Drug Takeback Day: Pivoting Towards Community Services to Decrease Clinical Burdens

Drug Take Back Day also known as National Take Back Initiative is a DEA coordinated national event with the aim to have a voluntary removal of unused pharmaceuticals from the general public. These events are normally operated out of local municipalities, hospitals, pharmacies, and government buildings. Most often the event is held biannually on the last Saturday of April and October. Acceptable medications are prescription and over-the-counter medications, normally illicit drugs and syringes are not accepted but may be accepted at other year-round disposal sites that are sometimes operated by local police departments, sharps collection sites are also operated by state and local services but availability may vary based on location.

The business benefit of this federal service is often understated when it comes to clinical and specialized service. With operational margins being tight across all forms of health care, reduction and optimization of extraneous situations help streamline services. With a close association with the sites doing the disposals no longer will physician offices, infusion centers, and pharmacies would be burdened with the disposal of patient-returned prescriptions. Patients commonly bring back their prescribed medications when they are replaced with other medications, when family members pass away, or when the prescription itself expires. The average patient is not usually aware that their normal offices and pharmacies do not have on-site disposal available and rely on traditional means. In turn this results in the provider having to dispose of the medications sub-optimally (flushing/trash) or the expensive mode of secured destruction which incurs operation costs of storing the containers as well as a pickup and disposal charge of each of the containers. These fees can easily enter in the thousands depending on the scale and frequency of removal. The addition of the occasional pill bottle to a hazardous bucket in a cancer center may not “break the bank” but at a larger scale, it would be a line-item concern.

Further general exposure to the drug takeback program can result in decreased medication return attempts in clinical areas. This can be achieved not only by the drop-off spots having higher visibility but also previously affected clinical sites educating and informing patients. In some cases, this information can be communicated directly on the prescription label of the medication or counseling materials provided at dispensation.

The first collection event in April of 2023 resulted in 4,955 individual sites being available nationwide which resulted in 332 tons of medications collected on that date alone. A total of 8,650 tons have been collected since the inception of the program in 2010. As some states such as North Dakota operate their own statewide collection on a more regular basis than twice yearly their reported DEA Drug Takeback Day is lower than the actual collection weight so the provided number is most likely greatly understated.

An Underreported benefit of this program is also an ecological issue. The primary tool for disposing of medications in the general public is to flush them down the home plumbing system or to render them generally unpalatable and dispose of the medication in the trash. Specifically the water-based disposal, those areas that have water reclamation facilities and sewage treatment plants are not aligned to nor are equipped to remove chemical substrates such as dissolved medications from the water supply. This then results in increased levels of multiple medications in the water table and potable water supply. The impact of the medication is not as harmful over time when dissolved as if you were directly taking the medication but the reduction of medical pollution in the water supply should be the primary priority.