Transcript Document

IMPLEMENTING A STATEWIDE
MAIL BACK PROGRAM FOR
EXPIRED AND UNUSED
PRESCRIPTION DRUGS
Improving Patient Safety through Informed Medication
Prescribing and Disposal Practices
October 31, 2007
UMaine Center on Aging
Maine Benzodiazepine Study Group
Camden Hall
25 Texas Avenue
Bangor, Maine 04401
207-262-7920
www.mainecenteronaging.org
Historic State Legislation
• Public Law 2003, Chapter 679
– Maine Unused Pharmaceutical Disposal Program
– Program administration – Maine Drug
Enforcement Agency
– Maine Drug Return Implementation Group
• LD 411 “An Act To Establish a Pilot Program
for Return of Unused Prescription Drugs by
Mail” (Sponsored by Representative Anne
Perry) (Signed 6/27/07)
Maine’s Prescription
Drug Problem
• In 2002, nearly 90% of Maine drug deaths were
caused by prescription drugs (Maine Department of Health
and Human Services, Office of Substance Abuse, 2005)
• Maine Drug Enforcement Agency arrests for
prescription drug misuse or diversion has increased
dramatically to 16% of all arrests (Maine Department of
Health and Human Services, Office of Substance Abuse, 2005)
• In terms of greatest drug threat and the relationship
of pharmaceuticals to violent crime and property
crime, Maine ranks number one in the country
(National Drug Intelligence Center, 2006)
• Maine ranks second in terms of the availability of
pharmaceuticals for abuse (National Drug Intelligence
Center, 2006)
Project Overview
• Unique opportunity to test and refine statewide field model
• Phased mail-in return program
• Funded by the U.S. Environmental Protection
Agency (EPA)
• Working prototype for state and beyond
• Future full scale establishment of Maine
Unused Pharmaceutical Disposal Program
Project Goals
• Remove unneeded prescription drugs
from circulation
• Disposal in compliance with applicable
state and federal laws and sound
environmental practices
Project Objectives
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Quantification by weight, type and
hazardous characteristics by actual pill
count and classification
Cost feasibility of rollout
Education campaign concerning
proper disposal
Phased
Implementation
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Two-phase, 18-24 month project
1. 1,800 mailers available to consumers
through distribution by a pharmacy
2. Refine process; 7,200 mailers available
Number of mailers distributed in both phases
has increased by 50% to 9,000 pieces
Phase I
• 1,800 mailers available through
distribution centers at approximately 7
pharmacies
• Aroostook, Cumberland, Kennebec, and
Penobscot counties
• No formal campaign to drive individuals
into pharmacies to return medications
Phase II
• 7,200 mailers available through
statewide network of participating
pharmacies
• Statewide rollout – 16 counties
• Refinements based on Phase I
experience
• Public communications to drive
individuals into the distribution centers
Key Components
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Secure and manage network of
distribution points (pharmacies) where
individuals pick up mailers to return
medication
Create and issue to distribution
centers informational materials for
pharmacists, staff, and individuals
acquiring mailers
Key Components
• Create and distribute to distribution centers
9,000 mailers and accompanying surveys for
those returning medications
• Collect, inventory and destroy returns in
compliance with applicable state and federal
laws and sound environmental practices
• Conduct activities in a four-county region in
Phase I and statewide in Phase II
Key Components
• Generate, analyze and report on survey and
inventory data in manner that allows
physicians, pharmacists, insurance
companies, patients and others to modify
behaviors to minimize unused medications
• Disseminate related educational information
through statewide network of community
health promotion organizations and municipal
health officers
Project Collaborations and
Advisement
Maine-Based Organizations
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Maine Benzodiazepine Study Group
(MBSG) & Drug Disposal Group
Maine Department of Environmental
Protection
Maine Drug Enforcement Agency
Maine Office of Substance Abuse
Maine Department of Health
Maine Office of the Attorney General
Maine Office of Elder Services
Maine Pharmacy Association
Maine Independent Pharmacies
Maine RSVP Programs
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Margaret Chase Smith Center Policy
Center
Northern New England Poison Center
Federal & National Organizations
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U.S. Drug Enforcement Administration
U.S. Postal Service
Community Medical Foundation for
Patient Safety
National Council on Patient Information
and Education
Office of the U.S. Attorney General
Rite Aid Corporation
American Pharmacists Association
The Benefits of a Maine
Project
• Large rural regions and urban centers
• 38th in population density; < 10 residents per
square mile in over half of state
– Distribution/collection and financial challenges
– Chronic illness and related drug use higher in rural
areas
• Oldest state
– Median age 41.2 years (United States Census, 2005)
– Americans 65+ account for over 1/3 of
prescriptions dispensed, but only 13% of the
national population
Drug Collection Benefits
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Prevent environmental exposure
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Minimize accidental overdoses and
poisonings
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aquatic ecosystem
people, pets and wildlife
Limit “pharming” and drug-related theft
Provide alternative to drug stockpiling
Preclude bad drug donations
Reduce inefficiency in the health care
system
Project Data Collection
• Geographic and demographic patterns of
prescription drug accumulation
• Pharmacoeconomic assessments
– Waste
– Implications for prescribing, insurance
reimbursement, and dispensing policies
The Mailers
• Full compliance for mailing
– USPS/State/Federal requirements
• Postage-paid mailers accommodate a
range of contents
• Padded mailers nondescript and not
easily identifiable to a criminal element
Drug Inventory & Disposal
• Compliance with Maine Drug
Enforcement Agency, Department of
Environmental Protection
– 2 law enforcement officers (double
verification)
– Secure consolidation facility at an MDEA
location
– Repeat count of number of packages
received
– Proper disposal of all drugs collected
Insuring
Elder Involvement
• Community Advisory Board created with older
adults from each county
– Membership reflects state’s diversity
• Community members will serve as
Distribution Site Educators
– Deliver mailers and materials to distribution sites
– Educate site pharmacists and staff on the process
– Refer pharmacists and staff to toll-free project
number and web site
• Educators will promote the benefits of
returning unwanted medications
Projected Outcomes
• Understanding practicality and costs associated with
mail back medication return program
• Information on best methods to educate older adults
concerning hazards of unused medications and
improper disposal
• Reduction in medications available for improper
disposal, diversion or poisoning
• Heightened awareness by public-at-large and older
adults that could lead to reduction in accidental
deaths, human and animal poisonings, and suicides
caused by unused medications
Projected Outcomes
• Hundreds, if not thousands, of
pounds of unwanted medications
collected from households in Maine
and disposed of in prudent fashion
Want to Know More
About the Project?
Please contact:
Daily operations:
[email protected]
Project administration:
[email protected]
Technical issues:
[email protected]