[Pharmwaste] FW: Washington State Pilot Approaches to Controlled Substances

[Tenace, Laurie]

Post from Will Perry of King County WA



Here in Washington State, the PH:ARM (Pharmaceuticals from Households: 
A Return Mechanism) pilot project is nearing the end of its 2 work to 
develop and demonstrate the feasibility of  drug return system for 
unwanted residential system.   The project is working with a health 
care organization (Group Health Cooperative - 25 collection sites), a 
retail pharmacy chain (Bartell Drugs - 12 collection sites) and 3 
boarding homes.  Detailed info is available at www.medicinereturn.com.  
To date, the pilot has collected and incinerated around 15,000 pounds 
of material.

Regarding controlled substances, the pilot is using two approaches -
At Group Health's clinical pharmacies, a secure collection bin 
(http://www.takebackexpress.com/product_p/dvdc0075.htm) is in the 
waiting area of the pharmacy.  The bin has a large sign that lists the 
materials that are accepted or not accepted by the program - 
"Controlled Substances" are the "Not Accepted" list.  A customer with 
unwanted medications approaches the bin and drops the drug containers 
down the chute.  There is no interaction with the Group Health pharmacy 
staff during this process.  Back at Group Health's warehouse, the 
collected material is screened to cull out items not accepted by the 
incinerator (e. g., mercury thermometers, sharps) - there is no attempt 
to identify or remove controlled substances during the screening.  
Consolidated materials are transported to the incinerator by a reverse 
distributor and the material is burned as a witnessed destruction.  

At the Bartell Drugs retail pharmacies, the collection bins are locked 
until opened by trained pharmacy staff.  This allows "pre-screening" by 
the staff - all controlled substance drugs and other unacceptable 
materials are rejected.  Customers with controlled substances are given 
a hand-out with the "Kitty litter & garbage can" disposal advice 
currently offered by the Office of National Drug Control Policy.  This 
pre-screening protocol has facilitated the disposal of collected 
material through Washington State's hazardous waste disposal blanket 
contract.  The "kitty litter" advice is quite unpopular with the 
rejected customers - a mailer addressed to a law enforcement office is 
one obvious way to get those controlled substances into proper hands 
(like in the Maine program) - our pilot doesn't have such a system.  

As the PH:ARM pilot was developed, the team communicated and worked 
with our local DEA office to develop secure collection bins and 
operating protocols.  A DEA field investigator has visited one of the 
Group Health sites and was satisfied that the set-up and operations 
were secure.  I wouldn't say that the DEA is a partner, but they are 
quite aware of our pilot and its operation, and that office hasn't 
opposed or complained.  Individual DEA employees have expressed an 
understanding of the public health and environmental problems that 
swirl around drug waste, and they've expressed general support for drug 
return programs.  

Our program's also talked to people around the country that have had 
very different experiences with their local DEA officials.   There's 
lots of common ground to explore.  Hope this is helpful & Good Luck - 

Will Perry
Health & Environmental Investigator II
Public Health / Seattle & King County
401 Fifth Ave, Suite 1100
Seattle, WA 98104
206-263-8477   william.perry at kingcounty.gov



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