Organized prescription drug collection programs may have minimal impact
WINSTON-SALEM, N.C. – Nov. 15, 2016 – More than 3.8 billion controlled medications, such as hydrocodone, oxycodone, Valium and Adderall, are dispensed by pharmacies annually in the United States. It has been estimated that only about 30 percent of these drugs are used by the people for whom they were prescribed. The remaining 70 percent represent a large surplus of controlled medications that could be abused or sold to others for abuse.
It's not surprising, then, that non-medical use of prescription drugs is the second most common form of illicit substance abuse in the country, trailing only marijuana use.
Disposal of unused medications through community-wide take-back events and permanent receptacles also known as drop boxes is a strategy that is widely employed across the United States to reduce the availability of controlled medications for improper use and abuse.
But according to a study published in the current online issue of The American Journal of Drug and Alcohol Abuse, these programs may be minimally effective in reducing the availability of controlled medications.
"Similar to other studies, we found that only about 5 percent of the collection from take-back events and drop boxes consisted of controlled medications susceptible to abuse," said the study's lead author, Kathleen Egan, M.S., research associate in social sciences and health policy at Wake Forest School of Medicine, part of Wake Forest Baptist Medical Center.
"The remaining 95 percent consisted of non-controlled substances, such as vitamins and over-the-counter medications, but unlike previous studies we then compared the number of controlled medications to the number dispensed by pharmacies. And what we found surprised us – less than 1 percent of dispensed controlled medications were collected by the disposal programs."
The study measured the quantity and type of controlled medications collected during three federal Drug Enforcement Administration-sponsored take-back events and in permanent drop boxes in five Kentucky counties in 2013-14, and compared the figures with the number of controlled medications dispensed in the participating counties during the same time period.
A total of 21,503 units of controlled medications were collected at take-back events and drop boxes. But that represented just 0.3 percent of the more than 20 million units prescribed, according to the research team.
"Our findings don't necessarily mean that these programs don't work," Egan said. "The study was limited in both time and scope; the results might be different in different communities, and over time these programs may influence community norms and behaviors related to storage, disposal and abuse of controlled medications."
Further research in this area is definitely called for, but it appears that these disposal programs, at least when used in isolation, may not be as effective at reducing the availability of controlled medications as many of us had hoped, she said.
Support for the study was provided by the Substance Abuse and Mental Health Services Administration under SP019436 and the Association of Accredited Public Health Programs.
Co-authors are Mark Wolfson, Ph.D., of Wake Forest Baptist; Eric Gregory, Ed.D., of the Save Our Kids Coalition, Bowling Green, Kentucky; and Michael Sparks, M.A., of Sparks Initiatives, Kihei, Hawaii.
Additional information on how to properly dispose of unused or expired controlled medications is available on the U.S. Food and Drug Administration's website at http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm186187.htm.