Pharmacy dropboxes can help improve proper drug disposal, study results

Proper disposal of leftover drugs can prevent overdoses and protect waterways from drug pollution. Drug take-back boxes are a safe and secure way to dispose of unwanted drugs, but a new Portland State University study shows awareness of these mailboxes and knowledge of the risks of improper disposal remain low.

Amy Ehrhart, PhD student in PSU’s Earth, Environment and Society program and lead author of the study, said the findings suggest efforts to reduce improper disposal should focus on legislation mandating the use of dropboxes in pharmacies and the pressure on the pharmaceutical industry to finance the proper disposal of drugs.

Federal legislation in 2014 allowed retail pharmacies to create personal boxes within stores to collect leftover drugs throughout the year. The drugs are then collected and generally incinerated or disposed of as hazardous waste, which is the approach recommended by the Environmental Protection Agency. Flushing medications down the toilet and throwing them in the trash is not recommended because they pollute groundwater, rivers and oceans.

The study looked at customer disposal behavior, pharmacist recommendations and attitudes regarding the disposal of leftover medications, and the challenges of implementing proper disposal.

Among the results of the study:

• Over a third of the customers in the sample store unused drugs at home, and the most common disposal methods reported were throwing them in the trash (27.5%), rinsing them (15.8%), and using a dropbox (8.3%).
• Having a personal box in a pharmacy has been associated with increased customer awareness of proper drug disposal and safer pharmacist recommendations to customers.

“The focus group highlighted that consumer education would not be successful until we have more dropbox availability,” Ehrhart said. “From their anecdotal experience, those personal boxes fill up quickly and therefore cannot be used until they are emptied.”

The focus group also pointed to costs as a major obstacle to dropbox adoption, with attendees strongly emphasizing that the pharmaceutical industry should be responsible for meeting costs.

In 2019, Oregon joined with five other states to pass a new law requiring drug manufacturers to pay for and operate a statewide drug take-back program. The program is expected to be operational by July 2021. At the request of those pushing for legislation, data collected by this and other PSU studies on the environmental effects of pharmaceutical pollution has been shared with the law and policy makers.

“Legislation that requires pharmaceutical manufacturers to pay for disposal or at least provide some kind of financing to have disposal options is really important,” Ehrhart said.