Pharmacists Perspective on UnwantedWaste Pharmaceuticals: Group Healths Experience

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Pharmacists Perspective on Unwanted/Waste
PharmaceuticalsGroup Healths Experience

• Oregon Drug Take Back Program Convening Meeting
• Portland, OR
• June 24, 2008

Shirley Reitz, Pharm.D., BCPS Associate Director,
Pharmacy Clinical Services Group Health
Cooperative Seattle, WA
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Pharmacists Perspective
Is there a problem? If there is an issue, what
are the primary challenges for Pharmacy in
helping to solve this issue? What has been Group
Healths experience? What is needed to move this
issue forward?
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Is there a problem?

• Patient Demand
• 2006 WCRC survey of 400 King County households
  revealed
• 39 have 10 or more medicine containers in their
  homes
• Only 33 report that they are currently using or
  plan to use these meds
• 74 stated they would be willing to dispose of
  the meds in a convenient location
• We are cleaning out my Grandfathers house and I
  have a suitcase full of drugs that we need to get
  rid of. Can we bring them into your disposal
  site?
• Our neighborhood association (over 400 homes)
  would like to provide some education to the
  families in our neighborhood about drugs in their
  homes can we tell them to bring their meds to
  you for disposal?
• Please dispose of this medication. Enclosed is a
  donation.

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Is there a problem?
Patient Safety - Teens and Prescription Drugs
2007 White House ONDCP report

• New abusers of prescription drugs have caught up
  with new users of marijuana
• Pain relievers, such as OxyContin and Vicodin,
  are the most commonly abused prescription drugs
  by teens
• One third of all new abusers of prescription
  drugs in 2005 were 12-17-year olds
• Prescription drugs are the drug of choice among
  12- and 13-year olds

• The majority of teens (57), who use these
  products, say they get prescription drugs for
  free from a relative or friend (47), or take
  them from a relative or friend (10), without
  asking and
• Adolescents are more likely than young adults to
  become dependent on prescription medication.

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Is there a problem?
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What are the challenges for Pharmacy?

• Regulatory
• Controlled Substance Act
• Drug Enforcement Agency
• State Boards of Pharmacy
• Cost
• Need affordable solutions
• Pharmacies/Patients should not be required to
  fund solutions
• Lack of Educational Outreach
• Education of patients and healthcare
  professionals
• Lack of guidance at the national level
• National pharmacy associations

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Group Healths Goal

• Work with community partners to develop a
  medication disposal system within Group Health
  that is
• Secure
• Affordable
• Reproducible
• Sustainable
• Meets all regulatory requirements
• Easy for our patients to use
• Remove medications from the home that have the
  potential for causing unintentional poisoning,
  overdose, or abuse

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Group Healths Bin Design
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Group Health Bin Signage
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Group Health Patient Brochure
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Group Healths Experience
Disposed to Date Over 10,500 pounds
130 pounds of consumer pharmaceuticals fills one
cage every 3 days
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Is there a problem?
Collected Drugs, Percent by Weight

• Patient Demand
• Over 10,500 lbs of unwanted medications collected
  and incinerated
• Implemented in all 25 Group Health pharmacy
  locations
• Regional pharmacy chain implementing in 10
  additional pilot sites

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Opportunity to Learn More
14 Doses of Enbrel 5,600
Migranal Nasal Spray 120
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Interesting Findings
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Is More really Less?
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What do we need to move forward?

• Models that demonstrate a safe, secure,
  convenient, affordable disposal system
• Pilot program in 25 Group Health Pharmacy
  locations in Washington state
• Design and develop secure disposal bin
• Tracking system from consumer deposit to
  incineration
• Regulatory responsiveness
• Allow secure collection of controlled substances
  from public in convenient locations (pharmacies)
• Reduce administrative burden
• Cost
• Ensure that burden of disposal cost does not fall
  to patients or to the pharmacies

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What do we need to move forward?

• Educating consumers to take action
• Media campaign
• Training for care providers to educate patients
• Web site development (such as www.medicinereturn.c
  om)

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What do we need to move forward?
National Dialogue and Development of Partnerships

• Health Care Providers
• Group Health
• Businesses
• Bartell Drug Company
• Non-profit agencies
• Interagency Resource for Achieving Cooperation
  (IRAC)
• Northwest Product Stewardship Council
• WA Citizens for Resource Conservation
• Pacific NW Pollution Prevention Resource Center

• State and local government
• King County Local Hazardous Waste Management
  Program
• Snohomish County Solid Waste Management Division
• Public Health Seattle and King County
• WA Department of Ecology
• Advisors
• WA State Board of Pharmacy
• WA Department of Social and Health Services
• Pharmaceutical Manufacturers

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Pharmacists Perspective

• Contact Information
• Shirley Reitz, Pharm.D., BCPS
• Associate Director, Pharmacy Clinical Services
• Group Health Cooperative
• Seattle, WA 98168
• 206-901-4334
• Reitz.sj_at_ghc.org