Pharmaceuticals

Why are we concerned about pharmaceutical waste?

• $225 billion in medications are prescribed per year; and it is expected to grow to $550 billion by 2017.
  
  
• A 2002 study by the United States Geological Survey (USGS) found that 80% of streams in the U.S. have measurable concentrations of prescription drugs including steroids and hormones.
  
  
• 40% of prescribed drugs aren't taken.
  
  
• Agriculture uses more than half of all drugs - such as antibiotics.

Without convenient disposal options, people often discard unused and expired medications by dumping them down drains, flushing them down toilets, and throwing them in the trash. Areas with municipal water treatment systems treat waste water, but trace amounts of drugs can still be found in the treated water that is ready to discharge to waterways. Studies like the USGS study referenced above show that exposure, even to low levels of drugs, can have negative effects on fish and other aquatic species and may also have harmful effects on human health.

Many pharmaceutical companies that sell drugs in the US are already practicing good stewardship of unused drugs in British Columbia and Ontario, Canada. California needs a pharmaceutical stewardship program and we encourage pharmaceutical companies to help establish one.

News & Events

• Pharmaceuticals found in drinking water, affecting wildlife and maybe humans —Associated Press, no date
  
  
• Pharmaceutical Industry Yields to Pressure from San Francisco —SF Public Press 5/24/11
  
  
• Pharma May Pay to Dispose of Your Old Medicines —SF Bay Citizen 11/23/10
• Pharmaceuticals: It’s Time for Product Stewardship —American Public Works Association Reporter Magazine 3/10
• For Frogs, And Perhaps Humans, There’s Something Strange in the Water —Greenwich Time.com 2/28/10
• Preliminary Summary of the Pharmaceutical Content of Municipal Solid Waste Landfill Leachate Study from three landfills in Maine and Summary Tables of Pharma in Leachate —R. Behr, D. Stahler, and A. Pistel 2/10
• National Association of Counties resolution supporting producer responsibility for unwanted medicines 7/28/09
• Health Care Facilities Flush an Estimated 250 Million Pounds of Drugs Each Year — USA Today, 9/15/08
• Teleosis Launches Bay Area Green Pharmacy Coalition —PRLog 4/13/09
• Pharmaca Integrative Pharmacy
  • Free, Eco-Friendly Medicine Disposal Now at All Pharmaca Stores: Pharmaca sets the bar high with exceptional retail take-back program 11/08
    
    
  • Pharmaca Integrative Pharmacy expands medication “take back” sites: Green pharmacy program keeps unused medications out of local water supply 10/20/08
• MSNBC.com carries Associated Press report on discarded medications 9/14/08
• Solving the Drug Disposal Problem Through Product Stewardship 2.5 MB 12/06
  PowerPoint by Sego Jackson

Policy & Legislation

Local

• County of Alameda Drug EPR Ordinance (Draft)
  
  
• City and County of San Francisco Safe Drug Disposal Ordinance

The proposed ordinance (11/23/10) is the first true EPR ordinance in the world drafted by a local government and was first considered on October 26, 2010 with further amendments. A digest summarized what the ordinance would do, and CPSC sent a letter of support. At the November 23rd hearing, County Sup. Ross Mirkarimi asked for the pharmaceutical companies to come back with a viable alternative if they cannot support the ordinance. The Safe Drug Disposal Ordinance (proposed ordinance and digest and amendments are below) was then put on hold while the City worked with the Pharma companies on a voluntary pilot take-back project funded at $110,000 to accomplish the following:

• 18 month time frame
  
• 20 or more collection sites
  • Non-controlled substances:
    • Pharmacy - 15 sites
    • Police - 5 stations
  • Controlled substances: Police collection
    
• Strictly following the CA Model Guidelines (Model Guidelines -- see "criteria and procedures"), which includes two-key collection bins, use of a licensed medical waste hauler, etc.
  
• $50,000 budgeted for public outreach

"Safe Drug Disposal Information Ordinance" Passed 5/24/11
An entirely different Ordinance was passed, serving as a supplement to the pilot program. When Walgreens and Safeway decided not to participate, Mirkarimi responded by requiring all stores selling pharmaceuticals in San Francisco to advertise how residents can safely dispose of their unwanted or expired medication. In effect, this Ordinance requires the big stores who won’t take-back to advertise the little stores who are collection points. City staff is charged with developing the language and look of the in-store display materials in a public process.

