1. Methods
• Stakeholder Interviews: In person and over the phone interviews
were conducted to generate perspectives regarding EPR of PhRMA
lobbyists, chain pharmacies, small-scale pharmacies, and members of
the city government.
• Surveys: 50 Santa Clara County citizens were randomly surveyed
regarding public knowledge of safe disposal and preferences for
disposal options in front of the Martin Luther King Jr. Public Library
in San Jose, CA.
• GIS Mapping: Current drop-off locations in Santa Clara County
were overlaid with population density data for the area.
• Comparative Case Studies: Pros and cons of city-funded and
producer funded take-back programs were assessed for Sunnyvale
and Alameda County.
• Public Health and Water Quality Assessment: Risks generated from
improper consumption and disposal of medications for people and
the environment were evaluated.
Acknowledgements
Special thanks to Rob D’Arcy, Leslie Gray, Chris Bacon, and Stephanie
Hughes. We appreciate the participation of all of our interview subjects and
survey respondents.
Public Health and Environmental Concerns
• Drug poisoning is the number one cause of accidental death of adults
in US.
• Elderly mix up drugs in the cabinets and can overdose.
• Leftover medications and controlled substances are stolen and
abused.
• “Pharm parties” during which pharmaceuticals and controlled
substances are ingested recreationally result from access to drugs.
• Pharmaceuticals that are excreted, flushed down the toilet, and
thrown in the trash, end up in local drinking water supply because
water treatment technology cannot treat for hormones, antibiotics,
painkillers, and other pharmaceuticals.
• Pharmaceutical residues detected in the San Francisco Bay may have
adverse effects on both aquatic species and humans and may affect
reproductive systems of aquatic species and stimulate development of
antibiotic resistant bacteria.
Analyzing Solutions for Unsafe Pharmaceutical Disposal
Allison McNamara, Keely Graskamp, Olivia Chambliss, Mallory Miller
Santa Clara University, Environmental Studies and Science Institute
Introduction
Pharmaceutical Research and Manufacturers of America (PhRMA) is a
multibillion dollar industry in the United States. Consumers who do not
finish their prescribed medications often do not know what to do with
unused pharmaceuticals. As a result they are either disposed of
improperly, left in the cabinet to sit, are stolen, or dangerously
consumed. An extended producer responsibility (EPR) program is the
ideal solution according to the Santa County Department of Agriculture
and Environmental Management.
EPR is defined by the Organization for Economic Co-operation and
Development as “an environmental policy approach in which a
producer’s responsibility for a product is extended to the post-consumer
stage of a product’s life cycle” (OECD). The purpose of EPR is not only
to shift responsibility, but also to encourage producers to consider
environmental issues in the design and production of goods.
Findings
• PhRMA does not support EPR county ordinances but rather a
federally funded program that would generate national consistency of
policy or a privatized take-back program.
• Pharmacies support take-back and drop-off given that they are
provided funding and advocate for EPR while also supporting
redistribution programs.
• Public awareness about pharmaceutical disposal is low, but people
are open to the idea of convenient drop-off locations.
• Both public health and environmental health are negatively
influenced by the improper disposal and storage of pharmaceuticals.
It has been seen to result in contamination, drug abuse, and death.
Policy Strategy Specific Policy Description
County Ordinance • Alameda County Case
Study
• EPR program funded by PhRMA
City-Funded Disposal • AB-45
• Sunnyvale Case Study
• Drug disposal container picked up with
household trash managed by existing
waste management, consumer funded
• City-funded drop-off program
Redistribution
Program
• SB 798
• SIRUM
• Counties can recover unused drugs from
participating facilities to redistribute to
people in need
• Company operating under SB 798
Stakeholder Opinion
PhRMA Lobbyist Against county adopted EPR ordinances due to danger of drug
diversion, supports AB-45 as citizen, not lobbyist
Past PhRMA Lobbyist PhRMA wants a consistent policy that is controlled by the federal
government as to avoid discrepancies between counties
Small-scale pharmacies Supports producer funded EPR with drop-off locations at
pharmacies and redistribution programs
Chain pharmacy Suggested police stations for drop-off locations
SCU Cowell and Facilities
representatives
Support campus as a drop-off location, but need resources
SC County Recycling and
Waste Reduction Division
Manager
Supports PhRMA funded EPR and safe disposal of drugs with
drop-off locations at pharmacies
Research Questions
• What is PhRMA’s opinion of EPR? What is PhRMA’s desired
program to deal with unused pharmaceuticals?
• What do pharmacies (small-scale and chain) think of EPR? What is
pharmacies’ desired program to deal with unused pharmaceuticals?
• What does the public know about safe drug disposal? What is the
public’s desired program to deal with unused pharmaceuticals?
• How do unsafe disposal and consumption of pharmaceuticals affect
the environment and public health? Stakeholder Opinions of Pharmaceutical Programs
Policy Suggestions for Safe Disposal
These maps highlight Santa Clara County's current
pharmaceutical drop-off locations (left) and current
pharmaceutical distribution locations (right). If each pharmacy
acted as a collection center for pharmaceuticals, residents
would experience greater convenience for disposal, and
therefore reduced risk, of unwanted or expired medications.
References
Christenson, S., and Cozzarelli, I., US Geological Survey, “The Norman Landfill Environmental Research Site: What Happens to the Waste in
Landfills?” 2003.
Daughton, C., and Ruhoy, I., Environmental Footprint of Pharmaceuticals: The Significance Beyond Direct Excretion to Sewers,
Environmental Toxicology and Chemistry, Vol. 28, No. 12, pp. 2495–2521, 2009.
“Environmental Policy Tools and Evaluation.” OECD. 2015.
Pharmaceutical Research and Manufacturers of America; Generic Pharmaceutical Association; Biotechnology Industry Organization, v.
Alameda County, California; Alameda County Department of Environmental Health. The United States Court of Appeals for the Ninth
Circuit. 22 Jan. 2014. Print.
Mullin. (2014, December 1). Assembly Bill No. 45. Retrieved March 6, 2015, from http://www.leginfo.ca.gov/pub/15-16/bill/asm/ab_0001-
0050/ab_45_bill_20141201_introduced.htm
Conclusion
Pharmaceutical disposal is an issue that directly puts the public at risk,
therefore immediate action is needed. It seems that the only way to
encourage pharmaceutical companies to fund take back programs is
through political action. Proposed bills such as AB-45 are one method
of mitigating the issue, but would require public education and
involvement. Counties that are trying to pass EPR ordinances are facing
resistance from PhRMA due to costs and safety concerns during
transportation of the take-back process. Currently, the Santa Clara
County public is not aware of the issues of improper pharmaceutical
disposal. Public education, financial support, and government action
are all necessary for a solution. Due to the political mire created by
attempts to implement EPR, the solution to this issue must address the
needs of each stakeholder both fairly and equitably.
Recommendations based on research are:
• Increase public awareness and concern about pharmaceutical
disposal.
• Encourage use of redistribution agencies to decrease waste.
• Continue pressure on producers and PhRMA to accept EPR
ordinances.