Green Buckeye RN


EPA Aging Initiative Listserve: Pharmaceuticals in the Environment
June 7, 2010, 1:27 pm
Filed under: News

U of Maine Center on Aging Final Report
Reducing Prescription Drug Misuse Through the Use of a Citizen Mail-Back Program in Maine

The Safe Medicine Disposal for ME program is a statewide model for the disposal of unused household medications using a mail-back return envelope system. Established through state legislation and implemented in 2007 with a grant from the U.S. Environmental Protection Agency’s Aging Initiative, the program is authorized to handle both controlled and non-controlled medications. All drugs collected undergo high-heat incineration, according to the procedure already established for Maine’s law enforcement drug seizures.

The mail-back program, during its first two phases of EPA-funded operation, has disposed of more than 2,300 lbs of drugs, representing 3,926 returned envelopes. A total of 9,400 enveloped were distributed during this period representing a 42% envelope utilization and return rate. There have been eight cataloging events during this period.

Additionally, over 380,000 pills were cataloged via the drug inventory process, 2,777 telephone calls were answered via the program helpline, 250 pounds of controlled drugs have been destroyed, the average weight of a returned envelope was 7 ounces, and the Estimate Average Wholesale Price (AWP) of medicine collected was $572,772.35 (US Dollars).

Approximately 17% of the drugs were schedules II, III, and IV – “controlled drugs.” These included narcotic pain relievers, tranquilizers and sedatives, as well as stimulants.

Most returns were in pill form. Fourteen percent of returns represented liquids, gels, ointments and patches. A negligible amount of medical supplies and devices were returned including unused morphine pumps. Full, unused bottles were sometimes returned, including prescriptions from mail-order pharmacies or VA pharmacy services, as well as anti-retroviral drugs for HIV/AIDS treatment. It was not uncommon to find a mix of returns from both local and mail order pharmacies sometimes where a patient was receiving the same drug from both sources.

Based on surveys and analysis of returned drugs, it is estimated that the percentage of program participants who would have used the trash or toilet to dispose of drugs prior to program implementation = 83% x 2,373 lbs of drugs = 1,970 lbs of drugs that were prevented from entering the water supply and landfills.

Findings from program participant surveys confirm multiple reasons for drug accumulation in their homes, including:

* Medicine belonged to a deceased family member (19.6%) 
* A physician told the patient to stop taking the medication or gave the patient a new prescription (27.3%)
* The person had a negative reaction or allergy to the medicine (11.9%)
* The person felt better or no longer needed the medicine (18%)

Participants had multiple reasons for removing the drugs from their homes, including concerns for the environment, drug compliance, drug safety, as well as preventing drug diversion. Some noted they did not want anyone else to use the medicine. Some were concerned about the potential poisoning dangers to children, or the risk of drug abuse diversion. Often the medicine was expired or outdated and no longer useful. Nearly half (46%) of those surveyed reported that, in the absence of a take back program, they would have flushed drugs down the toilet. Another one third (37%) would have dumped left over prescriptions into their trash. Overwhelmingly, 77% of program survey respondents cited participation because, “it’s best for the environment.”
 
The executive summary can be found at http://www.epa.gov/aging/RX-report-Exe-Sum/index.html
 
The complete report, which is quite large, is available at
http://www.safemeddisposal.com/documents/MailbackProgramReportFINAL.pdf

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