Taking back the drugs: Providence adds kiosks to collect, dispose of unused medications

As a way to fight opioid abuse, Providence Health has installed regional drug take-back kiosks so people can dispose of unused medications.

Opiod misuse is an ongoing problem. In Spokane County, there were 197 opioid-related deaths from 2013-2017, according to the Spokane Regional Health District. The agency says that in 2014, 1.7 percent of Spokane County adults reported using an opioid medication to get high in the previous 30 days. And in 2016, 4.9 percent of high school students reported using opioids to get high in the previous month.

Providence Health’s new medication take-back kiosks include one in Sacred Heart Medical Center’s main lobby near the pharmacy and another in Holy Family Hospital’s north entrance. It also installed kiosks at Mount Carmel Hospital in Colville and St. Joseph’s Hospital in Chewelah.

The Providence sites join other drug disposal boxes at area law enforcement and pharmacy facilities, although not all pharmacies can accept controlled substances. The new hospital sites can under program guidance and regulations of a Drug Enforcement Administration division.

“This is actually part of an approach for us to address the opioid crisis in our communities,” said Sean Dobbin, a Providence regional director of pharmacy services in Spokane. “Having the drug take-back kiosks located strategically in our communities makes it available for folks to get rid of their unused medications with emphasis on the controlled substances, specifically the opioids, and getting those out of people’s medicine cabinets.”

Securely disposing of all unused or expired drugs reduces the risks of accidental poisoning, overdoses and thefts of medications from residences, he said. People also can use the Providence kiosks to dispose of old vitamins, pet medications and over-the-counter medicines.

Disposal removes the chance of unused drugs being found by young children or teens as well as anyone else who visits a home, Dobbin added.

“Prescription drug abuse is growing,” he said. “It might be a drug that doesn’t have an abuse potential, but a person taking it might not know that, or might be trading drugs. Any drug has a risk and a benefit. I’d imagine any of those drugs that get out in community and are used for anything other than their prescribed reason would be a high-risk situation.”

Incineration vs. flushing

Another benefit of such kiosks is to keep pharmaceutical waste out of regional waters, providing a better choice than flushing pills down the toilet, Dobbin said.

Residual pharmaceuticals levels – even after wastewater treatment – is a concern nationally, said both Mike Petersen with the Lands Council in Spokane and city of Spokane spokeswoman Marlene Feist.

“Take-back programs like this are a great option,” Feist said. “And we don’t encourage (that) people flush medications in the toilet. We encourage them to use programs like this or to mix them in with things like coffee grounds, so they dissolve and then put that in the trash.

“Treatment plants don’t remove all pharmaceuticals from effluent,” she added. “Pharmaceuticals will always end up in wastewater, however, through people’s wastes.”

Petersen, Lands Council executive director, said he’d like to see more drug-take boxes around the community along with awareness. Among its roles, the Lands Council works with the health district and the Department of Ecology to keep toxins such as plastics and pharmaceuticals out of the Spokane River.

“This seems like a very positive step,” he said. “Some of these drugs wouldn’t necessarily be broken down; some are very persistent. Other cities have done studies and found they can make it through the treatment plant, and then get discharged in our case in the Spokane River.”

At Providence sites, Dobbin said all medicines put into the kiosks are taken to a secure location and incinerated. Although Spokane has a waste-to-energy system, there are risks of people rummaging through trash if residents simply throw away drugs, he said.

“In areas that have incineration available, drugs disposed of in the waste are still at risk for others to take out and use prior to incineration.”

At Providence’s kiosks, drugs can be dropped off in their original containers or in daily-reminder pill boxes. But Dobbin recommends that people remove any identifiers such as labels, “just out of an abundance of caution,” although the sites are secure and only pharmacy staff handles the removal.

“Even within our team, we don’t in any way sort or go through those medications,” he said. “They’re just secured and securely shipped to the incinerator.

“We prefer that people keep their medications in the original containers, but we understand that some people do the daily-planner boxes. But ultimately, it’s secured … there is no mechanism of where people are sorting through those.”

Taking in veterinarian-prescribed medicine also helps with community safety, Dobbin said, because those pills have active ingredients similar to what is given to humans.

So far, the deposit rate seems steady among all Providence kiosks. It’s taken in about 130 gallons, the volume of all contents including packaging, bottles and pills, that fill the liner bags for kiosks, he said.

Dobbin also cautions for medications in use, that people store them in a locked cabinet or somehow secured, especially in a multigenerational home or if grandchildren regularly visit.

Allowed vs. not allowed

Providence lists items that can go into kiosks:

Prescription drugs and patches

Vitamins

Prescription ointments

Over-the-counter medicines

Items that aren’t accepted:

Needles

Inhalers

Aerosol cans

Thermometers

Lotions or liquids

Hydrogen peroxide

Two online sources map drug take-back locations: Washington Poison Center’s http://www.takebackyourmeds.org/ for statewide locations, and the DEA’s Diversion Control Division at https://apps.deadiversion.usdoj.gov/.

The DEA division also promotes a national prescription drug take-back day in the fall and spring, with the next one scheduled April 27.