Products

Pharmaceuticals and Product Stewardship

Pharmaceutical use in the general population is common and growing. Nationwide the average 2006 prescription rate was 11.1 prescriptions per person, for a total of $192 billion in prescription sales according to Kaiser State Health Facts. Americans purchased 71% more prescriptions from 1994 to 2005, compared to a US population growth of 9% according to the Kaiser Family Foundation May 2007 Prescription Drug Trends Fact Sheet (PDF file, 936KB).

This means that more often than not, households have left over medications that they need to dispose of including prescription drugs, over the counter medications, free samples, Drug Enforcement Agency (DEA) controlled substances, and dietary supplements (vitamins). A 2006 SoundStats survey of disposal practices for unwanted medicines (PDF file, 285KB) from the Washington Citizens for Resource Conservation found that King County residents in Washington State are actively using or planning to use only a third of the medicines they have in their households in the next six months.

Many households will store medications before they finally resort to flushing them down the toilet, disposing of them in the trash, or giving them to someone else.

For an overview of the issue, see Dave Galvin's presentation Household Pharmaceutical Disposal: Issue Overview and related presentations and handouts from the 2008 Medicine Take-Back Workshop.

What is the Problem?

Limited Options for Proper Disposal

Safe and proper disposal methods are currently not available to the consumer or family due to regulatory and financial barriers for take-back programs in the US. Therefore, people must use the avenues of disposal available to them. The 2006 SoundStats survey of King County residents found that “Slightly more than half (52%) of all respondents report their household typically disposes of their unused or expired medicines in the garbage and 20% of all respondents dispose of medicines by flushing them down the toilet or sink.”

Water Pollution

Pharmaceuticals enter the water when they are flushed down toilets and sinks, put into the garbage, or when humans and animals pass drugs through their bodies. Scientists are beginning to find chemicals from pharmaceuticals in almost every sample taken from surface water, effluent, and drinking water in the US and Canada. Conventional wastewater treatment is not able to eliminate the majority of pharmaceutical compounds.

Long Term Exposure

There is increasing concern regarding the disposal of pharmaceuticals in landfills. The leachate that is captured from some landfills may be discharged to water bodies via treatment plants that don't effectively extract pharmaceutical residuals. There is also concern that landfill liners may leak over time resulting in discharge of pharmaceutical contaminants to the ground water.

Poisoning

The most common poison exposure category in the US is medications. The massive amount of pharmaceuticals available in homes presents the potential for accidental poisoning if the medications are not securely stored or disposed. The Centers for Disease Control reported that in 2004, 95% of unintentional and undetermined poisoning deaths were caused by drugs. In 2000, poisonings led to $26 billion in medical expenses and made up 6% of the economic costs of all injuries in the United States. Find more statistics about drug related poisonings from the CDC.

Misuse and Abuse

Prescription drugs, over the counter medications, and controlled substances are targets of drug users. Unsecured disposal to the garbage or at improper facilities may result in increased drug abuse or dealing. The National Center on Addiction and Substance Abuse found that the number of Americans who abuse controlled prescription drugs has nearly doubled from 7.8 million in 1992 to 15.1 million in 2003. Prescription drug abuse among teens has more than tripled during that time. Learn more from the fact sheet Under the Counter: The Diversion and Abuse of Controlled Prescription Drugs in the US.

The Product Stewardship Solution

Pharmaceuticals present both a public safety and environmental hazard if no secure disposal options exist. Therefore, a safe collection and disposal alternative is necessary. Such a collection infrastructure will only work if Product Stewardship is integral to the design whereby residential customers can “take-back” pharmaceuticals to local pharmacies and drug stores.

• Manufacturers should be responsible for the stewardship of their products on behalf of the communities they serve and the environment on which those communities depend for their health and well-being.
• A take-back system can be modeled after other take-back programs such as those for light bulbs, thermometers, batteries, computers and oil.
• Take-back conveniences bring the customer into the store. In waste oil collection programs carried out by auto parts stores, such service leads to increased sales. In the case of recent electronics take-back programs, in-store collection generated first time customers.
• A collection program is capable of collecting data that can be used to reduce waste thru educational efforts in both pharmaceutical use and prescription writing.
• Separate collection helps communicate the environmental impact of this waste stream to the responsible parties: consumers, retailers, and manufacturers.
• The program's cost may be easily absorbed by industry as a customer service, and not so easily by local governments, consumers, and/or rate payers.
• Governments do not know as much about the product or the characteristics of the waste as the makers of the product, thereby making government less capable to manage this waste.

There are many successful and cost-effective examples of manufacturer stewardship in pharmaceuticals, including British Columbia, Australia, Prince Edward Island, France, Italy, and several other European countries. Learn more about International Pharmaceutical take back programs.

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