Holding a national prescription drug take-back day has some immediate benefit in terms of protecting the environment and reducing prescription drug abuse and accidental poisonings at the far margins. But if we are still doing these sorts of “events” a decade from now, it will be a policy failure.
A sheriff in an Arkansas town of about 25,000 people told me that at one poorly advertised 5 hour take back event his deputies held in a parking lot next to Wal-Mart, they collected 50,000 pills. That’s amazing for a town that size, but consider a bigger number: There will be about 150 million prescriptions written for a single pain killer (hydrocodone) this year. Single day events, however impressive, will not stem this tide.
What is needed instead is a change in cultural practice such as what has happened with recycling. In the late 1970s and early 1980s, recycling was something that happened rarely, and was billed as an event, e.g., A dozen non-profits will be recycling your old newspapers and glass at the shopping mall this Saturday, come on down! At one such event, a friend of mine who worked at the same non-profit as I did told me as I separated brown and clear glass that when he lived in Germany there were no recycling days. There were big bins for different types of glass and people just put their glass in. He assumed they would mix everything up and climbed up on a bin to see. He was shocked to observe that the glass was nearly perfectly sorted.
We need something like this mentality to take hold in our culture around prescription drugs, just as it has for recycling glass and newspaper. We don’t have “recycling day” any more, we just do it because it’s what you do. Those recycling days were in that sense a success, because they raised the visibility of recycling and helped make it a standing cultural practice (as did other things, like a deposit on bottles).
For the same cultural practice to take hold with prescriptions, getting rid of unused medication needs to be behaviorally easy and cognitively meaningless (i.e., we just do it because it’s what we do). One possible method is to give out pre-paid return mailers with every prescription and also have them available in libraries, community centers, post offices, hospital waiting areas and the like. Another is to work with private industry such that whenever you go to a drug store, you can toss your old meds into a bin next to cash register. Until we get such a system in place pragmatically and in our cultural habits, we have little chance of making a major impact on the epidemic of prescription drug addiction and overdose that is sweeping the country.