[Pharmwaste] HI take-back update

Wed Mar 7 12:22:33 EST 2018

The way our Board statutes read is that any pharmacy that wants to collect, has to do so in compliance with DEA regulations. It wasn't a long addition to the existing statutes because it requires pharmacies to comply with all of the DEA regulations, as well as disposal regulations. I've seen long versions that paste in the DEA language vs referring to the CFR, which requires a change in statute if DEA ever changes their rules. Referencing regulations managed by another entity is always a good practice. We had a few pharmacies that collected only non-CS pharms prior to the DEA regulations, and we have confirmed that they are now DEA compliant. If they were not, we were going to tell them they needed to become DEA compliant and accept CS or shut down. Because, correct, you can't effectively police the box without considerable pharmacy staff time and they are not interested in doing that work anyway.

HI must not have an opioid/CS problem? Opioids are also the leading cause of poisoning in homes as noted in the article Ed sent on Monday.

From: Pharmwaste [mailto:pharmwaste-bounces at lists.dep.state.fl.us] On Behalf Of Ed Gottlieb
Sent: Wednesday, March 07, 2018 10:54 AM
To: pharmwaste at lists.dep.state.fl.us
Subject: [Pharmwaste] HI take-back update

You may recall a post on 2/15 regarding a HI take-back bill.

The good news update, passed on from a colleague in HI,  is that the House version (HB 2125) is dead.

The Senate version is still active SB 2339.  They, and I, don't know what this means for the chances of it moving forward.  This is the bill, in it's entirety:

Authorizes pharmacies to accept for disposal the return of any unused, remaining, or expired prescription drugs, excluding opioids, that the pharmacy previously dispensed, via collection receptacles or mail-back programs.
Again, here is my testimony (sadly missing positive feedback for wanting to address the issue) submitted to the Senate committee considering the bill:
U.S. Drug Enforcement Administration (DEA) rules forbid pharmacy staff from touching previously dispensed medications when assisting a person who has come to drop-off unwanted medications. Staff can look at what a person has, and let them know what can and can't be deposited in a take-back kiosk. In existing pharmacy take-back programs, a pharmacist rarely interacts with a person doing drop-off. It typically happens only if that person has a question regarding if particular item can be deposited.
With SB2339:
1. Every person doing drop-off would need to wait for pharmacy staff to be free to review their items. They would have to dump what they have on a counter, or otherwise display, their unwanted medications for staff to identify, without touching any of it, which came from that pharmacy. Sometimes shopping bags full of unwanted medications are brought in. It would take an inordinate amount of time, for both the customer and staff, to review the medications that arrive.
2. To insure that review happens, the kiosk would have to be put behind the counter, where space is at a premium.
3. There is no way to know if what is in a bottle is actually the unwanted portion of what was dispensed in that bottle.
4. What should done when a person says a zip-lock bag full of pills came from that pharmacy?
Please consider introducing take-back legislation that provides free, convenient take-back opportunities for both prescription and over-the-counter medications (both human and veterinary) for all residents and, which is paid for by the manufacturers of these drugs.  For a take-back program to be a success, a robust outreach program is necessary.  For a model, refer to the most recent pharmaceutical take-back, extended producer responsibility laws past or pending in this country.  The Washington State bill, that recently passed their Assembly, is a particularly good model for your consideration.
As a first step, HI needs to change its rules to allow the DEA rule, permitting authorized collection, to proceed.  Almost every other state now permits pharmacies to register with the DEA and do take-back.
Regards,
Ed Gottlieb
Chair, Coalition for Safe Medication Disposal
Board Member, New York Product Stewardship Council
Member, National Association of Clean Water Agencies Pretreatment & Pollution Prevention Committee
Member, Product Stewardship Institute Pharmaceuticals' Policy & Coordination Work Group
Member, New York Water Environment Association Government Affairs Committee
Member, Tompkins County Water Resources Council
Industrial Pretreatment Coordinator
Ithaca Area Wastewater Treatment Facility
525 3rd Street
Ithaca, NY  14850
(607) 273-8381<tel:(607)%20273-8381>
fax: (607) 273-8433<tel:(607)%20273-8433>

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