By Mark Pew, Senior VP, Preferred Medical
This week I have two articles to share with you about drugs. The first article is about how to properly dispose of unused medicines. The second article is about the work still needed to combat the opioid epidemic in its broadest and continually evolving sense. Below are these articles and my thoughts on their implications.
FDA: Where and How to Dispose of Unused Medicines
This article details the different options you have to dispose of your unused or expired controlled substances in a safe way. Because while your drugs are safe for you, they may be harmful to others, especially children or pets. Even if you hold onto them for a “rainy day” your condition changes so they might not even be appropriate for you in the future. One key igniter of the opioid epidemic was unlocked medicine cabinets filled with dangerous drugs that could be abused by those in addiction. To dispose of drugs in a safe way you have many options, such as flushing, throwing in the trash or through a drug take back program.
Do you have any unused controlled substance medications in your home? They have long been a dangerous feeder to the opioid epidemic and why I have advocated for several years about the semi-annual DEA Takeback day (next is scheduled for April 25). Walgreens also has kiosks where unused medications can be anonymously deposited so you don’t have to wait for the DEA’s designated date. If you don’t need ’em, get rid of ’em. Thanks to Becky Quisenberry for reminding me that Walmart launched a program in January 2018—completely free to the patient —that provides a great way to properly dispose of unused medications via DisposeRx. “The innovative disposal solution will now be provided in addition to ongoing counseling available to Walmart patients on proper opioid use when filling an opioid prescription at any one of its 4,700 pharmacies nationwide. Now, pharmacists can also counsel patients on how to use DisposeRx and distribute an opioid awareness brochure outlining risks and helpful resources.” An even better option is precision medicine where the patient only gets the number of pills actually necessary. Or none at all because pills are not appropriate. The good news is that the practice of an automatic 30-day supply of opioids, without any strategic forethought, is over.
DEA: The U.S. opioid crisis is ‘ever-increasing’
While total and prescription opioid drug overdose deaths in the United States are on the decline, overdose deaths from synthetic opioids are still on the rise. The drug that is the largest contributor is illicit fentanyl, which accounted for almost 70 percent of all drug overdose deaths in 2018. We are still losing thousands of lives each year to opioids, which means there is still a lot of work to be done.
This is a good news (Rx opioid deaths are down) and bad news (continued increase in overdose deaths from fentanyl) story. The overall numbers are down (“Total drug overdose deaths in 2018 declined for the first time in 29 years“) but this perspective is needed: “When we see that we haven’t lost as many in previous years, we have to acknowledge that perhaps we are doing something right. But we’re at this point where we are still losing tens of thousands of lives a year. 57,000 deaths is still too many. It tells us there’s more work to be done.” This story includes two very interesting videos (“Fentanyl, Inc” and “The United States of Opioids”) that are worth a watch. If you want more details on how the opioid epidemic has evolved, the CDC describes the three “waves”:
- The first wave began with increased prescribing of opioids in the 1990s, with overdose deaths involving prescription opioids (natural and semi-synthetic opioids and methadone) increasing since at least 1999.
- The second wave began in 2010, with rapid increases in overdose deaths involving heroin.
- The third wave began in 2013, with significant increases in overdose deaths involving synthetic opioids, particularly those involving illicitly-manufactured fentanyl (IMF). The IMF market continues to change, and IMF can be found in combination with heroin, counterfeit pills, and cocaine.
According to their statistics, “399,000 people died from an opioid overdose between 1999 and 2017.” If anybody tells you that the opioid epidemic is all hype and no substance, ask them to speak to the family or friends of one of the 399,000 people that lost their lives. I have. It is heartbreaking. Which is why we cannot give up.