The first patented seat belt was created in 1885 to keep New York City tourists safe in taxis. Yet, it wasn’t until 40 years later that physicians began testing lap belts and realized the positive safety benefits for drivers and passengers involved in collisions. 
 
Fast forward to 1985, and a safety belt education campaign introduced crash test dummies to reinforce the life-saving benefits of wearing seat belts, which increased usage from 14% to 79% and saved an estimated 85,000 lives and more than $3 billion in costs to society. State governments eventually mandated their use and now we’re constantly reminded to “Buckle Up, It’s the Law” and “Click it or Ticket.” 
 
We face a similar need today for an awareness and education campaign to protect us from the dangers of leftover drugs so that safe home disposal becomes as ubiquitous as seat belt use. 
 
There is no disputing the impact of the opioid epidemic across the nation, where almost 50,000 Americans died in 2018 alone and the global pandemic is only exacerbating the public health crisis. Although there are no easy answers to drug abuse and addiction, we do know that leftover prescriptions lurking in medicine cabinets can be tempting to those struggling with addiction and may often be the start of abuse for others. 
 
Research shows that 70% of people with an opioid use disorder have taken others’ medications, and 80% of people who use heroin initially misused prescription opioids before transitioning to their current substance. 
 
Forbes article cited statistics from 2 studies showing that nearly 11% of high school seniors reported misusing a prescription medication and half of those admitted to getting the drugs from family members, friends, and other sources that could be traced back to prescriptions in the home. Further, approximately 30% of adolescents took leftover medications remaining in medicine cabinets. Most alarming is that 70% of youths who got prescription drugs had a substance use disorder within the previous year. 

Another health hazard posed by leftover medications is childhood poisonings. More than 60,000 children under age 5 are taken to emergency departments annually as a result of ingesting unsecured medication. More than 9000 children every year are hospitalized due to these poisonings and fatal drug poisonings involving children have increased by 10%.
 
Existing disposal methods can cause pollution and are inconvenient
Most of us have been told to dispose of drugs by flushing them down the toilet or drain when they are no longer needed; however, this practice can carry serious environmental risks that can profoundly and permanently affect the ecosystem and our drinking water. 
 
For example, a study of 50 wastewater treatment plants found 56 drugs in post-treated water, including oxycodone, high blood pressure medications, and OTC drugs. Another analysis of 25 drinking-water treatment plants found traces of carbamazepine, bupropion, cotinine, metoprolol, and lithium that persisted in the water after the rigorous filtering and cleaning process that occurs at the facilities. Further, 87% of water samples studied by the US Geological Survey contained measurable amounts of 25 medications. 
 
As dissolved drugs build up over time, they pose a significant risk to the environment and the ecosystem. For example, accumulated antibiotics in the water may result in antibiotic resistance that can render medications ineffective in treating infectious diseases.
 
Other disposal options, such as drop boxes or kiosks at retail pharmacies, and events such as the Drug Enforcement Agency’s (DEA) biannual National Prescription Drug Take-Back Days have been successful in removing more than more than 5900 tons over the past decade. Yet, scientific studies have shown that take-back days account for only 0.3% of scheduled drugs (eg, opioids) that are dispensed, while the majority of the collected weight reported by the DEA is from prescription containers, not the pills, tablets, or capsules. 
 
Programs such as take-back days also risk drugs being diverted into the community, because consumers store drugs in the home while they wait for the special days to occur. Overdoses, poisonings and deaths are not a twice-per-year problem, but rather a tragic everyday occurrence that should be addressed by the dispensing pharmacist at the prescription counter. 
 
Pharmacy education is key
Imagine if seat belts took several minutes to put on and fasten. If this were the case, far fewer drivers would bother securing themselves in their vehicles, and the number of vehicle-accident injuries and fatalities could skyrocket. Even when our personal safety is at stake, convenience often trumps compliance. That’s why consumers need access to a quick, safe, at-home medication disposal option.
 
This was the impetus for DisposeRx, an eco-friendly drug-disposal powder that when added to a prescription vial with warm water forms a thick gel that physically and chemically captures the drugs.
 
Now available in nearly 50% of the pharmacies across the United States, our product is most effective when presented with a prescription by a pharmacist. Education and consultation are critical, and the trusted pharmacist is the perfect person to provide guidance to patients about the dangers of leftover medications and proper disposal of leftover or expired drugs. 
 
Lifesaving, eco-friendly habit
Just as seat belts evolved from a strange new concept to commonplace in virtually all forms of transportation, we are at a point in which a disposal method for leftover medications at home must evolve and be made available with all dispensed medications. The time has come for consumers to be just as accustomed to disposing of their unnecessary medications as they are clicking their seat belts. 
 
By offering a quick, effective and eco-friendly disposal solution, pharmacists can play a critical role in fighting the nation’s opioid epidemic while protecting children from accidental poisonings and preventing environmental pollution. Over time, behaviors will change and lives will be saved as at-home drug disposal becomes a habit.
 
William Simpson is president of DisposeRx, an at-home drug disposal company committed to eradicating the misuse of leftover medications.