The Department of the Environment releases the "San Francisco Medicine Waste Characterization Study" evaluating the types of unwanted and expired medicine being disposed.

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The San Francisco Department of the Environment, in collaboration with the San Francisco Public Utilities Commission (SFPUC) and San Francisco Police Department (SFPD), launched the Safe Medicine Disposal Pilot Program in April 2012. The Pilot Program utilizes funding from pharmaceutical manufacturers to provide San Franciscans with a local and convenient opportunity to dispose of unwanted and expired medicines while protecting public health and the environment. This week, the Department and its partners announced an agreement with the Pharmaceutical Research and Manufacturers of America (PhRMA) to continue to fund the pilot program for an additional year with a new grant in the amount of $125,000.

"The success of this pilot program is beyond our initial expectations. Having collected almost nine tons of unused medicine in only one year illustrates the unmet need for a safe and secure method for our residents to dispose of unused medicines," said Melanie Nutter, Director of the San Francisco Department of the Environment. "With the support of our 13 partner pharmacies, the police department, the SFPUC and PhRMA, we are pleased to be able to keep this valuable program going and help residents keep unwanted medicines out of our landfill and water supply while we work towards a permanent and sustainable take back program."

 "We're excited about the success of San Francisco's pilot program," said David Chiu, President of the San Francisco Board of Supervisors. "The amount of unused medicine collected illustrates the demand and need for safe disposal of unwanted and expired medicine. The success we have had working with PhRMA to partially fund this program shows the need for industry to participate and take responsibility to properly dispose of their products. Over the next several months, I plan to work with the Department of the Environment to bring other generic and brand drug manufacturers to the table to help fund a permanent, ongoing medicine collection program supported by all manufacturers."

Unused medicine is a threat to public health and safety, as well as to the environment. Since 2003, more drug overdoses have occurred annually from prescription medicines than from cocaine and heroin combined. According to the Center for Disease Control, "Prescription drug abuse is the fastest growing drug problem in the United States." Accidental poisonings from medicines stored in the home are also a concern for young children, seniors, and pets.

 "We are pleased that our partnership with the Department of the Environment and SFPUC will continue an additional year in order to keep controlled substances off our streets and help prevent accidental overdosing," said San Francisco Police Chief Greg Suhr. "Safe disposal of unused medicine is not just a benefit to our environment, it is a benefit to the health and wellbeing of our communities, and the more we can dispose of medicine properly, the less my department has to worry about it getting into the wrong hands." 

The SFPD's willingness to accept controlled substances, as well as other unwanted medicines at all ten San Francisco police stations 365 days per year has made San Francisco's pilot program more comprehensive than the other collection programs for controlled substances, most of which operate only a few days each year.

San Francisco Medicine Waste Characterization Study

As part of the initial pilot, the Department of the Environment commissioned a medicine waste characterization study to evaluate the types of products disposed using the program. The identification and characterization of the items in the study was performed by Supporting Initiatives to Redistribute Unused Medicine (SIRUM).  Dr. Joel Kreisberg of the Teleosis Institute, author of the Bay Area Medication Disposal Study 2009, was contracted to evaluate the data and present findings. The Study inventoried one week's worth of unwanted medicines collected at each of the 13 partner pharmacies and one month's worth of unwanted medicines collected at all ten of San Francisco's police stations for a total sample size of 472 pounds.

Key findings of the Study include:

  • 71.9% of items 1 identified in the sample were prescription medications.
  • Testosterone (3.3%), sevelamer carbonate (2.5%), ibuprofen (2.5%), acetaminophen (2.1%) and albuterol (2.0%) were the most commonly returned active ingredients in items identified in the sample.
  • Renvela (5.9%) and Testim 1% (5.5%) were the most common proprietary or brand name medications returned by a large margin.
  • Teva, a manufacturer of generic medications, represented the most commonly identified manufacturer of items (7.8%) in the sample.
  • The three most common therapeutic classes represented were central nervous system agents (17.4%), cardiovascular agents (11.4%), and respiratory agents (11.1%).
  • Controlled substances were identified as 11.6% of the items in the sample.

The study sample of 472 pounds represents 2.7% of the total 17,142 pounds collected in the Pilot Program's first year at 23 pharmacy and police station take-back sites.  The sample is large enough to provide an accurate picture of household pharmaceutical waste in San Francisco. The results of the study will be used in San Francisco and elsewhere to improve unused medicine collection programs and reduce over prescription.

"In the future, policy makers and funders would benefit from knowing qualitative data about the characteristics of users of the program, particularly in terms of complying with physicians' and pharmacists' instructions as well as patterns of accumulation in homes," said Dr. Joel Kreisberg, DC, MA, from Teleosis Institute and principal author of the waster characterization study.  "Without the data and analysis provided by this report, there was no certainty that San Francisco's program was operating as intended. Based on the results, it is clear that the pilot program is working."

"San Franciscans have shown that they will take extra effort to responsibly and safely dispose of unwanted and expired medicines when given a reasonably convenient opportunity.  By providing additional funding, the pharmaceutical industry is joining the Department and its partners in a commitment to provide this opportunity," added Nutter.

San Francisco Safe Medicine Disposal Pilot Program

San Francisco residents can find a safe medicine disposal location near them by going online to http://recyclewhere.org. Residents should prepare for their visit to the disposal location by removing all pills from their plastic bottles (which can be recycled in the blue bins after removing labels or marking out personal information) and put them in a small bag or as few containers as possible before bringing them in, and then put the pills directly into the locked disposal box. Liquid medicine should be tightly closed and the entire container placed in the safe medicine disposal bin. 

Notes:

(1) Please keep in mind that the "item" as a unit of measurement represents a container of one type of medication, like a pill bottle or a bottle of liquid medication. An item may similarly represent groupings of identical loose pills returned without their original container.  To reduce the volume of waste requiring special management, residents are requested to empty unwanted pills into a plastic bag or directly into the collection bin and recycle the original container.