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NPR: http://www.npr.org/blogs/health/2014/09/08/346850612/new-option-for-getting-rid-of-old-drugs-the-pharmacy
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<hr tabindex="-1">
<div id="divRpF588539" style="direction: ltr;"><font face="Tahoma" size="2" color="#000000"><b>From:</b> pharmwaste-bounces@lists.dep.state.fl.us [pharmwaste-bounces@lists.dep.state.fl.us] on behalf of Ed Gottlieb [EGottlieb@cityofithaca.org]<br>
<b>Sent:</b> Tuesday, September 09, 2014 9:32 AM<br>
<b>To:</b> pharmwaste@lists.dep.state.fl.us<br>
<b>Subject:</b> [Pharmwaste] NYT Story on DEA Rule<br>
</font><br>
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<div style="font-family:Times New Roman; color:#000000; font-size:16px">A big improvement over the LA Times.<br>
It does read like an advertizement for Med Return.<br>
<br>
<span style="color:black">Ed Gottlieb<br>
Chair, Coalition for Safe Medication Disposal <br>
Industrial Pretreatment Coordinator <br>
Ithaca Area Wastewater Treatment Facility<br>
525 3<sup>rd</sup> Street<br>
Ithaca, NY 14850<br>
(607) 273-8381<br>
fax: (607) 273-8433</span><br>
<br>
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<div class="WordSection1">
<p class="MsoNormal" style=""><b><font face="Times New Roman" size="5"><span lang="EN" style="font-size:18.0pt; font-family:"Times New Roman","serif"; font-weight:bold"><a href="http://www.nytimes.com/" target="_blank"><font color="blue"><span lang="EN-US" style="color:blue; text-decoration:none"><img id="Picture_x0020_1" src="cid:image001.png@01CFCC0C.F26B35E0" alt="The New York Times" height="26" width="185" border="0"><img id="Picture_x0020_2" src="cid:image001.png@01CFCC0C.F26B35E0" alt="The New York Times" height="27" width="185" border="0"></span></font></a></span></font></b></p>
<p class="MsoNormal" style=""><span class="SpellE"><b><font face="Times New Roman" size="6"><span lang="EN" style="font-size:24.0pt; font-family:"Times New Roman","serif"; font-weight:bold">D.E.A</span></font></b></span><b><font face="Times New Roman" size="6"><span lang="EN" style="font-size:24.0pt; font-family:"Times New Roman","serif"; font-weight:bold">.
to Allow Return of Unused Pills to Pharmacies</span></font></b></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">By
<a href="http://topics.nytimes.com/top/reference/timestopics/people/s/catherine_saint_louis/index.html" title="More Articles by CATHERINE SAINT LOUIS" target="_blank">
<font color="blue"><span style="color:blue">CATHERINE SAINT <span class="SpellE">
LOUIS</span></span></font></a><span class="SpellE">SEPT</span>. 8, 2014 </span></font></p>
<p class="MsoNormal"><font face="Times New Roman" size="3"><span style="font-size:12.0pt; font-family:"Times New Roman","serif""><img id="Picture_x0020_71" src="cid:image002.jpg@01CFCC0C.F26B35E0" alt="http://static01.nyt.com/images/2014/09/09/science/09drug/09drug-master675.jpg" height="450" width="675" border="0"></span></font><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif""></span></font></p>
<p class="MsoNormal"><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">Steel boxes made by MedReturn are being used to get prescribed drugs off the streets. Credit Jessica
<span class="SpellE">Kourkounis</span> for The New York Times </span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">Concerned by rising rates of prescription drug abuse, the Drug Enforcement Administration announced Monday that
it would permit consumers to return unused prescription medications like opioid painkillers to pharmacies.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">The move is intended to help reduce stockpiles of unneeded medicines in homes, which are often pilfered by teenagers.
Under the new regulation, patients and their relatives will also be allowed to mail unused prescription drugs to an authorized collector using packages to be made available at pharmacies and other locations, like libraries and senior centers.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">The new regulation, which will go into effect in a month, covers drugs designated as controlled substances. Those
include opioid painkillers like OxyContin, stimulants like Adderall and depressants like Ativan.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">Until now, these drugs could not legally be returned to pharmacies. The Controlled Substances Act allowed patients
only to dispose of the drugs themselves or to surrender them to law enforcement.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">“This is big news and long overdue,” said Dr. G. Caleb Alexander, co-director of the Center for Drug Safety and
Effectiveness at Johns Hopkins Bloomberg School of Public Health. “It’s baffling that it’s so easy to get a prescription for opioids and yet so difficult to dispose of these drugs safely.”</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">Injuries and deaths from prescription drug abuse, particularly opioids,
<a href="http://www.cdc.gov/HomeandRecreationalSafety/pdf/HHS_Prescription_Drug_Abuse_Report_09.2013.pdf" title="C.D.C. report (PDF)" target="_blank">
<font color="blue"><span style="color:blue">have soared in recent years</span></font></a>.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">More than 70 percent of teenagers say it is easy to get prescription drugs from their parents’ medicine cabinets,
according to a 2014 Partnership for Drug-Free Kids study.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">“The sooner we get those unused medications out of the home and medicine cabinets, the better and safer it is
for everyone,” said Carmen A. <span class="SpellE">Catizone</span>, executive director of the National Association of Boards of Pharmacy.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">Until now, consumers have had limited options for the disposal of controlled substances. Twice annually, citizens
could anonymously return them to police departments during thousands of national
<a href="http://www.deadiversion.usdoj.gov/drug_disposal/takeback/" title="About the events" target="_blank">
<font color="blue"><span style="color:blue">“take back” events organized by the <span class="SpellE">
D.E.A</span>.</span></font></a></span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">In the past four years, these events have removed from circulation 4.1 million pounds of prescription medications.
