Medication Disposal Kelli France, Pharm D Candidate Kim Burns, Professor LECOM School of Pharmacy
Objectives 1. Discuss the importance of proper medication disposal 2. Describe the impact of improper medication disposal 3. Examine current options for proper medication disposal 4. List current resources for medication disposal
Medication Accumulation • Unused medications left in the home leads to medication accumulation • Causes of medication accumulation: • Non-adherence • Changes in prescription regimen • Due to side effects, ineffectiveness • Expiration of medication What is the best way to get rid of medications you no longer need?
Importance of Proper Medication Disposal Environmental Accumulation of Medications Drug Poisonings Diversion
Environmental 1,2 • When medications are disposed of in sewers or trash, they can enter the environment • Can also enter by being excreted by people/animals • Drugs have been detected in water and soil • Including OTC pain relievers (e.g. Tylenol, ibuprofen), antibiotics, anti-seizure medications, and anxiety medications • While very small amounts are being detected, there are still concerns • We don’t know what the safe amount of medications in drinking water is • We also don’t know what kind of impact this has on the environment • E.g. traces of medications found in fish
Accidental Poisoning 3,4 • A concern if medications are left in the home or thrown in the garbage • Risk especially pertains to children/pets in the home • According to the CDC, every day more than 300 children are sent to the hospital due to poisoning • Of calls made to the poison control center for children, about ½ pertained to medications • The amount of children who overdose on medications is increasing over time • Yale School of Medicine reported that the amount of kids who went to ER for drug overdose has doubled from 1997 – 2012
Drug Diversion 5 • Drug diversion: when pharmaceutical drugs are used by an individual for whom the drug was not prescribed • Medications (especially opioids) can be taken from homes, garbage, etc. • Drugs may be diverted to family members or friends • Opioid epidemic: amount of deaths due to overdose of opioids has been rising drastically throughout the country Source: CDC Opioid Overdose Basics, Understanding the Epidemic
National Ov Over erdose De se Deaths Number of Deaths from All Drugs Total Female Male 60,000 50,000 40,000 30,000 20,000 10,000 0 Source: National Center for Health Statistics, CDC Wonder
National Ov Over erdose De se Deaths Number of Deaths from Opioid Drugs Total Female Male 35,000 30,000 25,000 20,000 15,000 10,000 5,000 0 Source: National Center for Health Statistics, CDC Wonder
Some PA Stats
Some PA Stats Source: 2015 PA Coroner’s Report
Current Options for Medication Disposal • Keep drugs in the house • NOT RECOMMENDED (safety concerns) • Throw away into garbage/flush down toilet • NOT RECOMMENDED (environmental/safety concerns) • Medication return units (MRU) Preferred • Drug take back events • FDA/DEA recommended home disposal • Only if no other options • Medication deactivation pouches
Medication Return Units (MRUs) • Safe way to dispose of your medications and ensure they don’t harm the environment or get into the wrong hands • Many located throughout Erie • 12 distributed at various Erie area law enforcement agencies • Can place any unused meds in box, where they will later be safely incinerated
Current Locations of MRUs • Albion Police Department • Location: 26 Smock Ave, Albion, PA 16401 • Hours available: Monday – Friday, 9 AM – 4:30 PM • Corry City Police Department • Location: 20 East South St, Corry, PA 16407 • Hours available: 7:30 AM – 3:30 PM • Edinboro Police Department • Location: 124 Meadville St, Edinboro, PA 16412 • Hours available: 24/7 (may need to use call button during non-business hours)
