Drug Topics - March 2009 - (Page H11) DRUG DISPOSAL “We are trying to work out solutions with public agencies so there is no additional cost to facilities, to pharmacies, or to the environment,” — Gene Memoli, RPh, DT Editorial Advisory Board member rules that would make it easier to dispose of controlled substances while reducing the potential for diversion. But the agency’s ability to ease current regulations is limited by the Controlled Substances Act. When passed by Congress in 1970, the CSA was written solely to control diversion. It made no provision for the disposal of unused medications. Once a product is dispensed, the CSA assumes that it will be taken as prescribed, with nothing left over. That leaves hospitals, long-term-care facilities, physician offices, dental offices, veterinary offices, and individual patients with few alternatives. Unused medications can be flushed, washed down the drain, mixed with some unpalatable substance such as coffee grounds or cat litter and disposed in trash, returned to one of a handful of DEA-authorized disposal facilities, or given to local law enforcement. Each of these methods raises concerns, Zimmer said. Flushing or washing down the drain puts controlled substances into surface water supplies. Medication put into trash that goes to landfills also leeches into the water supply. Few DEA-approved waste-disposal facilities accept controlled substances from individuals, and almost no law-enforcement agencies have the time, personnel, budget, or facilities to accept unwanted medications. “The act does not contemplate this disposal issue,” Boggs said. “The statute does not allow for the disposal of controlled substances. There will need to be a statutory change. I am not aware of any pending legislation, but Congress is definitely aware of this issue.” At least one group has found a partial solution. In Connecticut, long-term-care facilities have begun shredding unused unit-dose medications, including controlled substances. Two facility employees run unused blister packs through industrial shredders, then dump the chaff in solid waste, which is incinerated. “We are trying to work out solutions with public agencies so there is no additional cost to facilities, to pharmacies, or to the environment,” said Gene Memoli, president-elect of the Connecticut chapter of the American Society of Consultant Pharmacists and a DT Editorial Advisory Board member. “We couldn’t make this kind of recommendation if our garbage went to landfill.” March 2009 DRUG TOPICS H11
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