National Association of Attorneys General
Drug Takeback Programs � National Day Planned
A number of states and localities have instituted “drug takeback” programs. The purpose of such programs is to allow for safe, legal, and environmentally-friendly disposal of extra drugs that patients have not used. People instituting the programs – including Attorneys General offices – face a variety of legal and practical challenges: finding resources, complying with state and federal law, and setting up practical systems.
The Drug Enforcement Administration (DEA) is planning to assist state and local authorities by coordinating legal collection of unused prescription drugs in conjunction with state Attorneys General and local law enforcement authorities.
The programs serve two purposes. First, they reduce the risk of prescription drugs entering the water, potentially harming aquatic life or getting into a human water supply. In the past, people were advised to flush unused drugs down the toilet—but that option can lead to a questionable mix of contaminants ultimately going to wastewater treatment plants that are ill-equipped to handle the chemical and antibiotic components. Currently, the Environmental Protection Agency and the Food and Drug Administration encourage people to dispose of excess drugs by mixing them with kitty litter, coffee grounds, or other unpalatable items. This strategy, too, can be problematic. If the household waste is incinerated, the drugs are far less likely to pose an environmental problem than if they go into the waste water stream. However, if the household waste goes to a landfill, the constituents of the drugs will someday leach out—either to collection at the wastewater treatment plant, or directly into groundwater.
Perhaps more importantly, takeback programs reduce the risk of prescription drugs being consumed inappropriately—either by accident or through illegal sale. Widespread anecdotal and survey evidence indicates that a huge portion of illegal prescription drug use occurs when people raid friends’ and relatives’ medicine cabinets.
Proposals for takeback programs must address two requirements: accessibility and compliance with relevant legal requirements. Existing programs have followed three models. In one scenario, drugstores or other commercial outlets take back the leftover drugs and dispose of them in accordance with state and local law. In this model, the pharmacies or retail stores pay for disposal of the drugs which are returned to them. Of course this approach is convenient for the public. Almost everyone can get to a pharmacy, pharmacies are open for a huge proportion of the week, and certainly most people who already possess unused prescription drugs have access to a drugstore. Therefore, from the point of view of the public, accessibility is manageable under this model.
The drawback associated with the pharmacy-as-collection-point model is that pharmacy employees are not permitted to collect and dispose of controlled substances. A Walgreen’s staff person, for instance, can gather many standard prescription drugs that have not been used. “Controlled substances,” as defined by the DEA, however, must be collected or disposed of by DEA agents, or by someone authorized under DEA procedures to collect and dispose of such narcotics.
A different approach to collection is for law enforcement groups to collect the unused prescription drugs. Pursuant to federal regulations, law enforcement officials engaged in the enforcement of state or local law relating to controlled substances are exempt from registration with DEA in the course of their professional duties. As such, the law enforcement agency arranges for collection activities to occur at a private business or public location. On the collection day, law enforcement people are present so that they can physically take possession and maintain custody of the unused controlled substances. Under that scenario, the question of legal compliance is resolved, but accessibility and perhaps cost can become issues. Some part of the public might find it impractical to drop off unused prescriptions at the time when law enforcement staff are available.
Another variation, in use in several states, is to set up secure collection containers at law enforcement agency offices. In that situation, the unused drugs are always under the control of the law enforcement agency, which routinely empties the collection containers and takes their contents for disposal. In this situation, the accessibility question seems less prominent, since police stations are generally open at all hours and throughout the year. The problem of having to find authorized people to dispose of the controlled substances is also mitigated, since law enforcement officers are generally eligible to perform that function.
Parallel bills that would address takeback programs have been introduced in the U.S. House and Senate. H.R. 1359 and S. 3397 would both give the U.S. Attorney General authority to issue regulations allowing “ultimate users” of controlled substances to deliver them to authorized disposers, provided that the disposer operates in accordance with regulations issued by the U.S. Attorney General. Moreover, the bills specifically permit the U.S. Attorney General to authorize long-term care facilities to dispose of controlled substances. In May, 36 state Attorneys General signed a letter supporting the House version of the bill, H.R. 1359, the “Secure and Responsible Drug Disposal Act if 2009.” The U.S. Department of Justice has also provided Congress a letter giving its support of the bill.
State Attorneys General Greg Abbott (Texas), Steve Bullock (Mont.), Rob McKenna (Wash.), and Lori Swanson (Minn.), circulated a sign on letter in support of the Senate bill, S. 3397, the “Secure and Responsible Drug Disposal Act of 2010.” Forty-two Attorneys General signed it and the letter was sent June 25. The substance of the two bills is identical, although they were introduced at various times, and the Senate bill includes a series of congressional findings in support of the bill’s requirements. The House bill does not include the findings, although its substantive provisions are the same as those in S. 3397.
National Takeback Day Planned
In a different but complementary effort to reduce the risks and problems caused by the accumulation of unused prescription drugs, the DEA has initiated a collaborative effort to organize a nationwide day for collection of unused prescription medications on Sept. 25. The national “takeback day” will allow people who want to get rid of unwanted prescription drugs to comply with the law because DEA expects a multitude of state and local law enforcement authorities to participate in programs. The hope is for state Attorneys General to encourage local law enforcement to participate in the nationwide initiative. To further the planning for the national event, DEA expects to contact state Attorneys General in the near future. Attorneys General offices with questions about the takeback day may contact Mark Caverly, chief of the Liaison and Policy Unit, DEA, at (202) 307-7297 or firstname.lastname@example.org.