The solution to the unused drug problem is right at home


By Peter Pitts

A new ordinance in King County will require drug companies to reclaim and dispose of patients' unused prescription medicines. Health officials argue the take-back law will keep these medications out of water supplies and the hands of drug abusers.

In reality, the program will be a costly mistake, raising prescription drug costs for consumers while doing little to clean up the environment or curtail misuse. We already have a much easier – and less expensive – alternative.

Each year, 40 percent of the 3.8 billion prescription drugs sold, go unused. Much of that 200 million-pound total is improperly flushed down the toilet. Some drugs end up in unintended hands. In fact, the Drug Enforcement Administration (DEA) reports that more than 70 percent of people who abuse pain medications got them from friends or relatives.

With the help of the DEA, local governments have begun sponsoring take-back programs. This spring, nearly 6,000 localities collected more than 370 tons of drugs – a full 50 percent increase from last fall's take-back days.

While that collection number seems impressive, it's still just a tiny fraction of the unwanted or expired drugs sitting in medicine cabinets across the country. These take-back programs have clear limitations.

Research into such programs in Wisconsin found they managed to collect just 2 percent of the state's 4.4 million pounds of unused drugs in 2010. The study noted many people are entirely unaware of these programs, miss the collection day, or can't get to the drop off points.

These take-back efforts aren't necessarily a boon to the environment, either. Any traces of drugs found in the water supply usually end up there naturally, passing through the systems of people taking them. And the Environmental Protection Agency confirms these infinitesimal amounts don't pose any risk to humans.

Meanwhile, a study by Carnavale Associates found no evidence that take-back programs affect prescription drug abuse. The study concluded that "scarce prevention resources should fund proven policies, programs, and practices." More research on these programs' effectiveness was needed.

Nevertheless, some local jurisdictions want to double down on take-back programs, at the expense of drug companies. Alameda County in California imposed such a requirement last summer. Now, King County has regrettably followed suit.

The county's Local Hazardous Waste Management Program will soon prove a wasteful mistake. First, the program is expensive. Consumers who buy prescription drugs, and not just those in King County, will end up bearing the brunt of those costs. Second, there is a better, more effective, and completely free way to securely dispose of unused medicines – throwing them away with the regular household trash.

The pharmaceutical industry has developed SMARTx Disposal, a disposal program, to raise public awareness of the proper in-home way to get rid of unused or expired drugs.

The Food and Drug Administration also provides detailed instructions on in-home disposal on its website. Some particularly harmful drugs should indeed be flushed, but for most, the best procedure is to mix medicines with kitty litter or coffee grounds, put them in a sealed bag, and toss the bag in with the regular trash. Because household trash ends up in hermetically sealed landfills, there's no chance of environmental contamination.

Drug take-back programs can play a limited role in safely disposing of unused drugs. But in the end, the best choice is the trash can, and there's always one available at home.


Peter J. Pitts, a former FDA associate commissioner, is president of the Center for Medicine in the Public Interest

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