Prescription Drug Take Back Events Raise Awareness About Safe Drug Use, Storage, and Disposal

October 25, 2018 | ASTHO Staff

Oct. 27 marks the DEA’s next Take Back Day: a nationwide event designed to encourage communities to dispose of and destroy expired, unused, and unwanted prescription drugs. Prescription drug take back programs were conceptualized in the early 2000s with a dual purpose: (1) to reduce contamination caused by prescription drugs in the environment and (2) to prevent the misuse of unused prescriptions.

Since the first DEA Take Back Day in 2010, take back programs have proliferated at the state and local levels, growing even as the nation experienced an exponential rise in opioid overdose rates. This increase in popularity, however, has occurred even as questions persist about the program’s effectiveness at reducing substance misuse.

The need for safe drug disposal is well-established: approximately 42 percent of prescribed medications are unused by the patients they were prescribed for, leaving millions of pounds of unused prescription drugs in homes throughout the United States. Improper disposal of these medications can contaminate the environment with active pharmaceutical ingredients, resulting in negative impacts on both human and environmental health.

The EPA and FDA both support the use of take back programs to reduce unused prescription medication in the environment, with trash disposal as a secondary option for those without access to a take back program. A comparison of incineration through take back programs, wastewater treatment after toilet disposal, and trash disposal showed that incineration is the most effective means of reducing active pharmaceutical ingredients in the environment, but only at national take back participation rates close to 50 percent. Consumer participation in take back programs currently hovers between five and 15 percent, and pick up and transportation of drugs to incinerating facilities, sometimes poses challenges for localities and states.

Though prescription drug take back programs have garnered significant attention and support, research is yet to prove that the events reduce prescription drug misuse: studies conducted to date show that the majority of returned medications are non-controlled substances. Further, only a very small percentage of prescribed medications are ultimately returned. Research shows that consumers who participate in take back programs are primarily motivated by their desire to protect the environment and are not willing to travel more than five miles to dispose of unused prescriptions.

Despite these findings, there may be benefits that are less understood, such as how take back programs may shift attitudes and views on the abundance of prescription drugs in local communities. Health officials understand that these events can function as important conversation-starters within communities about the need for safe drug use, storage, and disposal. The evidence highlights the following key considerations for states seeking to implement or improve such programs:

• Maximize participation by understanding the community’s needs.
• Educate consumers about the relative dangers of specific prescription drugs.
• Ensure that consumers have a convenient location to return prescription drugs.
• Support incineration of drugs returned through take back programs.