Prescription Drug Take-Back Initiative Catches On

Unused medication collections expand amid addiction and environmental concerns.

Imagine tossing a bottle of leftover medication into the empty bed of a heavy-duty pickup truck.

Now, imagine a mountain of blister packs, pill bottles and boxes piling up to the point where it weighs more than the truck itself. That’s what has accumulated in less than three years’ time at the University of Vermont Health Network’s prescription drug removal bins, where people have safely discarded more than 7,500 pounds of their excess, expired, unsafe and unwanted drugs.

Add that to the tens of thousands of pounds of medication collected at community sites throughout the region, and it seems clear that the message has gotten out: Keeping unused medication at home can be dangerous, and traditional methods of disposal – like flushing – are not good for the environment.

“I believe that having a secure means of disposing of medications answers a need that has been in our communities for decades and is a necessary piece of combating the opioid epidemic,” said Renee Mosier, director of pharmacy at Porter Medical Center.

Disposal Programs Grow Rapidly

The U.S. Drug Enforcement Administration (DEA) has for years coordinated twice-annual, nationwide Take Back Days to collect medication. But widespread, year-round collection programs are a relatively new phenomenon: Statewide programs in Vermont and New York date to 2016 and 2018, respectively, and UVM Health Network’s first bins were installed in 2017.

There are now 85 sites across Vermont and 340 kiosks in New York. UVM Health Network maintains nine collection bins distributed across six affiliate hospitals.

The types of materials accepted for disposal varies by collection site; pills, patches and liquids commonly are accepted, though there are limitations. The blue MedSafe bins used at some UVM Health Network locations allow disposal of pills, patches and liquid containers up to 4 ounces, but no needles or syringes.

Such programs have expanded quickly as officials recognized the link between unused medication and addiction. The 2018 National Survey on Drug Use and Health said the most common source for misused prescription pain relievers is a friend or relative, and federal officials say such drugs often come directly from “the home medicine cabinet.”

In the midst of an opioid epidemic that continues to claim lives, officials and health care providers are pursuing every means possible to staunch the flow of painkillers into the community.

“This is making it possible for our community and our patients to have a safe, secure location to dispose of these things so that they’re not lying around the house where someone can misuse them or abuse them,” said Mike Garvey, regional director of pharmacy services for Champlain Valley Physicians Hospital and Alice Hyde Medical Center.

The push for collection sites is motivated by more than the risk of substance misuse and addiction. Officials are concerned about accidental medication consumption by children and pets, and improper disposal also has negative environmental impacts.

The New York Department of Environmental Conservation warns that “pharmaceuticals have been detected in many waters across New York State.” Collecting unused drugs “will provide the general public a better option of disposing of these medications, rather than flushing,” department officials say.

Secure Disposal Leads to Incineration

The preferred disposal option, officials say, is incineration. All of the drugs collected across Vermont and New York are destined to be burned, although the paths to that end vary.

For example, the MedSafe system at UVM Medical Center’s outpatient pharmacies features a double-locked bin and an inner liner that hospital staff can quickly seal and ship away for destruction. It’s a low-maintenance setup, and it’s a “really good, patient-centered service to provide” for patients, said Mark DiParlo, director of pharmacy services.

“It’s safe and it’s anonymous, so that people don’t have to worry,” DiParlo said. “We don’t see what they bring in; they don’t have to answer questions about it.”

Similarly, New York State has a contract with Covanta Environmental Solutions. Filled bags of medication are “shipped to Covanta’s waste-to-energy facility, where they are incinerated and produce electricity,” officials said.

And in Vermont, another type of collection system involves the help of the Lamoille County Sheriff’s Office, which has a contract to gather unused medications deposited at law enforcement sites around the state. Those drugs are given to the DEA for incineration.

Regardless of the collection method, a common thread among medication drop-off sites is security. “It’s always a concern – it’s always something we’re cautions about,” said Alex Homkey, substance abuse program manager for drug disposal at the Vermont Health Department.

“They are bolted to the ground – in many cases they have cameras on them,” Homkey said. “They’re locked. They’re not in a place that isn’t visible or isn’t secure.”

Drug Collection by the Numbers

Vermont Department of Health also introduced free mail-back envelopes for unused medication in 2018. The 8×11-inch envelopes are available at a variety of community locations as well as online, and they can hold up to 8 ounces of medication either in original containers or in sealed bags. So far, officials say there have been 4,278 envelopes returned.

Other key medication-disposal statistics from around Vermont and New York, measured by weight:

• 5,589 pounds collected from Vermont-funded drug-disposal kiosks at pharmacies and hospitals.
• 17,835 pounds collected from law enforcement sites in Vermont.
• 39,809 pounds of medication incinerated in New York State’s collection program.
• 882,919 pounds collected nationally on the DEA’s latest Take Back Day, held Oct. 26. There were 23,687 pounds collected in New York State and 6,734 pounds collected in Vermont.
• 12.7 million pounds collected nationally over the course of all 18 DEA Take Back Days. New York has accounted for 681,613 pounds, while Vermont’s total is 71,062.

Across UVM Health Network, the latest tallies show there has been 7,537 pounds of medication collected and destroyed. The most-used receptacles are at University of Vermont Medical Center and Champlain Valley Physicians Hospital.

More disposal options expected

Even as collections grow, officials can’t hazard a guess as to how much unused medication still is sitting in medicine cabinets and other unsecured areas.

So there are plans to expand collection networks to meet future demand. New York State officials say they plan to create 110 new disposal locations, and Vermont officials also see potential for growth.

“We’re continuing to see if other eligible pharmacies, hospitals or long-term care facilities are interested in drug-disposal kiosks and informing people of our mail-back envelopes,” Homkey said. “We’re looking to expand opportunities for people to dispose of their medications safely, especially in rural areas.”

For a listing of UVM Health Network’s safe, anonymous collections sites, click here

This story was reported by Mike Faher, with the University of Vermont Health Network.