Pharmacists’ Perspective on Unwanted/Waste Pharmaceuticals

PSI: Pharmaceuticals National Dialogue

Sacramento, CA

June 19, 2008

Shirley Reitz, Pharm.D., BCPS

Associate Director, Pharmacy Clinical Services

Group Health Cooperative

Seattle, WA

Pharmacists’ Perspective

Is there a problem?

If there is an issue, what are the primary challenges for Pharmacy in helping to solve this issue?

What is needed to move this issue forward?

Is there a problem?

Patient Demand

2006 WCRC survey of 400 King County households revealed

39% have 10 or more medicine containers in their homes Only 33% report that they are currently using or plan to use these meds 74% stated they would be willing to dispose of the meds in a convenient location

“We are cleaning out my Grandfather’s house and I have a suitcase full of drugs that we need to get rid of. Can we bring them into your disposal site?”

“Our neighborhood association (over 400 homes) would like to provide some education to the families in our neighborhood about drugs in their homes – can we tell them to bring their meds to you for disposal?”

“Please dispose of this medication. Enclosed is a donation….”

Is there a problem?

Patient Demand

Over 10,000 lbs of unwanted medications collected and incinerated

Implemented in all 25 Group Health pharmacy locations

Regional pharmacy chain implementing in 10 additional pilot sites

Collected Drugs, Percent by Weight

Is there a problem?

The majority of teens (57%), who use these products, say they get prescription drugs for free from a relative or friend (47%), or take them from a relative or friend (10%), without asking; and

Adolescents are more likely than young adults to become dependent on prescription medication.

•New abusers of prescription drugs have caught up with new users of marijuana; •Pain relievers, such as OxyContin and Vicodin, are the most commonly abused prescription drugs by teens; •One third of all new abusers of prescription drugs in 2005 were 12-17-year olds;•Prescription drugs are the drug of choice among 12- and 13-year olds;

Patient Safety - “Teens and Prescription Drugs” 2007 White House ONDCP report:

Is there a problem?

What are the challenges for Pharmacy?

Regulatory

Controlled Substance Act

Drug Enforcement Agency

State Boards of Pharmacy

Cost

Need affordable solutions

Pharmacies/Patients should not be required to fund solutions

Lack of Educational Outreach

Education of patients and healthcare professionals

Lack of guidance at the national level

National pharmacy associations

What do we need to move forward?

Models that demonstrate a safe, secure, convenient, affordable disposal system

Pilot program in 25 Group Health Pharmacy locations in Washington state

Design and develop secure disposal bin

Tracking system from consumer deposit to incineration

Regulatory responsiveness

Allow secure collection of controlled substances from public in convenient locations (pharmacies)

Reduce administrative burden

Cost

Ensure that burden of disposal cost does not fall to patients or to the pharmacies

What do we need to move forward?

Educating consumers to take action

Media campaign Training for care providers to

educate patients Web site development (such as

www.medicinereturn.com)

What do we need to move forward?

Health Care Providers

Group Health

Businesses

Bartell Drug Company

Non-profit agencies

Interagency Resource for Achieving Cooperation (IRAC)

Northwest Product Stewardship Council

WA Citizens for Resource Conservation

Pacific NW Pollution Prevention Resource Center

State and local government

King County Local Hazardous Waste Management Program

Snohomish County Solid Waste Management Division

Public Health – Seattle and King County

WA Department of Ecology

Advisors

WA State Board of Pharmacy

WA Department of Social and Health Services

Pharmaceutical Manufacturers

National Dialogue and Development of Partnerships

Pharmacists’ Perspective

Contact Information

Shirley Reitz, Pharm.D., BCPS

Associate Director, Pharmacy Clinical Services

Group Health Cooperative

Seattle, WA 98168

206-901-4334

Reitz.sj@ghc.org