Post on 23-Dec-2015
Helen Pervanas PharmD, R.Ph.Assistant Professor Pharmacy
PracticeMCPHS-Manchester/Worcester
I have no financial relationships to disclose
List the concerns associated with improper medication disposal
Describe the steps involved in organizing a medication disposal event
Discuss the results of a community based medication collection event
Prescription and Over-the-Counter drug use continues to increaseExceeded $200 billion in the U.S. in 2007*65 and older population projected to
increase from 12.4% in 2000 to 19.6% in 2030
*Sources: IMS Health and US Census Bureau, NERC photo
Flushing medication down the toilet Rinsing down the sink Throwing medication in the trash Stockpiling medications/sharing with
others
Environmental concerns Unintentional ingestion Drug diversion
Active Pharmaceutical Ingredients (API) in surface and groundwater
Detected pharmaceutical agents Estrogen hormones Anti-infectives Anticonvulsants Mood stabilizers
Source: US Geological Survey
Source: CDC
Source: NH Department of Environmental Services, April 2009.
•NH deaths up 350%•Exceeded traffic deaths in NH
Abuse of controlled substances doubled from 7.8 million in 1992 to 15.1 million in 2003
Prescription drugs are the drug of choice for teens; 12 and 13 years of age
Pain medications Ranked 2nd highest abused drug(marijuana
1st)
Source: Washington State Dept of Ecology and D.A.R.E.
Local Health Plan-Anthem BC/BS (400,000 lives), Manchester, NH
Earth Day, April 22, 2009 (9am-1pm)
Research Contact regulatory agencies Review federal and state laws Choose a venue
NH Board of Pharmacy (BOP) NH Drug Enforcement Agency (DEA) NH Department of Environmental
Services (DES)
Law enforcement required for controlled substance collection
Procurement of a temporary Environmental Protection Agency (EPA) identification number
Arrangements for pharmaceutical and hazardous waste disposal
Staffing/Volunteers Purchase supplies Advertising
•Press Release•Senior Centers•Email to employees•Local Newspaper•Public TV
ITEM COST (dollars)
Supplies $200
Giveaways for consumers
$200
Gift cards for volunteers $100
Waste Disposal Fee $50*
Hazardous Waste Disposal
$510
Traffic Control by MPD $250
Total Expenses $1310
* Cost was minimal due to MPD
Police officials Health Plan employees Pharmacists Student Pharmacists
Lap top computer/printer Flash drive Counting trays Drug identification resources Plastic bins/bags Non-latex gloves Face mask Reflective vest Bin for recyclables
Consumers drop off medications in a drive-thru fashion
Greeted by health plan volunteersPatient information distributed on proper
disposalProcedure for drop off
Drive up to entrance where pharmacist inspects medications
Medications transferred to counting area by police official
The White House Office of National Drug Control Policy recommends that you:
Take unused, unneeded or expired prescription drugs out of their original containers and throw them in the trash.
Mix prescription drugs with an undesirable substance, such as used coffee grounds or kitty litter and put them in impermeable, non-descript containers, such as empty cans or sealable bags.
Don’t flush prescription drugs down the toilet unless the label or accompanying patient information specifically instructs doing so.
Take advantage of community pharmaceutical take-back programs that allow the public to bring unused drugs to a central location for proper disposal.
•Greeters welcome consumers•Provide information
•Pharmacist inspects medications•Remove patient information
Pharmacists and student pharmacists collect, sort, count and document
Place medications in collection binsControlled substancesHazardous wasteAll other medications
Total of 41,601 units Weighing ~100 lbs 40 consumers
attendedMedications
Percent Units
Non-Controlled 78% 32,305
Over-the-Counter
18% 7,618
Controlled 3% 1356
Hazardous Material
1% 322
Top controlled substancesAnxiolytics and narcotic pain meds
Top non-controlled substancesPhosphate binders and psychiatric meds
Top OTC substancesVitamins
Top hazardous waste substancesMercaptopurineWarfarin
Name Number (%)Lorazepam 16%Hydrocodone APAP 15%Hydrocodone/Homatropine Syrup 13%Oxycodone/APAP 12%Pregabalin 8%
Name Number (%)Calcium Acetate 10%Risperidone 6%Olanzapine 5%Furosemide 5%Doxazocin 4%
Name Number (%)Multivitamin 11%Calcium + vitamin D 8%Iron products 8%Docusate sodium 8%Sennoside 7%
Early and extensive advertising Hold event on weekend day Explicit information regarding
acceptable medications i.e. original containers
“Relieved to have them out of the house and away from grandchildren”
“Wonderful! Been holding on to medication for over a year”
“Can’t flush, no one wants them” “Great to have this program. Did not
know what to do with them” “Waiting for event to dispose” “Great service to the public” “Delighted this program is being held”