[e-drug] Unused medication disposal

[Stevan]

E-DRUG: Unused medication disposal
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The Moderator has asked if I would mind compiling a list of the responses I received to my query regarding unused medications  disposal from the public. I am quite aware I have an incomplete picture, but I thought this might be a good time to give an extract of what I have received to date. I am cautious about identifying people.  But I would also like to take this opportunity to give the current state of responses and invite further contributions so that 
this list can be expanded. The overwhelming and vast majority have no contact person and that also would be most helpful if that could be provided. 

Where I have contacted individuals, reporting of what is unused/wasted has been generally in pound or kg. and little effort to identify class or active ingredient.

At present we have 2 examples in Australia, one of which has not responded. The other is RUM (Return Unused Medication which can be found on the web but with reports in weight and no pharmacological specifics.)

Several provincial wide programs in Canada: BC EnviRx, Alberta EnviRx, Prince Edward Island, Maine.

In the US there is the legislation initiating a program in the State of Maine now awaiting funding and regulation writing from the Maine Drug Enforcement Adminstration.  In Florida there is a clinic/pharmacy take back but no contact person for the county wide process. 

Indiana has a TRIAD take back over about 30 counties with little useable data other than weight. ( This is the oldest we have found that is continuous in the US and we have contacts for this program.)

In the response we were provided with information from Bahrain, France and Oman that programs exist but with no contacts.

In Finland, Great Britain, Poland, and South Africa we learnt that there are active collection programs linked with pharmacies. But no contact persons.

AS a related process, some US states recycle blister-packed medication that has not been dispensed to the patient from the nursing stations and return them to a facility that repackages them.  When querried for the pharmacoeconomic impact, nothing compelling was 
provided given labor costs.

Another issue that has been brought up around these programs up is drug diversion which is becoming a larger problem here in the US.

I would like to continue to gather and share more information on collection and disposal of unused medicines. In particular it seems it  would be helpful to know:

Geographic or Political entity, Country if country wide, Province, State, County, village, or other geo-political definition

Contact person locally with email, phone, and mail address. If in a non-English speaking area, an English speaking contact or US based liaison that could be contacted.

Year program started

Funding for project; Federal, local government, NGO, grant, industry, health system, consumer, etc.

Population size to which program has access.

Any documentation that is available regarding actual returns in as specific detail as possible down to name of medicine, dose size, quantity, local wholesale price, reason discarded.

Any assessment of impact on health care through this process including assessments of identification of counterfeit ( as occurred in South Africa) changes in dispensing process, labeling or administration guidelines.

It was not meant for the preceding to be daunting, but rather more a series of examples so that an evolving list could be maintained and lessons learned and shared. I will be approaching several other and non-medical lists to attempt to add to his compilation.

Stevan Gressitt, M.D.
Acting Secretary, Maine Benzodiazepine Study Group
www.noemaine.org/benzo/benzo.htm
207-441-0291
"Stevan Gressitt" <gressitt@uninets.net>