The Health Crisis in Your Cabinet
The Atlantic

Every year, tens of thousands of kids get their hands on bottles of prescription medicine and manage to wrestle off the childproof caps. About 71,000 end up ingesting enough to get sick or even die. Older kids — and even adults — sometimes experiment with unused medication and start the cycle of misuse and addiction. As a community advocate for addiction recovery and founder of several support programs, including the Friends of Addiction Recovery–New Jersey, Jeanette Grimes was familiar with the dangers of substance misuse. However, she didn’t think about her unneeded or expired medications as being a risk to her grandchildren, others or the environment. “I never realized how leaving my medicine lying around could harm anyone,” says Grimes.

So when the Trenton, N.J., resident heard the statistics from the American Medicine Chest Challenge (AMCC) — and learned about their accompanying drug take-back program — she gathered all her unused and expired medications and took them to a nearby drop-off location. Now, as a consultant and community organizer for The Partnership for a Drug-Free New Jersey, one of the sponsors of the AMCC, she educates others on the dangers of unused drugs.

And the risks are serious. Sarah Wakeman, M.D., the medical director of substance use disorders at Massachusetts General Hospital’s Center for Community Health Improvement, gets a firsthand look at the growing epidemic of both fatal and nonfatal drug overdoses. She says many of her patients took their first steps toward addiction by experimenting with prescription medicines. In fact, about 65 percent of people misusing prescription painkiller report they obtained them from friends or relatives, according to the 2012 National Study of Drug Use and Health conducted by the U.S. Department of Health and Human Services. To put the problem in perspective, Wakeman says that prescription painkillers now kill more Americans than heroin and cocaine combined.

“Let’s get the pills out of the house and educate the public about the dangers they pose,” she says.

Drug take-back programs are proving to be an effective way to do that, says Wakeman. “They serve the dual purpose of providing education about the risks associated with these medications and providing a safe means of medication disposal.

Question:

If you could scale up one remarkable health care idea, what would it be?

Answer:

"Studies show that most misused prescription drugs are obtained from family or friends, and old prescriptions that languish in home medicine cabinets are susceptible to misuse. Drug take-back days in local communities serve the dual purpose of providing education about the risks associated with these medications and providing a safe means of medication disposal."

- Sarah Wakeman, M.D., medical director for substance use disorders at Massachusetts General Hospital’s Center for Community Health Improvement

 

The AMCC is one of a growing number of community-sponsored prescription drug take-back programs throughout the country. While the U.S. Drug Enforcement Agency sponsors an annual ”take-back” day every October, many communities are also increasing their involvement year round. Partnerships among local police departments, pharmacies, schools and universities, hospitals and civic organizations have brought forth not only take-back days, but also permanent drop-off sites at local police departments.

The nonprofit AMCC, which grew out of the Partnership for a Drug-Free New Jersey, became one of the first organized, statewide efforts in the country to focus on drug disposal efforts. The organization assists 1,000 community coalitions that sponsor a national day of awareness on the second Saturday in November, according to Chief Executive Officer Angelo Valente. The group also works nationally with the 46 states that offer permanent drop-off locations.

To bring attention to the dangers of keeping unneeded medicines, the AMCC created the “5-Step American Medicine Chest Challenge,” which includes taking inventory of your medicine; securing your medicine chest; disposing of your unused, unwanted and expired medicine at an approved disposal site; taking medicine only as prescribed; and talking to your children about the dangers of prescription drugs.

“We are calling on residents to see their medicine cabinets through new eyes — as an access point for potential misuse and abuse of over-the-counter and prescription medicine by young people,” says Valente.

Securing medicines is only one aim of drug take-back programs. Missouri’s Prescription Pill and Drug Disposal Program (P2D2), established with support from the St. Louis College of Pharmacy, Missouri American Water and Metropolitan St. Louis Sewer District, educates the public about the best ways to dispose of prescription and nonprescription medications, not only to protect their health but to safeguard the environment as well. According to the Environmental Protection Agency, pharmaceuticals show up in our water systems partly through improper medication disposal, like throwing it in the trash or down the drain. While the risks of drugs in our water system are still largely unknown, their presence has been identified in nearly every water sample tested.

“Flushing medicines down the toilet sends them to wastewater treatment plants — which were never built to screen out active ingredients in medications — and then into our rivers and streams,” says Amy Tiemeier, a professor at St. Louis College of Pharmacy and vice president of Missouri P2D2. The group has permanent medication drop-off boxes in nine police stations around St. Louis County. Since April 2013, approximately 4,400 pounds of medication have been collected from Missouri P2D2 boxes and properly destroyed.

For areas where no take-back program is currently available, the Food and Drug Administration provides guidelines for proper medication disposal at home. But, for a growing number of people, the programs offer a convenient, safe and easy way to dispose of potentially dangerous medications. For addiction recovery advocate and grandmother Jeanette Grimes, keeping on top of what’s in her own medicine chest has now become a regular routine. “You change the clocks, and you know to check the batteries in your smoke detector,” she says. “Cleaning out my unused drugs is just something else I do to keep my loved ones from harm.”