(The next one is Sept. 27, from 10 a.m. to 2 p.m.)</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">Still, about 3.9 billion prescriptions
<a href="http://kff.org/other/state-indicator/total-retail-rx-drugs/" title="Figures from the foundation" target="_blank">
<font color="blue"><span style="color:blue">were filled at pharmacies alone in 2013</span></font></a>, according to the Kaiser Family Foundation.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">“They only removed an infinitesimal fraction of the reservoir of unused drugs that are out there,” said Dr. Nathaniel
Katz, an assistant professor of anesthesia at Tufts University School of Medicine in Boston who studies opioid abuse. “It’s like trying to eliminate malaria in Africa by killing a dozen mosquitoes.”</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">Dr. Katz is optimistic that the
<span class="SpellE">D.E.A.’s</span> decision could have a powerful impact. Putting drop-off receptacles for controlled substances in pharmacies will mean consumers have year-round access to disposal services.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">It would be a “very positive” development if such access gets consumers in the habit of returning unused drugs
to the pharmacies from which they were obtained, Dr. Katz said.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">“It’s more likely to accomplish the objective of minimizing the reservoir of potentially fatal medications in
our medicine cabinets than can be accomplished by intermittent programs,” he said.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">Flushing controlled substances, especially prescriptions that might kill a child or pet with a single dose, remains
an option for consumers, as is throwing out other prescriptions in zipped plastic bag mixed with cat litter, but both are discouraged because of environmental concerns.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">The Environmental Protection Agency favors disposal through drug take-back programs over flushing to keep medicines
from entering streams and rivers. Yet the Food and Drug Administration recommends flushing unused medications when the potential for harm to someone in the household is great.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">The new programs will be voluntary. Pharmacies may choose to register with the drug agency to take back controlled
substances or to receive leftovers through the mail.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">To minimize the risk that returned drugs might be stolen, the
<span class="SpellE">D.E.A</span>. will require authorized collectors running mail-back programs to have and use an “on-site method of destruction to destroy returned packages.”</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">Organizations collecting unused drugs could be pharmacies, including those within a clinic or a hospital, narcotic
treatment programs or so-called reverse distributors — companies contracted by other collectors to destroy controlled substances. Retail pharmacies or hospitals and clinics with on-site pharmacies may manage collection receptacles at long-term care facilities.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">But some experts warn that there is no guarantee that pharmacies will establish take-back programs or set up
collection receptacles, and that a number of issues must be resolved.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">Police departments often use incinerators, for example, to destroy seized illicit drugs, but a local pharmacy
might not be able to accommodate an incinerator, limiting the number that could accept packages of prescriptions by mail.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">The new rules do not require a particular method of destruction, as long as the drugs are permanently and irreversibly
altered. Reverse distributors must do so within 30 days.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">Whether communities, pharmacies, insurance programs, patients or pharmaceutical companies must pay for disposal
costs also is not addressed in the new rule.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">Mitch
<span class="SpellE">Rothholz</span>, the chief strategy officer of the American Pharmacists Association, which supports the idea of pharmacy take-back programs generally, suggested that the costs of the system should not be “a burden on the pharmacy.”</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">Keeping returned medications secure also poses challenges.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">To get prescribed drugs off the streets, police stations in 49 states have installed roughly 1,500 permanent
steel boxes made by MedReturn, a Wisconsin company.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">Anytime the boxes “are available to the public, they have to be under law enforcement eyes, because they are
gold at the end of the rainbow for someone with an opioid addiction,” said Gary Tennis, secretary of the Department of Drug and Alcohol Programs in Pennsylvania, which has 200 MedReturn boxes and plans to install 100 more.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">In a letter to the
<span class="SpellE">D.E.A</span>. last year, the American Pharmacists Association expressed concern that pharmacies might be held legally liable should a secure drug drop-off receptacle be broken into and its contents stolen. Without more clarification, the
association cautioned, “there may be limited participation by pharmacies.”</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">But the biggest obstacle may be convincing the public that it is irresponsible to hold onto medications that
are no longer needed.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">“With our opioid crisis, the level of overdoses we have and the amount of kids who are stealing these drugs,
to be a good citizen you must get rid of your prescription drugs as soon as you’re finished with them,” Mr. Tennis said.</span></font></p>
<p class="MsoNormal" style=""><font face="Times New Roman" size="3"><span lang="EN" style="font-size:12.0pt; font-family:"Times New Roman","serif"">A version of this article appears in print on September 9, 2014, on page
<span class="SpellE">A19</span> of the New York edition with the headline: <span class="SpellE">
D.E.A</span>. to Allow Return of Unused Pills to Pharmacies.</span></font></p>
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