Resolution C-1 - Supporting Medication Return Programs

Introduced by:
Gary Goldbaum, MD, MPH
Dino Ramzi, MD, MPH
Alan Melnick, MD, MPH

 

WHEREAS, more than 92 million prescriptions were filled in Washington State in 20151; and

WHEREAS, up to 2/3 of prescribed medications are not used2, resulting in substantial accumulations of unused medications in households; and

WHEREAS, a recent study suggests approximately 1 in 5 adults have shared opioid prescriptions with another person and nearly half of adults with recent opioid medication use may not have received information on safe storage or proper disposal3; and

WHEREAS, more than 1 in 7 Americans aged 12 or older report nonmedical use of pain relievers at some time, approximately 1 in 25 report nonmedical use of pain relievers in the past year, and approximately 1 in 50 American adults and adolescents report nonmedical use of pain relievers in the past month4; and

WHEREAS, more than half of persons aged 12 or older who used pain relievers nonmedically in the past 12 months reported getting the drug from a friend or relative for free and more than 1 in 10 bought the drug from a friend or relative5; and

WHEREAS, unwanted medications left in the home increase opportunities for drug abuse, diversion, and teen “pharming,” (the slang term applied to the random ingestion of prescription drugs in order to become intoxicated)6, 7 ,8; and

WHEREAS, more than 3 of 5 King County heroin users <30 years of age report being “hooked on” prescription-type opioids before using heroin9; and

WHEREAS, overdose death rates have increased nearly 140% since 2000, including a nearly 200% increase in the rate of overdose deaths involving opioid pain relievers and heroin10; and

WHEREAS, of approximately 2 million drug misuse or abuse emergency department visits that occurred in the U.S. in 2008, more than half involved legal drugs, of which pain relievers were the most commonly misused drug11; and

WHEREAS, unwanted medications disposed into sanitary sewer systems are not removed by wastewater treatment facilities, allowing pharmaceuticals to be released into the environment12; and

WHEREAS, unwanted medications disposed into solid waste systems may end up in landfill leachate, either entering local groundwater directly or, if pumped to wastewater treatment facilities, ultimately released into the environment as noted above;13 and

WHEREAS, pharmaceuticals have been detected in the surface waters of Washington State and around the United States;14, 15 and 

WHEREAS, pharmaceuticals have been found in drinking water worldwide;15 and

WHEREAS, a coalition of Washington’s local and state governments, non-profits, and retail pharmacies collected more than 250,000 pounds of unwanted household pharmaceuticals since 2006, demonstrating the demand and feasibility of drug take-back programs;16 and

WHEREAS, these programs face reduced funding and cannot be sustained (much less expanded to accommodate demand) without dedicated funding; and

WHEREAS, pharmaceutical manufacturers have funded and operated successful pharmaceutical stewardship/drug take-back systems in Canada for over fifteen years17 and many countries in Europe;18 and

WHEREAS, pharmaceutical manufacturers currently fund and operate successful pharmaceutical stewardship/drug take-back systems in California and are currently implementing such systems in King and Snohomish counties; and

WHEREAS, a statewide pharmaceutical stewardship program funded and operated by pharmaceutical manufacturers would provide convenient, safe, secure, environmentally sound and sustainable drug return options to all state residents; THEREFORE BE IT

RESOLVED, that the WSMA support legislation to create a convenient, safe, secure, environmentally sound and sustainable product stewardship program for the collection, transportation and disposal of unwanted medications from Washington State households, with such program to be funded and operated by pharmaceutical manufacturers. (Directive to Take Action)


References:

  1. Henry J. Kaiser Family Foundation. (2016). Total number of retail prescription drugs filled at pharmacies.  Available online at http://kff.org/other/state-indicator/total-retail-rx-drugs/?state=WA,  accessed 7/1/16.
  2. Law A, et al. Taking stock of medication wastage: Unused medications in US household. Research Social Admin Pharmacy. 2015;11:571-578.
  3. Kennedy-Hendricks A, et al. Medication sharing, storage, and disposal practices for opioid medication among US adults (Letter). JAMA. Published online June 13, 2016.
  4. Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health.  (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Retrieved from http://www.samhsa.gov/data/.
  5. Substance Abuse and Mental Health Services Administration. Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings. NSDUH Series H-48, HHS Publication No. (SMA) 14-4863. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.
  6. Repard P. Drug thieves find new targets at open houses. San Diego Union-Tribune. Published March 11, 2014.  Available online at: http://www.sandiegouniontribune.com/news/2014/mar/11/prescription-drugs-abuse-theft-open-house/, accessed 6/30/16.
  7. Banta, C. Trading for a High. Time Online.  Published online July 24, 2005. Available online at: http://www.time.com/time/magazine/article/0,9171,1086173-2,00.html, accessed 6/30/16.
  8. Alikhani L. Thieves target open houses for prescription drugs. ABC News.  Published online February 1, 2013.  Available online at: http://abcnews.go.com/blogs/headlines/2013/02/thieves-target-open-houses-for-prescription-drugs/.
  9. Cedarbaum ER, Banta-Green CJ. Health behaviors of young adult heroin injectors in the Seattle area. Drug Alcohol Depend. 2016;158:102-109.
  10. Rudd R, et al. Increases in Drug and Opioid Overdose Deaths – United States, 2000-2014.  Morb Mort Weekly Rep.  2016;64:1378-1382.  Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6450a3.htm?s_cid=mm6450a3_w.
  11. Substance Abuse and Mental Health Services Administration, Office of Applied Studies. Drug Abuse Warning Network, 2008: National Estimates of Drug-Related Emergency Department Visits. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2010. Available online at: www.odmhsas.org/resourcecenter/ResourceCenter/Publications/Current/2005.pdf, accessed 7/1/16.
  12. Washington State Department of Ecology (2010). Focus on Pharmaceuticals and Personal Care Products. Available online at: http://www.ecy.wa.gov/pubs/1003003.pdf, accessed 7/1/16.
  13. Barnes K, et al. Pharmaceuticals and other organic waste water contaminants within a leachate plume downgradient of a municipal landfill. Groundwater Monitoring Remediation. 2004;24(2):119-126.
  14. Johnson A, et al. Results of a Screening Analysis for Pharmaceuticals in Wastewater Treatment Plant Effluents, Wells, and Creeks in the Sequim-Dungeness Area. Olympia, WA: Washington State Department of Ecology, 2004.  Available online at: http://www.ecy.wa.gov/biblio/0403051.html, accessed 7/1/16.
  15. Kolpin D, et al. Pharmaceuticals, Hormones, and Other Organic Wastewater Contaminants in U.S. Streams, 1999-2000, Environ Sci Technol.  2002;36:1202-1211.
  16. Take Back Your Meds.  (2013). Washington Residents Use Medication Take-Back Programs.  Available online at: http://www.takebackyourmeds.org/what-you-can-do/washingtonians-use-medication-take-back-programs-1, accessed 7/1/16.
  17. Health Products Stewardship Association. (2016). History. Available online at: http://healthsteward.ca/about-us/history, accessed 7/1/16.
  18. European Environment Agency. Pharmaceuticals in the Environment: Results of an EEA Workshop.  Copenhagen, Denmark: European Environment Agency, 2010.  Available online at: http://www.eea.europa.eu/publications/pharmaceuticals-in-the-environment-result-of-an-eea-workshop, accessed 7/1/16.

 

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