[Noozhawk’s note: This article is part of Day 12 in Noozhawk’s 12-day, six-week special investigative series, Prescription for Abuse. Related links are below.]
Leslie Robinson, like other officials at the Santa Barbara County Public Works Department, has her eyes on San Francisco.
That’s because San Francisco recently struck a deal with pharmaceutical companies to create more places to drop off expired or unwanted prescription medications. Robinson and others would like to see a shift toward collections at pharmacies, which the program specialist says would be more convenient for the public.
Because of San Francisco’s pilot program, residents can now dispose of their medicines — for free — at 16 pharmacies and five police stations in the city. All medications are accepted at the police stations, and the pharmacies will accept everything but controlled substances.
Locally, the Sheriff’s Department and the county Public Works Department’s Resource Recovery and Waste Management Division have been providing people a place to dump their unused drugs through the successful Operation Medicine Cabinet program.
Officials say expanding the take-back effort could be key to preventing more abuse. Seven out of 10 people who abuse prescription painkillers reported getting them from friends or relatives, according to the 2009 National Survey on Drug Use & Health.
San Francisco got the attention of the pharmaceutical industry, and smaller municipalities are taking note.
“We’re going to watch that and see how it goes,” Robinson said.
Many pharmacies currently accept the return of noncontrolled medications, but consumers must pay three or four dollars for an envelope to mail them in.
“It’s not anything that’s widely practiced in this area,” Robinson said.
That became clear last week as sheriff’s Deputy Desiree Thorne emptied out one of the drop boxes outside Sheriff’s Department headquarters at 4436 Calle Real. Over a two-day period, nearly 40 pounds of medication had been dropped off at the location.
Formerly, only law enforcement could handle medication disposal, but a new law is about to make that a thing of the past.
The new law allows consumers to get rid of their own drugs, as long as the disposal conforms to federal guidelines, and permits long-term care facilities to dispose of the drugs of their residents. The Drug Enforcement Administration has begun drafting regulations to implement the law.
Another bill has been introduced in the House of Representatives by Rep. Louise Slaughter, D-N.Y. The proposed Pharmaceutical Stewardship Act of 2011 would require pharmaceutical producers to fund comprehensive take-back programs in each state.
Leslie Wells, program manager of the county Waste Management Division, says that more and more people are asking the manufacturers to take some responsibility.
“People are going to the pharmacy to get these meds,” she said. “It’s natural for them to bring them back. We’re really trying to support any legislation that is looking into that as an option.”
Another solution to the region’s prescription abuse problem could be a shared system in which doctors could check records of patients. Doctor shopping has repeatedly come up as an issue during Noozhawk’s research for the Prescription for Abuse series, and although a state database monitors prescriptions, it’s had limited success as a gate-keeping measure.
Cottage Health System and Sansum Clinic each have their own systems to track what is prescribed and when, but they don’t share information because of Health Insurance Portability and Accountability Act (HIPAA) implications.
The goal over the next year is to improve communications between health-care organizations. Efforts for a shared database were under way about a decade ago, but Dr. Chris Lambert, director of Cottage’s Frequent Opiate User program, said worries about exchanging proprietary and confidential information hindered the move.
“We don’t necessarily talk to each other as well as we could,” Lambert said. “A stumbling block all along has been the lack of a common database.”
Perhaps the best solution to prescription drug project isn’t just about more barriers. Educating the public — especially young people — about the dangers of prescription drug abuse is key, according to Shereen Khatapoush, Youth Services System director of the Santa Barbara Council on Alcoholism & Drug Abuse.
“There needs to be education and supply reduction,” she said. “Doctors need to be more conscious of the prescriptions being written, and people need to understand if they don’t take their full course of medication there are easy ways to dispose of what they don’t use.”
With this theme of education, Noozhawk plans to launch several community forums this winter to talk about solutions that could work in Santa Barbara.
Whether those solutions come from changes at the state or federal levels, the impacts will remain local. Families will continue to be ripped apart by drug abuse until education and tighter controls take place.
“Addiction had robbed us of everything,” Lisa W., a source for Noozhawk’s first Prescription for Abuse series story, said of her family. “That one Vicodin can — and will — put you in prison, emotionally and physically.”