As the widespread availability of prescription drugs has increasingly become an issue of concern around the United States, the county is considering revamping its disposal system for residents’ unused medication.
Last week, the Santa Barbara County Board of Supervisors voted 3-1-1 to hold a hearing later this month to consider an ordinance drafted primarily by the county’s Public Health Department that would shift to local drug producers the responsibility of collecting and disposing of residents’ unused medication.
Fourth District Supervisor Peter Adam voted against the proposal and Fifth District Supervisor Steve Lavagnino abstained.
Since 2009, the county has addressed the issue through its Operation Medicine Cabinet program, where residents can drop off their unused medication in one of eight bins spread out at sheriff’s stations around the county.
Though the bins have collected over 30,000 pounds of medication the past several years, the program hasn’t kept up with demand, the county found, and the Extended Producer Responsibility ordinance is intended to solve both these issues.
Drug producers operating in the county would pay for the collection, transportation, and disposing of the unused medications, and would be required to develop stewardship plans that, among other things, address safety, access, and how they will carry out drug collection, transportation, and disposal.
Unused medication left in homes can lead to misuse, abuse, or in the worst case, an overdose, and the improper disposal of medication can pollute the environment.
One of the ways to address drug misuse and dependency, said Third District Supervisor Doreen Farr, “is to try and create a better environment so that people don’t start down the path of opioid dependency to begin with, and that means trying to eliminate the ability for people to have access to these medications who haven’t had them prescribed.”
A dozen public commenters urged the Board of Supervisors to adopt the ordinance, citing the effects of drug misuse and potential environmental degradation.
Public Health staff said that several other counties in California have an Extended Producer Responsibility ordinance, and that after collection, the unused drugs are incinerated.
The first six months after adoption of the ordinance would involve identifying drug producers, and by 12 months, staff said, the ordinance should be ready for implementation.
In the other counties with these ordinances, staff said, drug producers typically collaborate to create and abide by one or two stewardship plans covering all of them, rather than individual ones, and sheriff’s departments and many pharmacies voluntarily join the program to help out.
Adam expressed skepticism that the ordinance was taking the right approach.
“This assumes that people are going to take the drugs out of their medicine cabinet,” he said. “Why don’t we go after that behavior? If (removing unused medicine is) the type of behavior you’re trying to create, it’s almost like you should make it illegal to have drugs in your medicine cabinet at some point after their expiration.”
A chief concern he and Lavagnino brought up was how drug producers would respond to having to pay for their stewardship plans.
Unless the county — meaning, ultimately, its taxpayers — picked up the tab, Lavagnino said, the drug companies would pass on the costs to its customers, the ones who will primarily use the new disposal system.
Per the ordinance, companies will not be able to add a new surcharge onto their products for the disposal system, but staff and the supervisors agreed that drug prices, will, inevitably, rise a little.
The disposal program, Lavagnino said, could be thought of as a new service that will be built into the price of the drugs.
“I do think that at the end of the day, the manufacturers should pick up the cost,” he said.
The Board of Supervisors also heard a report on the county’s use of the drug methadone to treat opioid addiction.
Methadone, itself an opioid, is widely employed to maintain long periods of abstinence from opioid use and to treat pain.
“As you have no doubt heard, the United States is in the midst of an opioid crisis,” Alice Gleghorn, the director of the county’s Department of Behavioral Wellness, told the board.
“Opioid deaths now exceed car accidents as the No. 1 cause of accidental death in the country, so it’s very important that we spend some time looking at treatment modalities that are effective in how people overcome opioid addiction,” she said.
The county currently contracts with narcotic treatment program Aegis Treatment Centers, which has offices in Santa Barbara and Santa Maria, to carry out medication-assisted treatment for people addicted to opioids.
Medication-assisted treatment combines behavioral therapy with medication, with methadone often utilized as that second component. The drug has been used in the county to treat opioid addiction for 40 years, Gleghorn said.
According to Aegis, the company treats roughly 700 clients in the county at any given time, 80 percent of whom come in every day for a dose of methadone and 20 percent of whom have take-home doses.
The average treatment runs between three and three-and-a-half years. Aegis also does group and individual counseling.
In order to qualify for treatment with methadone, Gleghorn said, a patient must be addicted to opiates, have failed in previous treatment attempts, and demonstrate that methadone would benefit both themselves and the community.
“Addiction is a disease, and I think it’s important, first and foremost, to understand that,” said First District Supervisor Salud Carbajal.
“And then once you understand that, I think it’s easy to understand the importance of these types of services.”
— Noozhawk staff writer Sam Goldman can be reached at sgoldman@noozhawk.com. Follow Noozhawk on Twitter: @noozhawk, @NoozhawkNews and @NoozhawkBiz. Connect with Noozhawk on Facebook.