California State

For information on current legislation affecting pharmaceuticals, see 2011 State Legislation.

• CPSC letter to CalRecycle providing comments on report “Evaluation of Home-Generated Pharmaceutical Programs in California” 8/20/10
• Watch as the City of Roseville Debates Their Resolution and Stewardship for Sharps and Pharmaceuticals 7/21/10
• Pharmaceutical Ad-Hoc Committee Comments on Model Procedures 11/21/08
• The Ad-Hoc Pharmaceuticals Committee, a collaboration of local government, agency and industry representatives, is commenting on proposed collection protocols under SB966 guidelines. Review the working document 11/13/08
  
• SB 966 Pharmaceutical Drug Disposal
  Approved 10/12/07
  This bill created a directive for the California Integrated Waste Management Board (now CalRecycle) to develop model programs to devise safe, efficient, convenient, cost-effective, sustainable and environmentally sound solutions to the drug disposal problem.
• CPSC Support Letter for SB 966 3/22/07
• San Francisco Support Letter for SB 966 3/22/07
• Criteria and Procedures for Model Home-Generated Pharmaceutical Waste Collection and Disposal Programs

Federal

• HR 2939 – Federal – Pharmaceutical Stewardship Act of 2011
  The Act would create a National Pharmaceutical Stewardship Organization and require manufacturers and brand owners of drugs marketed in the United States to participate in a certified pharmaceuticals stewardship program.
  • CPSC Support Letter for HR 2939
    
    
• S 3397, Secure and Responsible Drug Disposal Act of 2010
  Signed by President 10/12/10
  This legislation creates more opportunities for collecting unused medicines from homes and long-term care facilities and gives communities more options for providing secure take-back programs.

What You Can Do To Help

What Consumers Can Do

• Dispose of unused or unwanted medications at take-back sites or events.
  Find a medicine take-back location here.
• Do NOT dispose of any medication down the toilet or in the trash
• Purchase drugs in small amounts, limiting the amount of expired medications
• Ask for medications with low environmental impact
• Encourage your provider to take-back unwanted drugs
• Share the message of safe disposal with family and friends
• Commit to wellness strategies to reduce your reliance on medications
• Practice healthy product stewardship

What Pharmacists and Health Providers Can Do

• Do not prescribe more medications than can be used
• Prescribe starter packs and refill packs
• Review and regularly reassess a patient's total consumption of medication
• Consider environmental impact when prescribing medications
• Learn more about which drugs have large environmental impacts
• Educate consumers about the importance of proper disposal of pharmaceutical waste
• Host a take-back site

National Resources

• American Public Works Association - Statement of Purpose for the Safe Disposal of Pharmaceutical Waste
  
  
• NRDC White Paper on Pharmaceuticals in Water: “Dosed Without Prescription”
  —Natural Resources Defense Council (NRDC) 12/09
  
  
• Teleosis Institute
  The Teleosis Institute is devoted to developing effective, sustainable health care provided by professionals who serve as environmental health stewards.
  • Green Pharmacy Toolkit
    
    
• CPSC Case Study on British Columbia Pharmaceutical Program 6/8/09
  
  
• Oregon Association of Clean Water Agencies website
  • Oregon Pharmaceutical Take Back Stakeholder Group Executive Summary 7/07
  • Oregon Pharmaceutical Take Back Stakeholder Group Final Report 7/1/07

International Resources

• Spain
  

  • 2007 Annual Report for Spain’s SIGRE program to manage pharmaceuticals and related packaging

• British Columbia
  
  
  • Post Consumer Pharmaceutical Stewardship Association (PCPSA)
    British Columbia Medications Return Program
    Pharmaceutical producers are currently regulated under the Recycling Regulation and their program allows consumers to return (at no charge) their residual medications to most pharmacies in the province.
    
    
  • Pharmaceutical Disposal Programs for the Public: A Canadian Perspective - Health Canada
    This report discusses Canada's need for a pharmaceutical stewardship program.
    
    
  • British Columbia Ministry of Environment webpage
    Provides overview of product stewardship agencies, BC's stewardship plan, and annual report.
    
    
  
  

Links

• Take Back Your Meds
• The Drug Take-back Network
  
  
• Pharmaceutical Drug Waste (CalRecycle)
• Best Management Practices for Managing Pharmaceutical Waste
• Pharmaca Integrative Pharmacy