BANGOR, Maine — Nationwide, about half of all prescription drugs purchased go to waste when patients die, have an allergic reaction or simply decide they don’t want to take the medication their doctors order.
In Maine, 17 percent of the drugs collected so far through the state’s mail-back program have been controlled substances — prescribed medications such as narcotic painkillers with a potential for abuse and addiction.
“OxyContin is still the No. 1 drug of choice for recreational use in Maine,” said Rodney Larson, dean of the Husson University School of Pharmacy. “This is a safety issue, getting this stuff out of people’s medicine cabinets.” It is also a matter of environmental stewardship and of saving money in the health care system, he said.
On Tuesday, Larson and a number of Husson pharmacy students and faculty were participating in a critical research component of Maine’s Safe Medicine Disposal for ME program — counting and cataloging the discarded medications mailed to the Maine Drug Enforcement Agency.
The program is in its second full year of operations. In 2009, Mainers mailed more than 2,300 pounds of unused medications of all kinds to the Maine DEA headquarters in Westbrook, using padded, postage-paid envelopes available for free from pharmacists.
That’s probably just the tip of the iceberg, said program director Jen Crittenden of the University of Maine Center on Aging.
“We imagine we’ll have three times that much this year,” she said Tuesday during the counting session at Husson, where only a fraction of drugs received by the Maine DEA this year were being cataloged.
A small avalanche of white mailers occupied a corner of the fluorescent-lit room. Students and faculty from the pharmacy school worked at nearby tables, opening the mailers one by one and carefully removing the contents.
Over-the-counter bottles of baby aspirin, brown containers of prescription painkillers, outdated asthma inhalers, preloaded syringes of insulin and epinephrine, zip-lock bags filled with colorful kaleidoscopes of mixed pills and capsules — it all got sorted into big cardboard boxes marked “non-control,” “control,” “inhalers,” “unidentified” and “sharps.”
One out of every 10 envelopes was sent to a special table where gloved students cataloged the contents in detail. First-year pharmacy student Nicole Daskalopoulos of Florida found herself holding a folder of individually packaged Thalidomide capsules, a potent chemotherapeutic agent infamous for its use in the 1950s to prevent miscarriages. That application turned tragic when the drug was found to cause serious birth defects.
Still on the market, unused Thalidomide is supposed to be returned to its manufacturer for safe disposal, said Crittenden, whisking the folder out of the young student’s gloved hands and into a plastic biohazard bag.
Daskalopoulos said she agreed to take part in the drug count in part to help meet a community service requirement for graduation. But Ahmed Abdelmageed, director of experiential education and assistant professor of clinical pharmacology, said participation in the returned drug count provides a valuable learning opportunity for his students.
“There is nothing like a hands-on experience to help them understand the problem of unused medications and the potential for substance abuse,” he said.
Insurance companies often give a price break to consumers who purchase a three-month supply of a medication, he said.
“But if the patient has a problem with the drug 10 days later, you’re left with all this waste,” he said, gesturing around the room.
If not for the mail-in program, said Maine DEA agent Stephan Mazziotti, “all this would have been put out in trash cans, available to anyone who picks up the trash or works in a trash processing facility.” Alternatively, he noted, drugs flushed down the toilet wind up in trace amounts in the natural environment, contaminating water supplies and accumulating in fish and other creatures.
Public funding for Maine’s mail-in drug disposal program will run out in 2011. Supporters hope to piece together enough from private sources, including pharmacies and drug manufacturers, to keep it running.