2/24/10

Pharmacists help “flush away” improper medication disposal

By now many people know that flushing medication down the toilet is harmful to the environment. However, Illinois-Indiana Sea Grant (IISG) is trying to reduce the potential for improper disposal before drugs reach the medicine cabinet.

IISG, in conjunction with the Indiana Department of Environmental Management (IDEM), introduced pharmacists and hospital workers to the discussion at a recent workshop — Collection of Unwanted Medicines in Indiana. According to Elizabeth Hinchey Malloy, IISG Great Lakes ecosystem extension specialist, past workshops featured primarily waste managers, who “deal with the problems created by improper medication disposal.” She said that including pharmacists and hospital workers in the process will help prevent unsafe disposal earlier on.

“We’re trying to reach the frontline of the problem,” said IISG Coastal Sediment Specialist Susan Boehme, who worked alongside Hinchey Malloy at the workshop. “Pharmacists and hospitals are the ones actually handing medicine out, and they want to know how they can help.”

Recent estimates report that up to 40 percent of prescription medication is never used by the patient. Furthermore, according to a survey published in 1996 in Veterinary & Human Toxicology, only five percent of pharmacies had “regular recommendations” for customer medicine disposal.

"Dispensing of unnecessary quantities of medications can be a problem,” said Steve Cummings, director of pharmacy services at Marsh Drugs and a workshop attendee. “Patients should ask their doctor or pharmacist if a small starter quantity is available if the medication is new and the potential for side effects is real. If the therapy doesn't work out, dollars have been saved by the patient, and unused, unwanted medication has been eliminated from the home.”

Although education is a major component of preventing unnecessary medication disposal, the goal of the workshop was to move beyond awareness-building. “Our audience knew the issues,” said Hinchey Malloy. “They were there because they wanted solutions.” Among the 117 attendees, the workshop featured solid waste managers, wastewater treatment managers, pharmacists, hospice nurses and administrators, recycling educators, community leaders, law enforcement agents, and even a research student.

According to Hinchey Malloy, the workshop provided a forum for the many different players to address questions, such as what can and cannot be dropped off in collection programs, how to get funding, and what the laws are on medication disposal. The workshop also featured several speakers, who have run or are running successful medication collection programs.

Every participant received an IISG toolkit, Disposal of Unwanted Medicines: A Resource for Action in Your Community, which contains the necessary information for a community to start up a collection program. This includes case studies, outreach material, literature on the subject, legislation, and information on international donation.

IISG’s follow-up efforts primarily consist of offering information and resources when needed. For instance, IISG plans to purchase the first two drop boxes for a state-wide effort, led by the Indiana Prosecutor’s Office, to collect unused medication at police stations in Indiana. Police station collections allow people to drop off controlled substances, which would otherwise involve complex legal issues.

Some pharmacies are also providing drop off sites. Next month—March 13 and 14—Marsh Pharmacies will be holding a statewide medication collection at their 41 locations.

Boehme pointed to the recent creation of the Indiana Medication Disposal Task Force, which consists of members of various fields connected to medication disposal, as an important response to the workshop. The purpose of the task force is to get representatives from all sides of the issue to work together to find answers to the problem.

“I think the task force is a really key piece to the solution,” Boehme said. “Anytime IDEM gets new programs off the ground on this issue, they have a panel of experts ready to help them.”

The workshop was also sponsored by the Indiana Board of Pharmacy, the Indiana Pharmacists Alliance, the Indiana Household Hazardous Waste Task Force, and Eli Lilly.

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