Wednesday, December 11, 2013
Mainers have a new way to get rid of unused and unwanted medications, and also keep them out of the environment and away from people who might abuse them.
And if advocates get their way, drug manufacturers will soon be footing the bill for the new disposal system, under a first-of-its-kind funding mechanism.
Special leakproof mailing envelopes are available, or soon will be, at participating pharmacies across the state. Anyone with unwanted drugs, whether prescription or over-the-counter, can take a mailer home, fill it and send it away -- postage-free -- to be incinerated in the presence of drug enforcement agents.
The statewide rollout of this program is one of the first such mail-back programs in the nation. It follows a limited test program earlier this year that provided mailers for senior citizens at 11 pharmacies in four counties.
The University of Maine Center on Aging, with support from state agencies and other organizations, is using federal grant money to place 50 mailers in each of the pharmacies as part of a statewide pilot program. Once those mailers are used up, however, so is the funding.
A new proposal headed to the Legislature next month could make Maine the first state to require drug makers to pay for a permanent disposal program for their unused products. Drug makers already are opposing the idea, arguing that a costly disposal system is unnecessary and may even increase the odds that drugs get diverted and abused.
''There's a huge amount (of old medications) out there,'' said Ann Pistell of the Maine Department of Environmental Protection, which helped draft the new legislation. An old-drug drop-off event in the midcoast region recently took in more than 16,000 pills, such as pain medications and antidepressants, in just four hours, Pistell said.
Because there is no safe and simple disposal option, she said, a lot of medications are flushed down toilets and into waterways. Traces of pharmaceuticals have started showing up in drinking water supplies in some parts of the country, although there has been no comprehensive testing for such contamination in Maine, Pistell said.
''It's showing up everywhere else; there's not much reason to believe Maine is any different,'' Pistell said.
Advocates for Maine's elderly are helping to drive the effort. Medicine cabinets full of unused prescription medications pose the risk of accidental poisonings or theft and drug abuse, they say.
Law enforcement agencies, including the Maine Drug Enforcement Agency, also support the disposal system as a way to fight the state's high rate of prescription drug abuse. Some Maine school officials see a disposal solution as a step toward keeping the pain pills and other drugs out of the hands of curious teens.
''Almost every day, somebody asks us about what to do with their unwanted drugs,'' said Susan Anderson, owner of the Medical Center Pharmacy in Brunswick.
In the past, Anderson advised people to hold on to the expired drugs for special collection days. ''But, you know, it's not always a really good idea for elderly people to hold on to their medicines,'' she said.
The pharmacy got its supply of mail-back envelopes this month and has given away at least half a dozen, she said.
The CVS Pharmacy at Portland's Westgate Shopping Center, which expects to receive the mailers, also has customers who are eager for a solution and want to stop flushing medications down the toilet, said Paul McGrath, a pharmacist there. ''Right now, I tell them to put their prescriptions in the regular trash,'' he said.
Federal agencies recommend that unused medications be mixed with cat litter or coffee grounds, sealed in a containers and thrown in the trash. The exception is a list of narcotics, such as OxyContin and Percocet, which the Food and Drug Administration says should be flushed down the toilet to make sure they are not abused.
Advocates of a collection system say the advice is too complicated and confusing, and that putting the drugs into landfills is still risky to the environment.
Drug makers, on the other hand, say a Maine-style collection system is unnecessary.
Such programs ''do not make environmental sense when the easiest, most acceptable way to rid the home of unused medications is to dispose of them in household trash,'' Ken Johnson, a senior vice president of the Pharmaceutical Research and Manufacturers of America, said in a written statement supplied for this story.
Johnson said the collection of old medications could actually increase the risk of the drugs being diverted and abused.
''Drug recycling and take-back programs would be an unnecessary burden on patients when safe and environmentally friendly methods for disposal already exist,'' he said.
Pistell, of the Maine DEP, said the legislation would prohibit the manufacturers from collecting any new disposal fees from consumers. Though the annual cost of a statewide collection is unknown, it ''should be minimal'' and not add more than pennies to the cost of drugs, she said.
Mail-in collection systems paid for by drug makers are common in Europe and British Columbia, according to advocates.
Maine is one of three states, including Washington and Oregon, that could soon require drug makers to pay for statewide disposal systems, said Scott Cassel, executive director of the Product Stewardship Institute.
Cassell has been working with state and federal agencies, as well as drug makers, to create a national disposal solution.
Maine, which was the first state to require manufacturers to pay for disposal of old televisions and computer monitors, ''would be a prime candidate for this,'' Cassell said. ''Maine is definitely a national leader in producer responsibility.''
Staff Writer John Richardson can be contacted at 791-6324 or at: