Most people likely don’t give much thought to getting rid of unused medications. They are likely thrown in the trash or flushed down the toilet.
Both are problematic. Which is why Maine’s mail-back program for unused drugs was discussed as a possible national solution to the growing problem.
The U.S. Geological Survey sampled water from 139 streams in 30 states (not including Maine) in 1999 and 2000. Eighty percent of the samples were contaminated with personal care products, including prescription drugs.
Aside from environmental concerns, unused drugs clutter medicine chests, sometimes leading to confusion and accidental overdoses. They can also be a target for thieves looking for prescription drugs.
Nearly one in five of Maine’s high school seniors say they have abused prescription drugs, drugs that were found in the medicine cabinets, dresser drawers and trash cans of their parents or grandparents, Sen. Susan Collins told her colleagues on the Senate Special Committee on Aging. The committee recently held a hearing on prescription drug disposal.
Sen. Collins has co-sponsored a bill to remove federal barriers to the collection and disposal of prescription medications. It is supported by 36 state attorneys general.
In addition to considering a disposal system, the senators wisely also talked about ways to limit drug waste before prescriptions are filled. This makes a lot of sense.
In 2004, the Maine Legislature passed a bill creating an unused pharmaceuticals disposal program. In 2007, the University of Maine’s Center on Aging received a $150,000 grant from the U.S. Environmental Protection Agency for a prescription drug mail-back pilot program. Prepaid mailers were made available to the public through pharmacies and medical clinics. Unused drugs were to be put into the mailers, which went to the Maine Drug Enforcement Agency where pharmacists tabulated what types of drugs are being discarded. The drugs were then sent to a hazardous waste incinerator.
As part of this work, the Center on Aging found that the top reason prescription drugs are thrown away is that a doctor told the patient to stop taking the medication. Nearly 12 percent of those surveyed said they disposed of medication due to a negative or allergic reaction. Based on this information, physicians could be encouraged to prescribe smaller amounts until they are certain a given drug is right for that patient.
The project collected more than 2,000 pounds of drugs, including 250 pounds of controlled substances, including painkillers and stimulants. Eighty-three percent of participants said they would have either thrown their unused medication in the trash or flushed it down the toilet in the absence of the mail-back program.
The cost of the mail-back envelopes was reduced to $7.50 by the end of the study period.
Getting unused drugs out of homes, or ensuring they don’t end up there in the first place, will improve patient safety and the environment. Maine has developed a promising way to do this.