Americans are using more pharmaceutical drugs than ever before. About half of all Americans take at least one prescription drug each month, and 10% take more than four. In 2013, more than 3.9 billion prescriptions were filled at pharmacies in the United States. Americans may be prescribed a whole lot of drugs, but we certainly don't use them all. So what are we to do with all the unused, unwanted, or expired drugs that remain in our medicine cabinets? Federal Law: A Barrier to Safe Disposal of Unused Drugs
More than 40 years ago, President Nixon signed the Controlled Substances Act into law, which essentially provided the public with two options for their unused drugs: surrender them to law enforcement or dispose of them yourself. Even pharmacies, which dispense significant amounts of pharmaceutical drugs, are prohibited from taking unused drugs back without law enforcement present. Therefore, the best option for safe disposal has been take-back days held by the DEA and local law enforcement. In the past four years, these events have removed 4.1 million pounds of prescription medications from circulation in the US. CCE supports these events and encourage the public to participate. However, given the sheer amount of pharmaceutical drugs out there, these events don't even scratch the surface of the problem. Take-back days only occur a couple of times per year, and are inaccessible to many people. While some police precincts are also housing permanent drop boxes for unused drugs, safe disposal remains inaccessible to many. The result: drugs are stockpiled in medicine cabinets, drugs are abused, or they are flushed.
An Emerging Environmental Threat
This gets me to the point of why an environmental organization is so concerned about pharmaceutical drugs. For decades, the recommendation by the Environmental Protection Agency (EPA) and others was to flush your unused drugs, despite the fact that sewage treatment plants, septic systems, and drinking water infrastructure were never designed to remove these contaminants. While flushing is no longer recommended, it remains a common disposal practice by many residents and in many hospitals and long-term care facilities.
Scientific studies are now demonstrating that all of this flushing of drugs is polluting our waterways. National studies have found trace amounts of pharmaceutical drugs in drinking water supplies of 41 million Americans. A study conducted by the USGS found low levels of drugs such as antibiotics, hormones, contraceptives and steroids in 80% of the rivers and streams tested. Throughout New York State and Connecticut, water sources have tested positive for trace amounts of heart medicines, antibiotics, estrogen, mood stabilizers, tranquilizers, and more.
The effects of constant, low-level exposure of various pharmaceuticals on humans are uncertain, and more research is needed. Possible health concerns include hormone disruption, antibiotic resistance, and synergistic effects.
While the health effects on humans have not yet been proven, pharmaceutical drug contamination has been proven to adversely impact fish and aquatic life. For example, studies have shown male fish have been feminized (produced eggs) when exposed to hormones (birth control pills). Other drugs, such as anti-depressants and beta-blockers, reduce fertility or affect spawning in certain aquatic organisms.
Congress Takes Action
With the growing epidemic of prescription drug abuse and the environmental impact of flushing, Congress recognized the need to provide the public with greater access to safe disposal options for their unused or expired drugs. The Secure and Responsible Drug Disposal Act of 2010 was passed into law to encourage voluntary drug take-back programs, beyond just take back days held with law enforcement.
The law required the DEA to develop implementing regulations, which didn't happen overnight. CCE, along with leaders such as Senator Schumer, worked for years to urge the DEA to move forward with their regulations. Finally, after four years, just this week the DEA announced that they had finalized their regulations, which will go into effect in October of 2014.
A Game Changer for Safe Disposal
Release of the long-awaited regulations is a game changer -- the biggest step yet to provide the public with greater access to safe disposal options. The biggest barrier to safe disposal of pharmaceutical drugs by the public has been a lack of access to safe disposal options. The new regulations help to overcome this barrier by allowing pharmacies to finally take back unused pharmaceutical drugs--whether it be a secure lock-box at the pharmacy or the option to mail back unused drugs in an envelope. What could be easier than allowing the public to return drugs to the very same place that they get them--right in their neighborhood pharmacy? Pharmacies at hospitals and heath care facilities will also be able to take back unused drugs. This is critical since many health care facilities, which obviously have a large amount of pharmaceuticals on site, still flush controlled substances as a common disposal practice.
Next Steps
As we celebrate the release of these regulations, we are reminded that our work is never done. While the regulations allow pharmacies to take back unused drugs, it is merely voluntary. We must ensure that pharmacies step up and provide this critical public service to our communities. While CCE will be reaching out to pharmacies directly, we also need your help. Next time you stop in to your local pharmacy, encourage them to participate and provide pharmaceutical take-back for its customers. We can keep dangerous prescription drugs out of the hands of abusers and out of our waterways with easy, safe disposal options!