On October 6, 2014, the Drug Enforcement Administration (DEA) expanded the list of entities that may take back controlled-substance medications from households. Pharmacies and clinics, along with a few other locations, can now take back medications from customers for destruction.
This is brand new, as the practice was strictly forbidden for many years by the DEA due to the concern that these drugs, instead of being destroyed, could go back to customers for abuse or reuse. The new rule allows reverse distributorships to take back drugs, something they have been authorized to do for decades, primarily from pharmaceutical companies that have large amounts of outdated or contaminated controlled substances for destruction.
This ruling is welcomed by those who have wanted an easy and secure way to dispose of opioid painkillers in their medicine cabinets, rather than flushing them down a toilet or hiding them in items such as baby diapers and throwing them in the trash.
The DEA held its last controlled substance take-back event in September 2014. For the public’s convenience, the National Association of Drug Diversion Investigators will continue to provide take-back boxes at law enforcement facilities across the country. The locations of these boxes can be found online at www.rxdrugdropbox.org, where a zip code can be entered to find the closest collection receptacle. Some law enforcement agencies also continue to sponsor their own take-back days, although these have diminished with the increased availability of take-back boxes, and the new ruling will probably diminish them further.
An unintended consequence of the new rule could be an upswing in abuse inside pharmacies as drugs are dropped off or mailed to pharmacies, allowing open access to controlled substances with virtually no tracking. Once pharmacies take back medications for destruction, they must fill out a DEA 41 form and have a witness to the destruction of the drugs, but this will work only if those receiving the medications don’t divert them for their own use, illegally sell them, or return them to the public supply chain for distribution to unknowing patients. This new practice could be viewed as a money-maker for an unscrupulous pharmacy, and is one of the reasons this practice was not allowed by the DEA in the past. However, as we all know, the vast majority of pharmacists in this country are honest and law-abiding, doing their best to serve the public every day.
So, with the Department of Justice estimating that more than 17,000 people die each year of an unintentional prescription drug overdose, with a portion of these drugs coming from America’s medicine cabinets, is this a step in the right direction? I have mixed emotions about this, but I am leaning toward applauding this new practice, although time will tell how it is managed. I hope it is a huge success and that it directly decreases the number of prescription overdose deaths in the United States.
Keep your fingers crossed for a successful program that will reduce at least 1 facet of prescription drug abuse. Of course, the public needs to be acutely aware of the problem in order for this new rule to make a difference, and people need to participate in this and other programs designed to get unused controlled substances out of our medicine cabinets.
Cmdr Burke is commander of the Warren County, Ohio, drug task force and retired commander of the Cincinnati Police Pharmaceutical Diversion Squad.