February 22, 2023

Story brought to you from Ozarks Headwaters Recycling and Materials Management District

From antibiotics to Xanax, Americans rely on a lot of prescriptions. Researchers say nearly  70% of the country’s population is on at least one prescription, which means asking ourselves questions about the impacts of these medications’ end-of-life is becoming more and more necessary.

Ozark Headwaters Recycling and Materials Management District (OHRD) has a membership with the Product Stewardship Institute, a global nonprofit that facilitates local product stewardship councils. OHRD’s own Planner Angie Snyder runs the pharmaceuticals workgroup for Missouri, which has been around for about four years.

The problem Snyder and her team face is not that Americans are on more prescriptions than ever before, but rather that citizens don’t know what to do with their leftovers. Conflicting information about flushing or landfilling these drugs only makes it more confusing.

Snyder and the PSI team hope to make it easier for Missourians to dispose of pharmaceuticals—and to educate the public about how important it is to do so responsibly.

The Solid Waste Advisory Board, an arm of the Missouri Department of Natural Resources Waste Management Program, said in their 2021 annual report that “the proper disposal of pharmaceuticals is becoming an issue in some regions (of the state), particularly those with numerous medical centers and an aging population.”

The “issue” SWAB cites in their report is a multi-faceted one that impacts our waterways, taxpayer dollars, and even the health of our friends and families.

Every year in the States, more than $1 billion worth of leftover medicines are thrown in the trash, flushed or relegated to medicine cabinets, according to the PSI. Doing so can be dangerous.

Flushing drugs down the drain means they end up in area wastewater treatment plants, not all of which can use the intensive procedures necessary to rid the water of the chemicals. In turn, those same drugs end up in our waterways—like Wilson’s Creek or the Little Sac River—jeopardizing the health and reproductive abilities of aquatic wildlife and oftentimes making their way back to humans.

Even if your home uses a septic tank, flushing pharmaceuticals can be dangerous as the drugs can ruin the tank system.

Another reason to take pharmaceutical disposal seriously is that it mitigates accidental poisoning and minimizes drug abuse. Accidental poisonings are among the most common calls to the Missouri Poison Center. In fact, 70% percent of people who abuse prescriptions get them from friends and family, often from medicine cabinets.

Creating permanent solutions

One of the Missouri PSI pharmaceutical workgroup’s biggest goals since its inception was to set up a statewide map of permanent take-back locations, and in October 2020 the team launched the interactive map, which displays more than 600 take-back locations across the state—plus addresses, hours, contact information and take-back limitations. 

Creating the map was an arduous process, said Lelande Rehard, senior associate for programs and policy at the PSI and district manager for the Mid-Missouri Solid Waste Management District. With grant funding help from the Missouri Product Stewardship Council and web hosting help from the Mid-America Regional Council Solid Waste Management District, planners throughout the state collected data on accepted items at open locations.

While efforts to promote the map and run a social media campaign to educate citizens about safe disposal have seen some success, the group has encountered challenges at the same time. Rising to the challenge to inform the public has been one of the workgroup’s ongoing efforts.

In addition to these take-back programs being relatively unknown to residents, the SWAB 2021 annual report says the programs are costly, and many locations can’t accept all kinds of pharmaceuticals because of federal drug enforcement rules.

Many people know about the U.S. Drug Enforcement Administration’s National Takeback Days, but not everyone knows that local pharmacies and many law enforcement stations have drop-off locations in operation year-round, Snyder said.

Rehard agreed that awareness is low. This proves challenging on multiple fronts: both for securing funding and for educating the public about the importance of responsible pharmaceutical disposal.

Many of the take-back locations are voluntary and have been in operation thanks to a three-year fund the Missouri Board of Pharmacy received as part of the country’s initiatives to address the opioid epidemic. Once that funding runs out, Rehard said, many of the voluntary locations have no requirement to remain open. Smaller pharmacies may not be able to budget for the cost of shipping their collections, too.

Next on the group’s docket is to establish partnerships with entities that can create and sustain these take-back programs. Because there are no Extended Producer Responsibility laws for pharmaceuticals in Missouri to hold manufacturers financially responsible for their products’ end-of-life costs, the Missouri PSI has turned to reverse distributors. Here’s how it works:

1. Chain pharmacies and smaller pharmacies alike establish safe locations for residents to drop off used prescriptions. Some mom-and-pop pharmacies are entitled grant funding to help defray some of the cost of maintaining the location.

2. Pharmacies ship the drugs to third-party reverse logistics companies.

3. From there, reverse distributors incinerate the drugs.

4. The Missouri pharmaceuticals work group continues their efforts on outreach and education all the while.

Drug take-back programs are a fairly new concept in the U.S., Rehard said. In the last decade, organizations like the PSI have increased pressures on national pharmacy chains to fund and staff take-back programs.

These programs aren’t always convenient for Missouri residents, Rehard explained, as not every take-back location accepts the same items. There are still gaps in locations, too, especially in rural areas.

The top priority with take-back locations in Missouri is to improve convenience, Snyder said. One of the loftier goals of the PSI pharms group is to begin filling in the gaps in take-back locations throughout Missouri. The group aims to establish a take-back location within 15 miles of every resident in the state. While this is a far-away goal, making drug drop-off easy and accessible will benefit everyone.

Rural areas are likely to face the greatest barriers, Rehard said. Until there is a better way to secure sustained funding to create, staff and maintain sites, the workgroup has their work cut out for them. 

What you can do:

For advocates:

•  Push for Extended Producer Responsibility legislation, which would hold pharmaceutical manufacturers responsible for the disposal of their drugs once consumers are done with them.
• Tell others about safe drug disposal.
• Push for funding to help smaller, independent pharmacies offer take-back programs, which can be expensive to operate long-term.

For prescription holders:

• Buy only the medications that you need.
• Dispose of leftovers promptly; do not let them sit in your cabinet for someone to take—either by accident or on purpose.
•  Use this interactive map to find take-back locations near you.
• Do not flush or throw out pharmaceuticals.
• Find ways to reuse medicine bottles as they cannot be recycled.

For medical professionals:

• Tell your patients about safe drug disposal.

 

About the Author 

Diana Dudenhoeffer is a multimedia journalist from Springfield, Missouri. She studied journalism, sustainability and documentary storytelling at Missouri State University. She is the current media intern at OHRD, writing blogposts like this one.

 

Featured image and social media promo credit: Photo by Toqfiqu Barbhuiya on Unsplash.