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    Drug take-back: A call for a permanent solution

    Janet Chang, PharmD Candidate 2017Behind astonishing U.S. pharmaceutical sales that reach $400 billion a year, an alarming 2.8 million pounds of prescription medications go unused. This staggering amount of unused medications raises a public health concern and emphasizes the need for drug take-back.

    All players involved in the drug-product chain — pharmaceutical companies, distributors, pharmacies, and the government — must collaborate to design and implement an effective drug disposal and collection system. Pharmacists, in particular, must be proactive in supporting this movement to protect the health and safety of patients and consumers.

    Human and environmental hazards                                  

    Unused medications are often stored in the home, thrown into the trash, or flushed down the toilet.

    Medications stored in homes are dangerous sources of drug diversion that often results in abuse and accidental poisoning. At least 62% of teens use prescription drugs taken from their parents’ medicine cabinets, thinking that Rx meds are safer than illegal drugs such as cocaine and heroin. Prescription drug misuse has contributed to nearly 600,000 visits to U.S. emergency rooms and account for up to 85% of unintentional poisoning and deaths, many involving children and elderly.

    It is essential to dispose of unused medications. However, the improper disposal of drugs flushed into our waterways threatens the ecosystem. Pharmaceuticals have been detected in streams and drinking water across the country. Most commonly found are acetaminophen, metformin, and carbamazepine, as well as antibiotics, a grave concern in light of growing bacterial resistance. Traces of medications have disrupted the development and reproduction of aquatic organisms; for example, they have had a feminizing effect on male fish and have altered the male-to-female ratio.

    Challenges in today’s system

    Biannual events hosted by the U.S. Drug Enforcement Administration (DEA) have not been able to sustain the ongoing public demand. The situation has become more complex now that the DEA has chosen to stop sponsoring national event and instead is allowing entities such as manufacturers and pharmacies to voluntarily provide mail-back programs and on-site drug collection receptacles (kiosks or bins).

    Janet Chang, PharmD Candidate 2017
    Janet Chang is a 2017 PharmD candidate at Touro University, Vallejo, Calif. Contact her at [email protected]

    3 Comments

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    • kpurdy@------.org
      I'm sorry, but the tone of this article has the usual "America bad...rest of world good" that students have been indoctrinated with in most institutions of higher education for the last 70 years or so. I find it hard to believe that South American countries have an infrastructure that is better in any way than the U.S. The recent Olympics was an example of the lack of an infrastructure that can even take care of its citizen's garbage and pollution. Given that, I doubt that they take care of expired drugs better than we do. My point....when you make statements like this...please back them up with at least ONE reference.
    • Anonymous
      kpurdy, clam down please, Ms. Chang's article is trying to bring awareness to the issues and risks of pharmaceutical waste. It is not meant to denigrate anyone's pride of "American exceptionalism". It is not a scientific paper meant for in the Journal of Pharmaceutical Science or New England Journal of Medicine that require peer reviewed references. Did you reference your statements of "students have been indoctrinated with in most institutions of higher education for the last 70 years or so" or your doubts of other countries have "better infrastructure than the U.S..... they take care of expired drugs better than we do"? I am a pharmacist, recently retired from pharmacy directorship after 40 years. I happen to agree with Ms. Chang call for awareness and solution in dealing with pharmaceutical wastes by all stakeholders (consumers, pharmacy profession, drug manufacturer and law enforcement...etc.
    • margaret.shield@------.com
      Thanks for a good article on an important topic Janet! There's such a need for more convenient medicine drop box locations. I encourage pharmacies and pharmacists to get involved. Secure drug take-back is a critical part of a comprehensive approach to the prescription drug abuse epidemic. It also reduces risk of preventable poisonings in the home, and keeps leftover and expired medicines out of our water supplies. There's more positive news about county pharmaceutical stewardship ordinances. In June 2016, two more counties passed laws similar to those described in the article. Snohomish County WA. And Santa Barbara CA too. There are now 9 counties - 2 in WA and 7 in CA - with pharmaceutical stewardship laws. Under all these county pharmaceutical stewardship laws, pharmaceutical manufacturers finance and coordinate the secure collection and safe disposal system, and promote the program to residents. Pharmacies and pharmacists do their part by partnering with the manufacturers to host a secure drop box, helping to staff the box, and to explain the program to customers. It's a community service that residents really need and appreciate! Also, because of great demand, the DEA resumed coordinating twice-a-year National Prescription Drug Take-Back Events in late 2015. The next event is October 22nd. The DEA medicine events are really needed, but not a long-term solution. Ongoing drop boxes at convenient pharmacies, where residents go to shop regularly, is the solution we’re working towards. Margaret Shield, PhD Community Environmental Health Strategies
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