[Pharmwaste] Municipalities seek ways to help people dispose of medications - article

[Tenace, Laurie]

Municipalities seek ways to help people dispose of medications

http://www.redding.com/news/2010/apr/22/rx-roundup/

More Americans are faced with a growing problem: what to do with expired, unused or unwanted medications.

The common practice of tossing pills in the trash or flushing them down the toilet has led to an increase in drinking water contaminated by prescription drugs of all kinds, including mood stabilizers, hormones and antibiotics. An Associated Press investigation in 2008 found that 51 million Americans' drinking water was affected.

There's also the problem of children and others finding the tossed pills and ingesting them. 

Adding the problem is an increase in drug use and purchases. Big-box stores offer large quantities of over-the-counter medications and an aging population turns to medication to cope with chronic conditions and other illnesses. One activist organization estimates that as many as 40 percent of all prescriptions are tossed. 

What can patients do?

So how can patients and their families safely dispose of pills?

There are a variety of methods people can take. Some cities, including Redding, offer take-back events during the year in which people can drop off their medications. Mail-back programs to drug manufacturers are also available. And there are some products available that make medications water-insoluble so they can be discarded without endangering groundwater.

However, pharmaceuticals can end up in wastewater another way - through the act of taking them.

Our bodies absorb a lot of the medications we take. But, said Marcia Ames, industrial waste supervisor for the city of Redding, not everything is metabolized, so they go through our systems and get flushed, winding up in our wastewater. 

Redding's wastewater, while thoroughly treated, isn't screened for pharmaceuticals, Ames said. Screening means identifying a substance, not removing it.

Adequately screening for drugs, Ames said, would require millions of dollars of equipment.

And removing those elements would be even more costly. There are different methods to remove specific chemicals from wastewater, said Nancy Cameron, laboratory director at Redding's Stillwater Wastewater Treatment Facility. But, she added, since there's such a wide spectrum of medications, pinpointing each drug isn't easy. 

"You have to know a specific drug to look for to detect it easily," she said. 

Too many pills

Two trends help contribute to this growing problem: Big-box stores selling high quantities of painkillers and other over-the-counter medication; and people filling 60-day to 90-day prescriptions before they know whether the medication will work for them. 


And the problem is expected to grow as people live longer and develop chronic conditions, said Dr. Julie Becker, director for Pharmaceutical Waste for Healthcare without Harm, an international coalition of more than 470 organizations in 52 countries.

Here are steps consumers can take to reduce the amount of waste.

n Only purchase over-the-counter drugs and pharmaceutical drugs in quantities you know you'll use.

"Just because the doctor writes a prescription and your insurance will pay for 30 days of painkillers you haven't even tried yet, you have the choice to say you only want three pills until you know how you'll react well with it and know you'll use the whole 30 days," said Heidi Sanborn, executive director of the California Product Stewardship Council, a nonprofit organization that encourages companies to offer programs to take back its products and assume recycling costs to keep them out of the waste stream.

n Ask manufacturers to design their products to create less waste.

"It's a consumer driven economy," Sanborn said. If enough consumers demand less wasteful packaging, manufacturers will take notice.

Counties take action

Some action has been taken to encourage drug companies to take back unwanted medications. In July 2009, the National Association of Counties unanimously adopted a resolution encouraging the pharmaceutical industry to pay for taking back unused prescriptions and over-the-counter drugs, without government funding. Manufacturers would absorb costs for collection, transportation and hazardous waste disposal.

Maine, Minnesota and Washington state currently have pending legislation to create mandatory take-back programs. Maine's program would be modeled after a program in British Columbia, Canada, which has seen pharmaceutical collections increase from almost 51,000 pounds in 2007 to more than 76,000 pounds in 2008.

The British Columbia program had an additional result: it gave drug companies incentives to reduce packaging. Drug laboratories implemented 144 prevention measures affecting 26.6 million packages that reduced their weight and volume while ensuring that packaging materials were environmentally friendly.

California is working on drafting producer responsibility legislation that would include pharmaceutical take-backs. But it's a steep climb, Sanborn said.

"Manufacturers ... said they'd leave California if it passed," Sanborn said.

Who's paying now

Currently, the cost of pharmaceutical disposal is dumped on solid waste facilities. In Redding, medications received in the take-back events are ground up and incinerated by a third-party company. Each take-back event costs the city about $3,000 in disposal costs.

Pharmacies have options consumers don't. Many contract with manufacturers who will take back expired and unused prescriptions. And some drug companies have mail-back programs for some of their harsher drugs, said Cameron at Redding's Stillwater Wastewater Treatment Facility.

Sanborn says it's up to consumers to drive a solution. 

She suggests asking your pharmacist or local government how to safely dispose of the drugs. If you don't get a useful response, write a letter to the drug's manufacturer or from where you purchased the medication. 

"Tell them you're a consumer, that you're concerned about order quality and about safe drug disposal," she said, "and that as a consumer service, I need a safe place I can return them (and) I want you to do it."


Laurie Tenace
Environmental Specialist
Waste Reduction Section
Florida Department of Environmental Protection
2600 Blair Stone Rd., MS 4555
Tallahassee FL 32399-2400
P: 850.245.8759
F: 850.245.8811
Laurie.Tenace at dep.state.fl.us  

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