Why Retail Pharmacies Should Have an Unused Medication Collection Receptacle

MAY 25, 2016
Robin Watson, MPH, MS, and Jan Harris, MPH, BSDH
Do patients ever come into your pharmacy holding a bag of unused and expired medications and asking you to take them?

Patients and their caregivers want to do the right thing in that they don’t want to keep unused medications in their homes with the potential risk of an unauthorized individual—perhaps a child or grandchild—ingesting them. They also don’t want to just throw those unused medications into their trash, where they would end up contaminating landfill leachate and, ultimately, the water supply.

Many patients have also heard that flushing unused medications is bad for the environment in that it can contaminate our lakes and rivers, causing mutations of fish and perhaps even harming humans. To prevent the dangers that arise when disposing of unused medications improperly, these caring individuals ask their trusted pharmacists for guidance.

The need for a simple, reliable, and effective solution is growing more crucial, as the increasing “abuse of certain prescription drugs—opioids, central nervous system depressants, and stimulants—can lead to a variety of adverse health effects, including addiction,” according to the National Institute on Drug Abuse (NIDA).

“Among those who reported past-year nonmedical use of a prescription drug, nearly 14% met criteria for abuse of or dependence on it,” the NIDA reported. “The reasons for the high prevalence of prescription drug abuse vary by age, gender, and other factors, but likely include greater availability.”

Because of this “greater availability”, the Drug Enforcement Administration (DEA), under the Department of Justice (DOJ), took action.

On September 9, 2014, the DOJ published a final rule to implement the Secure and Responsible Drug Disposal Act of 2010, which expanded the options available to collect controlled substances from ultimate users (eg, patients) for the purpose of disposal. This rule allows registered collectors, such as retail pharmacies, to update their DEA registration to become a collector and place receptacles at their pharmacies for the collection and disposal of ultimate users’ controlled substances (Schedules II-V).
 
As outlined in § 1317.60 of the Disposal of Controlled Substance Regulations, a collection receptacle is composed of a substantially constructed permanent outer container and a removable inner liner. Collection receptacles must be securely fastened to a permanent structure, and the outer container must include a small opening that allows contents to be added to the inner liner but does not allow removal of the inner liner’s contents.
 
In a retail pharmacy, this receptacle is placed in front of the pharmacy within eyesight of employees, so that they can monitor use of the receptacle and answer any questions that the patient may have during the process. 
 
The process of managing the installed receptacle is easy and streamlined. Once full, the liner is removed and replaced with a new one. The inner liners are returned via prepaid postage and shipped via common carrier to a DEA-registered reverse distributor facility for proper destruction. Since drug diversion is always a concern, all of these steps must be conducted by 2 pharmacy employees.

King Kullen, a grocery/pharmacy chain with stores located throughout Long Island, New York, recently installed receptacles in its stores that have pharmacies, and according to Albert W. Hesse Jr., RPH, King Kullen’s Director of Pharmacy, “Expanding the program to all drugs is critical to providing a one stop for safe disposal for all our customers.”

“This critical expansion will only continue to build upon the success of the program,” he said. “We are gratified that people have heard our message and come to our stores to dispose of their unused or outdated medications. It is a strong signal that these types of programs are needed. People understand their role in protecting our waters and getting unused medications out of the home.”

Intermountain Healthcare, a not-for-profit health system based in Salt Lake City, Utah, with 22 hospitals, clinics, and services, implemented a drug disposal receptacle program in 2015.

“Through a 3-pronged effort of public awareness, provider education, and treatment services, we aim to reduce misuse and abuse of prescription medications among our patients and within the communities in which we operate,” stated Mikelle Moore, vice president of community benefit for Intermountain, about why the receptacles are being used.

Placing a receptacle in the pharmacy offers additional benefits. For instance, it can be an excellent forum for discussions with patients regarding their medication use and compliance. It can also provide an opening for patients to ask that question about their medications they were always too afraid to ask. The placement of receptacles can even potentially generate additional foot traffic.

All of these benefits, plus an emphasis on reducing the possibility of inappropriate use by unauthorized individuals and contamination of the environment, are valuable reasons to offer current and prospective customers this convenient, safe, and compliant disposal option for unused medications.

Robin Watson, MPH, MS, is the Director of National Accounts for Sharps Compliance, Inc, a nationwide provider of solutions for improving safety, efficiency, and costs related to the proper disposal of medical waste by health care professionals.

Jan Harris, MPH, BSDH, is the Director of Environmental Health & Safety for Sharps Compliance, Inc.


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