NHPCO NewsLine Spring 2021 - 20

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provide safe, at-home disposal from cost, to having
a witness available to the inconsistencies between
state and federal laws.
Adding to the challenges posed by the lack of clear
compliance guidelines is conflicting information
about the effectiveness and availability of drug
disposal options.
Hospice and palliative care providers are often
tasked with advising patients and their relatives on
what to do with leftover medications, but not all
disposal options are created equal. For instance,
families may not have the time to take drugs to
in-person take back locations or events (and some
programs won't take prescription medications from
people other than the person for whom the
prescription was written). Other common methods
of disposal-such as sinking, flushing or throwing
drugs in the household trash after mixing them
with unappealing substances like coffee grounds
and cat litter-pose a risk to the environment and
maintain the integrity of the active drugs. These
improperly disposed of medications are still
available for abuse, diversion or leaching into
landfills and water systems.
While various states and care organizations have
different protocols, some care providers have found
success in helping patients and their families
through education on the importance of safe
disposal and by providing them tools to destroy
drugs conveniently and permanently at home.

Providing In-home Disposal Increases Safe
Disposal Behavior of Patients
Capital Caring Health, one of the leading nonprofit
providers of elder health, hospice, and advanced
illness care for persons of all ages in the midAtlantic region, has found a solution that works for
them. Since December 2018, Capital Caring Health
has provided Deterra® Drug Deactivation System
to every caregiver to dispose of all patient
medications at end of life.

20

Newsline / Spring 2021

Capital Caring Health distributes Deterra Pouches
to the patient and family and offers a team
member to assist them, some often ask the team
members to dispose of the medications on their
behalf. Throughout the process, Capital Caring
Health closely documents the medications
destroyed and deactivated for record keeping
purposes. The pouches are designed to be easy for
family members to use: In three steps, place pills,
patches, liquids or films into the pouch, add tap
water, close and shake - then it is safe to throw
away in normal trash. Administering the pouches
upon medication changes or after death not only
prevents abuse and diversion, but also prevents
environmental contamination stemming from
incorrect disposal methods, such as mixing with
kitty litter or coffee grounds, or flushing down sinks
or toilets.
" More than 75 percent of our patients receive their
hospice care in their home or a home-like setting,
making in-home medication disposal a critical
factor in preventing drug diversion, " said Jason
Kimbrel, PharmD, BCPS, Vice President of Hospice
Services at Optum and myNHPCO Pharmacist
Community Leader. " It is our responsibility as
healthcare providers to keep our community safe
and we should be doing everything we can to
prevent the misuse of our patient's medications. "
Studies have shown that providing options like
Deterra increases the safe disposal habits of
patients: Independent research conducted by the
University of Michigan and published in JAMA
Surgery found that patients prescribed opioids and
provided with Deterra for at-home disposal were 8
times more likely to properly dispose of left-over
and un-needed medications than those who
weren't provided disposal education or support.
Over the 2+ years of distributing Deterra Pouches
in the hospice setting, Capital Caring Health has
disposed of numerous medications which has led to
a decrease in opportunities for drug abuse and
diversion. Additionally, using the Deterra Pouches
for at-home medication disposal and implementing
https://www2.deterrasystem.com/l/547442/2021-02-01/hm5fh6
NHPCO NewsLine Spring 2021

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