Medicine Disposal: Mixing leftovers with pet feces

I didn't really want the first entry to be negative, but in the field of AOD prevention, sometimes we need a reality check. So forgive me if I rant on what I perceive as a crazy recommendation to prevent prescription drug abuse.

According to a news report, a new trial is about to begin with folks being told that they should dispose of leftover medicines not only in the trash but mixed with pet feces. The idea is to (1) stop the flushing of medicines which causes a serious environmental problem, and (2) to make the medicines undesirable to those who may take them out of the trash. All well and good. Except they offer no evidence that abusers of prescription drugs get them by sifting through household trash. Indeed, it is bazaar to think that anyone would.

Think of the odds. How many times is your trash poked through? I have never had a sense that mine is, and if it has been, I doubt it has happened often. So that's a very rare event; let's be conservative and say once a year. Now, think of the number of days you'd be disposing leftover medication that's of any value to an abuser. Hopefully that is also an extremely rare event; let's again be conservative and say once a year. Now, we need both very rare events to happen at the same time; on any given year, that would be a probability of 0.00000075 that a trash picker would get your medicine on any given day. So a trash picker would need to hit about 67,000 homes each year to have a 50% chance of striking prescription paydirt once that year. And let's not forget he or she would actually have to find the pills within the trash too. All that seems so unlikely that it is not surprising that we don't hear any evidence that trash sifting is a common source of prescription drug abuse.

Now I don't want to understate the growing problem of prescription drug abuse. Indeed, my colleagues and I have published on the very topic (see Report Vault). The interviewed folks in the news story are probably right that a good chunk of medicines get in the wrong hands when leftovers are kept. But why not recommend a reasonable disposal protocol first, and then go to the extremes if that causes problems. Tell people to throw away your unused medicines. I'd bet the number of people who will actually comply will be much higher if they know that this is fine. Instead these folks are recommending something that many will find disgusting, and will turn them off to change. So they'll flush or just keep the old medicines and nothing will have been improved.

Better yet, how about a sensible prescription policy that limits the number of pills to the amount actually needed. We've all been handed 30 pills when maybe we're expecting a day or two of pain. Afterall its not just kids who get tempted by the leftovers. Perhaps the reason they're not being disposed is because they can be too tempting not to keep.