Hawaii does not permit the return of medications to retail pharmacies once they are dispensed, making the need for take-back events even greater..
A partnership formed by the Hawaii Narcotics Enforcement Division and the University of Hawaii Hilo College of Pharmacy to accept unwanted or unused medications yielded more than 8,000 pounds of prescription and over-the-counter drugs from 2011 through 2012, during 11 take-back events throughout the state, according to recently released report published in the Hawaii Journal of Medicine and Public Health.
Hawaii does not allow dispensed medications to be returned to retail pharmacies after dispensing.
In 2011, retail pharmacies dispensed almost 3.8 billion prescribed medications in the United States. In Hawaii, the total was more than 16.6 million prescriptions from 2011 to 2012. More than 1.75 billion OTC drugs were purchased in the United States, and almost 7 million in Hawaii.
Of the dispensed medications from retail pharmacies in 2011, approximately one-third were never used, which included 5.5 million prescription containers in Hawaii. These unwanted and unused drugs in households pose health risks to children, the elderly, and household pets. In any given year in the United States, more than 71,000 children are taken to emergency departments for accidental overdoses of prescription and OTC medicines.
“Among two-year-olds, one of every 180 children treated in an emergency room is for a medication overdose. Unsupervised ingestion of acetaminophen, cough and cold medicines, nonsteroidal anti-inflammatory drugs, and antidepressants are most commonly involved in overdoses among children,” wrote Carolyn S. Ma, PharmD, Department of Pharmacy Practice, University of Hawaii at Hilo College of Pharmacy, and her colleagues.
Most of the medications that were returned were solid tablets and capsules. The top 10 returned prescription medications were simvastatin, lisinopril, prednisone, amlodipine, levothyroxine, metoprolol, furosemide, losartan, hydralazine, and tramadol. The top 10 returned OTC agents were aspirin, ibuprofen, naproxen, acetaminophen, famotidine, ranitidine, omeprazole, docusate, loperamide, and pseudoephedrine combination.
Controlled substances made up only 10% of the return medications, according to the report. The most common controlled substances to be returned were hydrocodone/APAP, oxycodone, oxycodone/APAP, codeine/APAP, and zolpidem.
“The presence of these medications in the home affirms the potential for home robberies and assaults by individuals who are interested in personal use and/or illicit resale,” the authors noted.
“Strategies including take-back lock boxes in pharmacies and law enforcement offices, regularly scheduled accessible Medication Take-Back events, prepaid return envelopes paired with every dispensed medication are all modalities that will provide Hawaii residents opportunities for safe disposal of unwanted/unused medications,” the researchers concluded.