As I counted the 258 tablets of Oxycodone that a patient’s elderly spouse brought to the adult foster home where he was now dying, I couldn’t help but think of Walter White’s doomed catapult into corruption and greed, (I admit, I too got “hooked” watching “Breaking Bad”). The innocent brown bag could have been the means for a serious drug infraction as the adult foster home owner planned to throw the intact bubble packed cards into the garbage. No, that is not the accepted means of controlled substance disposal! The Oxycodone tablets would no longer be beneficial to my patient; he could no longer swallow and now needed a concentrated liquid form of pain reliever. The small grocery paper bag filled with pills that the shaky hand of his elderly wife had handed me had a street value calculated at over five thousand dollars!
Getting rid of unwanted prescription drugs is an ongoing dilemma in our country. This of course is not the first time I have had to waste perfectly good narcotics, some that are extremely expensive; even all wrapped up and untainted, they still must be destroyed. Regulations from the federal government which demand none of these medications can be “recycled” but must be destroyed contribute to both drug cost and waste disposal throughout our county. There is no program for ensuring unused, unexpired, unopened and intact pain medications can be reused for another person (except the illegal use of diverted drugs, a significant problem everywhere!). I got to thinking, what if there was a credit, like turning in your bottles or cans for the rebate, and people were encouraged and possibly rewarded to leave their unused medications where they could at least be re-engineered?
In all our advanced technology, couldn’t some brilliant corporation develop a way to ensure these chemicals were not being misused but reused? Like a water treatment plant that washed and filtered the drugs just like we do our drinking water? But of course, I am oversimplifying a huge and complicated problem, and a bigger question is why would our pharmaceutical companies that are multi-billion dollar industries choose to develop a plan to recycle their drugs?
I know it is a ridiculous idea, and like I say I did get hooked on “Breaking Bad” which is my only excuse for even pondering narcotic recycling. Sometimes our ideas get us into A LOT of trouble. But somehow, in a society that is conscious of waste and attempting to find ways to lesson our impact on the planet, we have regulated ourselves into wasting literally millions of dollars worth of pharmaceuticals. At least they are now no longer flushed into sewage which is then recycled into drinking water, (though I cannot help but wonder what will happen to our contaminated soil as time and leaching dissolve these drugs into the earth).
Cost of attempting to reduce the use of illicit drugs: in excess of 25 billion dollars spent annually on the anti-drug war. This global issue being fought internationally has no solution offered for the bags, cartons, wrappers, syringes, and various containers of unused prescription drugs that a person no longer needs. It is not just the specialized labs and narcotic rings that are producing drugs to sell; it is also our legitimate pharmaceutical companies, and insurance companies, who allow someone to have a 90 day supply of pain medication filled (even though pain management changes sometimes quite rapidly as someone’s disease progresses, and the medication ordered one week isn’t used the next).
Though the DEA stipulates that law enforcement can take back controlled substances, very few “take back” programs exist for controlled substances from state to state. Fraught with difficulty due to destruction and disposal, there are very limited options for states to manage “taking back” narcotics, and all programs are wasting the medication, there is no “recycle” going on. People can and do have excessive numbers of narcotic prescriptions filled at their local pharmacies. The flip side of this is a person who really needs pain medication sometimes cannot obtain enough to adequately manage their pain, because physicians prescribing controlled substances feel scrutinized and everyone is aware of this massive problem but no one can offer a solution. I, too, am at a loss. But I feel this huge sense of guilt every time I waste unused narcotics and wish there was a way to avoid it.
So I am hoping that those of you who were captivated by Walter’s depraved use of his intellect and manipulating of everyone in his life might have been inspired to come up with a new way to manage not just pharmaceuticals in general, but also the incredible waste of expensive opiate drugs in this country.