1. Preventing Abuse & Misuse Taking Pills Out of Circulation
David Stevens, R.Ph.
Gordon’s Pharmacy, Canyonville
Pat Moore, Commander
Douglas Interagency Narcotics Team (DINT)

2. Transition from Rx to Heroin
Estimated 73% of Douglas County Heroin addiction cases begin with an Rx dependency (DINT, 2013)
Estimated rates by comparison:
75% in Seattle and Baltimore
80% West Virginia (2016)

3. Douglas County Drug Turn-In Locations
Police Stations
Sheriff’s Office
Gordon’s Pharmacy, Canyonville
Turn-in Numbers
312 lb destroyed via event participation since 2014
440 lb destroyed from police bins in 2017

4. Gordon’s Pharmacy Drug Turn-In Collection Unit

5. Why I Got Involved
Every 15 mins a child under 4 overdoses on drugs from home.
Everyday, about 2,500 young people between abuse a prescription painkiller for the first time.
4 of the top 5 drugs abused by 12th graders are Rx or OTC meds.
Majority of teens report Rx drugs are easier to get than illegal drugs.

6. Drug Turn-In Limitations
Inconvenience of police stations and take back events
People are uncomfortable going to a police station
Events require police officer presence increasing the cost to collect
Requires 2 officers and travel time to Salem (high labor cost and loss of valuable police time)
Not enough locations to encourage safe, convenient and routine turn-in

7. Why Pharmacies? Tight regulatory controls
Pharmacists frequently asked about medication disposal
People who use opiates visit pharmacy regularly (about 2-3 times / month)
Convenient hours and location
More cost effective destruction options
Natural fit and opportunity for community education

8. Pharmacy Turn-In Benefits
Reduce
Increase
Misuse and abuse of medications
Child and pet poisonings
Impact on landfills and wastewater treatment
Groundwater contamination
Foot traffic
New customers
Relationship with existing customers
Mail order
It’s just the right thing to do!

9. About one- quarter of all calls to the ASPCA Animal Poison Control Center are about human medications.
More information:

10. In a 2015 study by the USGS 100% of streams sampled contained pharmaceutical chemicals. Chemical Mixtures and Environmental Effects: A Pilot Study to Assess Ecological Exposure and Effects in Streams By Herbert T. Buxton, et al.

11. Steps to Starting a Program
Modify DEA Registration (2-5 min, no cost)
Notify the Board of Pharmacy
Choose authorized disposal service
Purchase collection unit and liners (cost varies with services and contract)
Arrange means for destruction
Secure the cabinet (carriage bolts, wall or floor)
Establish policy and procedures, including check lists, documentation, signage
Provide routine staff training
Example med return company: RxTakeBack, MedSafe, MedReturn, American Security Cabinets

12. Cabinet Security is a must!
Dagger and Niaca stand watch while I check to see if the container is full.

13. How to Get the Word Out: Promotions
Use available resources:
DEA
Board of Pharmacy
Oregon Pain Guidance Rx Disposal
Pharmacy signs and flyers
Rx bags and bottle stickers
Newsletter, phone hold, social media, advertising

14. How to Get the Word Out: Partnerships
Local law enforcement and community coalitions, e.g., Opiate Task Force
Providers, clinics, hospitals
Public health
Water Districts and City Water
Participate in take-back and “green” events

15. A Few Helpful Resources
DEA Take Back
Oregon Pain Guidance Rx Disposal
orcrm.oregonpainguidance.org/rx-disposal/rx-disposal-pharmacists-clinics/
Aware Prescription Drug Safety Program
awarerx.pharmacy/
AARP Clean Out Your Cabinet
Medsafe