Each day, Mainers manage and control several health conditions and diseases with over-the-counter and prescription medicines to keep themselves and their families happy, healthy and active. So, what should we do when medications expire or are no longer needed or wanted? We should dispose of them to reduce the risk that they fall into the wrong hands, such as young children or even criminals who seek to misuse or abuse them. But we need to do it properly.
The Maine Legislature appears to understand the problem, but some lawmakers are pushing the wrong solution by proposing an expensive, inefficient statewide “drug take-back” mandate in bill LD 1460. They don’t seem to recognize that a successful drug take-back system already exists in Maine.
Consumers all over Maine — from Aroostook to York counties and everywhere in between — already have numerous options for disposing of expired, unused or unwanted medicines. A voluntary network of 192 police and fire stations, sheriffs’ offices, chain and independent pharmacies, and waste management services and facilities is already in place.
On Saturday, April 27 — National Prescription Drug Take-Back Day — people across the state can easily and conveniently dispose of their medications at one of these places. And, according to the Maine Department of Environmental Protection, 59 of these sites are permanent and will take-back medications all year long. Plus, retailers, including CVS, Rite-Aid, Walgreens and Walmart, have pledged to increase the number and kind of medication disposal options, including more drop-off kiosks, mail-back programs, special in-home disposal packs, medicine deactivation solutions and more.
The World Health Organization says the vast majority — around 90 percent — of trace pharmaceuticals that appear in groundwater get there due to human use and excretion, not because of improper disposal. Unfortunately, LD 1460 would mandate a program that encourages individuals to drive to designated take-back centers where another vehicle (a reverse distribution truck) would drive to all the collection points gathering the accumulated medications, and then ship them even further across state lines for incineration in another state. Altogether, the fuel consumption, vehicle emissions, fly ash air pollution, bottom ash and slag from incineration could cumulatively create a much greater carbon footprint overall.
Drug abuse prevention is often cited as justification for take-back proposals such as LD 1460, but no research exists that shows a significant reduction in drug abuse due to these types of mandates. Canada has mandatory drug take-back program, but opioid poisonings caused an average of 16 hospitalizations per day from 2016 to 2017 — a 19 percent increase from the daily hospitalization rate from 2014 to 2015. And over the last 10 years opioid related hospitalizations in Canada have increased 53 percent. Mandatory drug take-back has done little to limit diversion of medicines in Canada or elsewhere.
These types of programs have failed to fulfill their promises, in part because of all the complexities. Participants in these collection programs must meet rigorous safety standards established by the U.S. Drug Enforcement Administration, transportation guidelines per the U.S. Department of Transportation, incineration protocols established by the U.S. Environmental Protection Agency and more. These complications are not addressed in LD 1460. Meanwhile, LD 1460 would place the responsibility for cost of disposal entirely on manufacturers, which could drive up the costs of drugs making access to medicines even more difficult for Mainers who can least afford it.
The over-the-counter medicine industry is committed to continuing our work educating consumers in Maine about the proper use, storage and disposal of medicines. But rather than creating a new, costly and inefficient government-mandated drug take-back program, Maine should instead focus on increasing consumer participation in the vast medication disposal network that already exists.
Carlos Gutierrez is vice president for state and local government affairs for the Consumer Healthcare Products Association.