Peninsula health officials review medicine return program

PORT ANGELES — Public health officials on the North Olympic Peninsula are monitoring regulations that require pharmaceutical companies to pay for and coordinate drug take-back programs.

Four counties in the Puget Sound region have adopted secure medicine return programs for the safe disposal of unwanted and unused medications.

Under new county laws, drug manufacturers must set up secure kiosks in pharmacies, hospitals and other locations where people can drop off prescription pills and other medications.

The idea is to get highly addictive opioids and other drugs off the streets and out of the environment.

Opioid addiction is considered an epidemic in Clallam, Jefferson and many other counties.

“Even if there wasn’t the opioid thing, there are lots of good medical and public health reasons for setting up some system that unused meds get taken out of the house,” said Dr. Christoper Frank, Clallam County health officer, at the June 20 Board of Health meeting.

King, Pierce, Snohomish and Kitsap counties have passed secure medicine return regulations, joining more than 10 counties in California and other states.

The Clallam County Board of Health will discuss Kitsap County’s secure medicine return ordinance at its next meeting Tuesday, July 18.

Dr. Margaret Shield, a consultant who is helping counties implement the program, briefed the Clallam County health board last month.

“I think Kitsap’s ordinance would be a great model for you to look at if you wanted to consider whether this is right for Clallam,” Shield said at that meeting.

Medications that are sent to landfills or flushed down toilets can harm the environment, health officials say.

Jefferson County

Storing narcotics in medicine cabinets is problematic, too, because a percentage of those drugs will be stolen or abused, said Dr. Tom Locke, Jefferson County health officer.

The Jefferson County Board of Health discussed secure medicine return several years ago when the program was in its infancy.

“Because there were a number of legal challenges, the decision was made to let King County blaze the path,” Locke said in a recent interview.

“From my perspective, this is something I support.”

Under the regulations, drug makers are required to fund collection sites, transportation and disposal of medications at a federally approved incinerator. The industry must also promote and administer the program.

King County’s ordinance, which was approved in 2013, withstood a legal challenge from the pharmaceutical industry, as did the program in Alameda County, Calif.

Smaller counties have since adopted similar regulations with less resistance from the industry.

“In many regards, the laws are very similar, but each has been tailored a little bit to each county,” Shield said.

“We’ve also been incorporating what we’ve learned from each one as we go along.”

Efforts to make secure medicine return a statewide program have so far stalled in the Legislature, Shield said.

“I know that within the 400 or so pharmaceutical companies, there’s differences of opinion,” Shield told the Clallam County Health Board.

“There are some pharmaceutical companies that say, ‘We should just start paying for this,’ just like they do in other counties. Then there’s some companies that are saying, ‘Hell no, not until we absolutely have to.’

“So then you get the trade association saying no because they don’t have consensus among their members,” Shield added.

More than 80 secure drop boxes have been installed in King County since drug manufacturers launched their Medicine Education and Disposal, or MED, project to comply with local regulations in late 2016.

MED-Projects in Pierce, Snohomish and Kitsap counties will be up and running later this year or in early 2018, Shield said.

Drug manufacturers have estimated the cost of the King County program to be about $2 million per year.

“Now, they’re selling about $2 billion worth of medications into the county, so it is a penny on every $10 or so for them,” Shield said.

“I suspect the $2 million is startup cost, too. There’s definitely more logistical arrangements and staff time with arranging for all these drop box sites.”

Before rules relaxed

Before the U.S. Drug Enforcement Administration relaxed its rules for drug collection sites, law enforcement offices were the only place where unwanted medication could be returned.

Several North Olympic Peninsula law enforcement agencies have medicine drop boxes in their lobbies.

Many have sponsored annual drug take-back events in conjunction with local pharmacies.

“Those law enforcement programs have been incredibly effective,” Shield said. “The amount of medicine just keeps going up every year.”

Port Angeles Police Chief Brian Smith said he would support a countywide medicine return program.

“That would be a really nice adjunct to what law enforcement has been doing for the last six years,” Smith said in a recent interview.

Smith attended a summit on reducing the supply of illegal opioids June 15-16 in Seattle. Frank and Shield were among the speakers at the summit.

“Recovering the supply of opioids that aren’t needed medically is really important,” Smith said. “We want to get unused opioids and other dangerous prescription drugs out of circulation and from places that would attract people to misuse them.”

If the medicine return program proves to be successful in Kitsap County, Locke predicted that the Jefferson County Board of Health would support it.

“If Clallam County is taking it up, that might actually increase the incentive to do it regionally,” Locke said.

“We try to coordinate our public health efforts between these three counties.”

Locke added that certain medications such as cancer chemotherapy drugs can be dangerous if mishandled.

“It really is the responsibility of the manufacturers to take back the unused medication,” Locke said. “Ultimately, they’re the experts. They know how to safety dispose of them.”

Clallam County Board of Health members said they would review the Kitsap County ordinance and determine the next steps.

“I think it would make real good sense for us to put a little bit more shape around what we’re hoping to accomplish,” said Mark Ozias, Clallam County commissioner and health board member.

“When it’s partially or mostly formed, I think that that would be an appropriate time to take it out to the broader community, perhaps looking at an ordinance.”

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Reporter Rob Ollikainen can be reached at 360-452-2345, ext. 56450, or at [email protected].

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