood poisonings.

By William Simpson

The first patented seat belt was created in 1885 in order to keep tourists safe in taxis in New York City. Four decades later, physicians began testing lap belts and realized their positive safety benefits for drivers and passengers involved in vehicular accidents.

Fast forward another 50 years to the 1980s, and you might remember an effective advertising and education campaign that introduced anthropomorphic crash-test dummies to testify to the benefits of wearing seat belts. The campaign was certainly “viral” for that time.

And after enough evidence mounted as to the efficacy of seat belts in saving lives, state governments eventually mandated their use. Today, we are constantly reminded to “Buckle Up, It’s the Law” and “Click it or Ticket.”

I believe there is a similar need today for a safety measure and campaign to protect us from the dangers of leftover drugs.

There is no disputing the fact that we are battling a public health crisis in all 50 states with the opioid epidemic which took the lives of almost 50,000 of our fellow U.S. citizens in 2017.

And while drug abuse and addiction have no easy answers, we do know that leftover prescriptions lurking in medicine cabinets can be tempting to those who are struggling with addiction and can be the start of abuse for others.

In fact, research shows that 70 percent of people with an opioid use disorder have taken others’ medications, and 80 percent of people who use heroin had initially misused prescription opioids before transitioning to their current substance.

Forbes recently released a story that cites statistics from two studies (The Journal of the American Academy of Child & Adolescent Psychiatry and JAMA Internal Medicine) showing that nearly 11% of high school seniors reported misusing a prescription medication and half of those admitted to getting the drugs from family members, friends and other sources that could be traced back to prescriptions in the home. And, about 30% of adolescents took leftover medications remaining in medicine cabinets. Most alarming is that 70% of adolescents who got prescription drugs had a substance use disorder within the previous year.

Another health hazard posed by leftover medications is childhood poisonings. More than 60,000 children under age five are taken to emergency departments annually as a result of ingesting unsecured medication, and more than 9,000 children every year are hospitalized due to these poisonings. In fact, child fatal drug poisonings have increased by 10 percent since 2000.

Existing disposal methods can cause pollution and are inconvenient
Most of us have been told to dispose of drugs by flushing them down the toilet or drain when they are no longer needed; however, this practice can carry serious environmental risks that can profoundly and permanently affect the ecosystem and our drinking water.

For example, a recent study of 50 wastewater treatment plants found 56 drugs in post-treated water, including oxycodone, high blood pressure medications and over-the-counter drugs. Another analysis of 25 drinking-water treatment plants found traces of carbamazepine, bupropion, cotinine, metoprolol and lithium persisted in the water after the rigorous filtering and cleaning process that occurs at the facilities. Further, 87% of water samples studied by the U.S. Geological Survey (USGS) contained measurable amounts of 25 medications.

As dissolved drugs build up over time, they pose a significant risk to the environment and the ecosystem. For example, accumulated antibiotics in the water can result in antibiotic resistance that may render the medications ineffective in treating infectious diseases in the near future.

Other disposal options include drop boxes or kiosks at retail pharmacies and events such as the Drug Enforcement Agency’s (DEA’s) biannual National Prescription Drug Take-Back Days. These methods are successful and have removed more than 5,900 tons of medications from homes over the past decade. Yet, scientific studies have shown that take-back days account for only of scheduled drugs (e.g., opioids) that are dispensed, while the majority of the collected weight reported by the DEA is from prescription containers, not the pills, tablets or capsules.

Programs such as take-back days also risk drugs being diverted into the community, because consumers have stored drugs remaining in the home while they wait for the special days to occur.

Overdoses, poisonings and deaths are not a twice-per-year problem but rather a tragic everyday occurrence that should be addressed by the dispensing pharmacist at the prescription counter.

A simple and convenient option
Imagine if seat belts took several minutes to put on and fasten. If this were the case, far fewer drivers would bother securing themselves in their vehicles, and the number of vehicle-accident injuries and fatalities could skyrocket. Even when our personal safety is at stake, convenience often trumps compliance. That’s why disposing of drugs at home should not be a time-consuming, complicated or inconvenient process.

A quick, safe, at-home medication disposal option is available and now being offered in nearly 50 percent of U.S. pharmacies.

The solution—DisposeRx—involves an eco-friendly drug-disposal powder that when added to a prescription vial and warm water forms a thick gel that physically and chemically captures the drugs.

DisposeRx is distributed and sold in many different ways and via multiple channels. However, we believe it is most effective when presented with a prescription by a pharmacist. Education and consultation are critical, and the trusted pharmacist is the perfect person to provide guidance to patients about the dangers of leftover medications and to encourage patients to act when it is convenient, such as when they open their medicine cabinet and see the leftover or expired drugs.

Creating a lifesaving, eco-friendly habit
Just as seat belts evolved from a strange new concept to commonplace in cars, airplanes, buses and virtually all forms of transportation, we are at a point where a disposal method for leftover medications at home must evolve and be made available with all dispensed medications. The time has come for patients to become just as accustomed to disposing of their unnecessary medications as they are clicking their seat belts when they get in a car.

By offering a quick, effective and eco-friendly disposal solution, pharmacists can play a critical role in fighting the nation’s opioid epidemic, while protecting children from accidental poisonings and preventing environmental pollution. Over time, behavior will change and lives will be saved as at-home drug disposal becomes a habit.

About the author:
William Simpson is president of DisposeRx, a drug disposal company committed to eradicating the misuse of leftover medications through its innovative technology.

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