Current Locations of MRUs • Edinboro University Police Department • Location: 911 Scotland Rd, Edinboro, PA 16412 • Hours available: 24/7 • Erie County Courthouse Lobby • Location: 140 West 6 th St, Erie, PA 16501 • Hours available: Monday – Friday, 8 AM – 4:30 PM • Girard Borough Police Department • Location: 34 Main St West, Girard, PA 16417 • Hours available: 8 AM – 4 PM (may call police department after hours to have an officer come and get the medications)
Current Locations of MRUs • Lake City Police Department • Location: 2352 Main St, Lake City, PA 16423 • Hours available: 8:30 AM – 5 PM • Lawrence Park Police Department • Location: 4230 Iroquois Ave, Erie, PA 16511 • Hours available: 24/7 (may need to use their phone if non-business hours) • Mercyhurst University Main Campus Police Department • Location: 501 East 38 th St, Erie, PA 16546 • Box located in Police and Safety, which is at lower McAuley hall • Hours available: 24/7
Current Locations of MRUs • Mercyhurst University North East Police Department • Location: 16 West Division St, North East, PA 16428 • Hours available: 24/7 • North East Police Department • Location: 58 East Main St, North East, PA 16428 • Hours available: 24/7 • Wesleyville Police Department • Location: 3421 Buffalo Rd, Erie, PA 16510 • Hours available: 9 AM – 4 PM • Pennsylvania State Police Department • Location: 4320 Iroquois Ave, Erie, PA 16511 • Hours available: 24/7
Resource: DEA list of registered collectors *does not show law enforcement agencies https://apps.deadiversion.usdoj.gov/pubdispsearch/spring/main?execution=e2s1
Medication Collection Events • DEA holds two national medication take back events each year • Next event: October 28, 2017 • Information on collection sites will be available on DEA website on October 1, 2017 • Occasional community take back events also take place
FDA/DEA Recommendations • Only recommended if you cannot dispose of your medications at a drop off box or take back event • Source: FDA: how to dispose of unused medications • https://www.fda.gov/ForCo nsumers/ConsumerUpdate s/ucm101653.htm
Medication Deactivation Pouches • Located at several pharmacies through out Erie • List: https://www.attorneygener al.gov/drug_deactivation/ • Currently, free bags made available to customers to safely dispose of their medications
Resources for Drug Disposal • Erie county department of health MRU info and locations: https://www.eriecountypa.gov/media/557928/med- return-flyer-_1.pdf • DEA drug disposal information: https://www.deadiversion.usdoj.gov/drug_disposal/ • FDA disposal of medications: https://www.fda.gov/drugs/resourcesforyou/consumers /buyingusingmedicinesafely/ensuringsafeuseofmedicine/ safedisposalofmedicines/ucm186187.htm • EPA PDF of drug disposal recommendations: https://www.epa.gov/sites/production/files/2015- 06/documents/how-to-dispose-medicines.pdf
Conclusion • Throwing away and/or leaving medications in the home can cause various public health concerns • Environmental • Accidental poisoning • Drug diversion • Proper medication disposal is an important public health initiative • Erie county has several locations available for people to drop off unwanted or expired medications
References 1. Pharmaceutical Waste: Pharmaceuticals in the Environment. Department of Ecology, State of Washington. http://www.ecy.wa.gov/programs/hwtr/pharmaceuticals/pages /pie.html. Accessed August 17, 2017. 2. Nikolaou A, Meric S, Fatta D. Occurrence patterns of pharmaceuticals in water and wastewater environments. Analytical and Bioanalytical Chemistry . 2007; 387(4): 1225 – 1234. 3. Protect the Ones You Love: Child Injuries are Preventable. Centers for Disease Control and Prevention Web site. https://www.cdc.gov/safechild/Poisoning/index.html. Updated April 28, 2016. Accessed August 17, 2017. 4. Fox M. More Children Sick, Dying From Opioid Overdoses: Report. NBC Health News. http://www.nbcnews.com/health/health-news/more-children- sick-dying-opioid-overdoses-report-n675731. Accessed August 17, 2017. 5. Opioid Overdose: Understanding the Epidemic. Centers for Disease Control and Prevention Web site. https://www.cdc.gov/drugoverdose/epidemic/index.html. Updated December 16, 2016. Accessed August 17, 2017.
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