Agencies flush original strategies in favor of promoting drug take-back programs

August 11, 2008

FDA has imposed a change in drug labeling that once advised flushing unused drugs down the toilet. Now the agency is encouraging consumers and pharmacists to take advantage of drug take-back programs.

The Environmental Protection Agency (EPA) and the Food and Drug Administration (FDA) want you to create your own medication take-back program.

That's one read on FDA's quiet change in drug labeling that once recommended flushing unused drugs down the toilet. The agency is encouraging consumers and pharmacists to use drug take-back programs instead. Federal drug disposal guidelines issued in 2007 include flushing more than a dozen drugs or disposing of drugs in household trash.

The change can't come soon enough for some pharmacists. In San Jose, Calif., just south of Silicon Valley, staff R.Ph. Robyn Shalinsky started a drug take-back program at Leiter's Pharmacy in 2007.

"A lot of people think it's OK to put drugs in the trash, including the American Pharmacists Association," Shalinsky said. "We need to reeducate people that it's not safe. What goes into the trash goes into a landfill, where it leaches into groundwater and the water supply."

The problem is that not all pharmaceuticals are degraded by current wastewater treatment technology, San Francisco-area pollution control expert Jennifer Jackson, of the Bay Area Pollution Prevention Group, said. That is as true of drugs excreted in urine and feces as of drugs that are flushed directly.

Household trash generally goes to landfill facilities. That makes trash a problematic disposal method. Some landfills are well sealed. Waste does not leach into groundwater supplies. Other landfills are unprotected and do nothing to prevent leaching. Most facilities are somewhere in the middle, Jackson said.

"Landfills don't want to be used for medication disposal," she said. "It's a potential pollution issue and a worker safety issue. Some medications are hazardous chemicals, and no one wants to expose workers to used sharps."

A coalition of water agencies, the EPA, and the California Pharmacists Association are staging a "No Drugs Down The Drain" public education program Oct. 4-11.

Leiter's is collecting about 300 pounds of unneeded Rx and OTC products monthly. Drugs are collected at the pharmacy and removed every two weeks by a medical waste carrier for incineration. The store spends about $125 monthly on disposal fees and other costs. Shalinsky said the take-back program offers a solid return on the investment.

"The take-back program has definitely increased our walk-in business," she said. "It's a great plus for any pharmacy. Just getting people to walk in the door is half the battle. We are hearing people talking about switching pharmacies because of the program."