Friday, December 13, 2013
When Mainers turn over thousands of pounds of unwanted prescription drugs on Saturday, a small army of University of New England pharmacy students will be at several of the drop-off locations to count every type of medication to determine which ones are wasted most often.
Saturday’s take-back event will take place from 10 am to 2 p.m. at various locations throughout Maine, including:
Biddeford: Public Works Recycling Center, 371 Hill Street
Saco: Community Center, Franklin Street
Old Orchard Beach: New Police Station, 16 East Emerson Cummings Boulevard
Lyman: Goodwin Mills Fire Station
Kennebunk: Hannaford Supermarket, 65 Portland Road
Kennebunkport: Police Station, Route 9 (across from the American Legion)
Buxton: Rite-Aid Pharmacy, 226 Parker Farm Road
Buxton: Hannaford Supermarket & Pharmacy, 24 Portland Road
Disposal is free and anonymous. Officials ask that personal identification information (name, address) be removed from labels. Prescription and over-the-counter pills, drops, ointments, et cetera will be accepted. However, no thermometers, batteries, durable medical equipment or intravenous solutions, injectables or syringes can be accepted.
"If you can look at the percentage of waste, then you start asking why," said Heather Stewart, who is earning her doctor of pharmacy degree at UNE. The answers, she said, could lead to medical practices that reduce waste and save money.
Stewart's research, however, could be in jeopardy, because of a loss of funding and a U.S. Drug Enforcement Administration rule that's under consideration.
The rule is aimed at protecting the drug take-back program by ensuring that only law enforcement officers are allowed to handle the drugs after they are dropped off. That's because some are highly sought after by addicts.
The rule would effectively shut down efforts to gather data on drugs collected in take-back programs in Maine and the nine other states where such analysis is being done.
The collection program also will be threatened if the DEA decides to cut funding for safe disposal of the drugs.
U.S. Sen. Susan Collins, R-Maine, sent a letter to DEA Administrator Michele Leonhart on Feb. 7, arguing that such data collection is important for developing policies to reduce the costly waste of prescription drugs.
There have been no drug diversions in Maine during the data collection process, she said, and the DEA should reconsider the policy.
Pharmaceutical Research and Manufacturers of America, a leading industry group, has said it supports local collectors gathering information on the medications recovered in take-back programs to help reduce waste in prescribing practices.
The rules for the drug take-back program are still being formulated by the DEA so it's not clear what they will say or when they might take effect.
Stewart's research of drugs collected at several sites in 2011 and 2012 has shown that in Maine, the largest single class of drugs being disposed of are cardiovascular medicines for conditions like high blood pressure and clogged arteries.
Of the 375,674 doses -- primarily pills -- counted from three take-back events, 11 percent fell into that category.
The analysis also showed that those medications have one of the highest levels of waste. On average, more than 79 percent of the amounts prescribed were left over. That means, for example, that a 30-pill prescription comes back with 24 pills remaining.
Similarly, more than 80 percent of prescriptions for gastrointestinal, antidepressant and asthma medications were left over.
"Now that we have an actual concrete number of what's coming back, we can start figuring out how to change it," Stewart said.
Surveys indicate that:
• 27 percent of the unwanted medications were discarded because doctors told patients to stop taking them;
• Almost 20 percent belonged to people who had died;
• 18 percent were discarded because the person no longer needed them;
• 12 percent were discarded because users had negative reactions.
Stewart has presented her data to state boards and groups that are studying prescription drug diversion in Maine.
With less waste, less medication would be flushed down drains, and insurance companies and MaineCare, the state's Medicaid program, would save money.
In her letter to the DEA, Collins said earlier data from the state's mail-in drug collection effort, which no longer exists, led to changes in MaineCare's prescription drug coverage that reduced the number of doses when a person first tried a medicine. That way, if the drug didn't work, lesswas wasted.
Since the DEA-sponsored drug take-back effort started in 2010, Maine has consistently led the nation in the amount of drugs returned per capita.
The volume grew from 7,820 pounds collected in the first take-back event to 19,980 pounds in an event in the spring of 2012. Collections dropped off to 13,980 pounds in the fall of 2012. Organizers attributed that to bad weather.
While the large amount of drugs collected in Maine may be attributable to the state's large elderly population, Michael Wardrop, the DEA agent in charge of Maine, noted that drug abuse issues have been well publicized here and Mainers are concerned about keeping unwanted medicine out of the environment.
"Everyone has stepped up to the challenge and are scouring their cabinets and bedside tables," he said.
Sixty to 65 police stations in Maine now have drug collection boxes where people can drop off drugs at any time.
Wardrop said his agency is concerned about drugs falling into the wrong hands but he feels the data collected is also important.
"That's the type of information that can somewhat drive policy and the complex issues with respect to prescribing practices," he said.
While state officials worry that the program would be cost-prohibitive for the state to run, efforts are under way to cut costs.
All of the medications collected are now taken to a specially licensed incinerator in Haverhill, Mass. But the state Department of Environmental Protection is working to allow the drugs to be burned in the state's three waste incinerators to save money.
Key to that effort is determining whether air emissions from incinerating the medications pose a health risk. Ecomaine in Portland is scheduled to do a controlled burn of some of the material on Monday to gauge the environmental impact, officials said.
The variety of medications being turned in is remarkable, said Cumberland County Sheriff's Deputy Joe Schnupp.
The sheriff's office maintains a drop box at the county jail. On Thursday, Schnupp sifted through a week's worth of collections, uncovering a blood pressure gauge and a blood sugar test kit, in addition to medicines that ran the gamut from bottles of Tylenol to more than 100 doses of Diazepam, a sedative also sold as Valium. Some of the medicines were 15 years old.
Stewart said the collection effort has produced some eye-catching examples, including a moving box full of unopened prescription lotion.
More than 100 UNE pharmacy students have volunteered to catalog the wide variety of drugs that will be collected on Saturday at collection points in Belfast, Saco, Scarborough and the UNE College of Pharmacy. They must have their tabulations complete by 2 p.m., when police haul the medicine away for disposal.
David Hench can be contacted at 791-6327 or at: