Prescription drug use is rising. According to the Centers for Disease Control and Prevention, by the year 2008, half of all Americans were taking one or more prescription drugs, and 37 percent of older Americans took five or more.
Clearly, these medications help us live longer and healthier lives. However, sometimes they expire – or the patient simply doesn’t want them. Alameda County supervisors say these unwanted drugs are a problem for environmental and public health. They’re proposing a new law that would force drug makers to collect and dispose of them.
Like any other pharmacy, United Pharmacy in Berkeley fills prescriptions. But this small drug store is a little unusual. In addition to handing out drugs, it also takes them back.
Pharmacist Pam Gumbs points to a green metal bin shaped like a mailbox that is part of a limited drug take-back program in Alameda County. Gumbs says the pharmacy serves between 10 and 20 customers a day, and four or five of those drop off unwanted or expired medications. In the whole county, about 24 places like this accept medications.
“It just seems to me to be unfair that people aren’t able to dispose of these medications in a convenient way,” says Supervisor Nate Miley.
Miley is sponsoring an ordinance that would put the burden on pharmaceutical companies, requiring them to organize and pay for the disposal of drugs. The proposed law must go through two rounds of votes. Supervisors approved it for the first time on February 28, 2012. Tomorrow it goes before them for a final vote.
If approved, Miley says it will become the first of its kind in the country.
“What I’d like to see happen is the program be established by the pharmaceutical industry so that people, consumers, could return expired, unused medications over the counter to their local pharmacy – just like we do with batteries and tires and other things,” says Miley.
This kind of product stewardship is a growing trend in the waste industry. California has passed stewardship laws for carpet, paint, and mercury thermometers. With pharmaceuticals, advocates argue stewardship could solve several problems. Unused drugs that are flushed down the toilet, or ones that leach from landfills ultimately end up in a water system not designed to treat them. Or they can sit in medicine cabinets and become potential sources of danger for young children and abuse among teenagers.
There’s a lot of data that shows that it’s like 25 percent of all drug-related crime relates to pharmaceuticals, there’s teen-farming, there’s suicides,” says Joel Kreisberg, executive director of the Teleosis Institute, a nonprofit that promotes environmental health.
“Fifty percent of all poisonings in emergency room visits come from pharmaceutical ingestion,” says Kreisberg, “and so this could really make a big impact if you don’t have pills lying around people’s houses.”
Industry trade group PhrMA denied repeated requests for comment, but in a letter to Supervisors, the group warned that such a law could add to rising health care costs. PhRMA also disputed environmental concerns, saying it’s sufficient to dispose of medications at landfills, rather than flushing them.
Stevan Gressitt, founding director of the International Institute for Pharmaceutical Safety disagrees. “There have been some incidents of landfill operators going through plastic bags looking for drug pills,” Gressitt says. “There are people in the environmental field who argue that landfill is not the best solution because it does end up in the leachate, which then goes to [treatment] plants which can’t remove it.”
Several states, including California, Washington, and Maine have tried passing pharmaceutical disposal laws without success. A federal bill has also stalled in Congress. Gressitt says the Alameda County decision could have a ripple effect. “Those who are involved in drug disposal or efforts to reduce drug waste, I think, are watching it very carefully,” Gressitt says.
Even if the County passes the law, Gressitt questions whether Alameda can handle monitoring drug companies all over the world for compliance. He also says it may not make sense to pass separate laws for every county. “The point being there would then be conflicting or incongruent or mismatched plans from county to county around the country.”
About a year ago, San Francisco got to the very place Alameda is now. Supervisors gave an initial approval and then PhRMA stepped in. The trade group brokered a deal: no law, and they would donate $100,000 for a pilot program. Biotech giant Genentech kicked in another $10,000. That program is just getting started. San Francisco officials guess the money will last from three months to a year and then they’ll need to come up with another plan.