Nursing professor promotes responsible disposal of medications
Jillian Monack participates in a medicine take-back program.


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1:08 p.m., Feb. 16, 2010----The YouTube video shows buckets overflowing with tablets, gel-caps, and capsules in every color found in a Crayola box, plastic tubs filled with brown plastic pill bottles, and more tubs loaded with cardboard panels from drug sample blister packs.

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The setting is “Medicine Cabinet Cleanout Day” at the Newark Community Center in April 2008, and a team of nurses with gloved hands is counting and sorting unwanted medications, some outdated by more than 30 years.

Evelyn Hayes, professor in the School of Nursing at the University of Delaware, would like to see this scene repeated on a regular basis at convenient locations throughout the state, perhaps even on the UD campus.

“We want to raise awareness of the issue,” she says. “The common advice a decade or two ago was to wash unneeded and outdated meds down the drain or flush them down the toilet but there is growing awareness of the effect on the aquatic environment, where even low doses of pharmaceuticals and personal care products, known as PPCPs, can affect the health of animals, plants and people.”

Researchers have reported changes in reproductive function, behavior and growth, as well as increased mortality, from exposure to some medicines or combinations of medicines at concentrations found in the environment.

“Most of these PPCPs are recalcitrant and not easily removed from wastewaters in sewage treatment,” says C.P. Huang, Donald C. Phillips Professor in the Department of Civil and Environmental Engineering.

Jillian Monack, a senior nursing student at UD, recently participated in a medicine take-back sponsored by Nurses Healing Our Planet (NHOP), an environmental task force of the Delaware Nurses Association.

“Medicine take-backs keep these products out of the environment, where they can harm ecosystems,” says Monack, who is interested in holistic nursing, “as well as out of the hands of children, who can be accidentally poisoned, and teenagers, who may abuse drugs they find in their parents' medicine cabinets.”

As of 2009, more than 20 states had collection programs for unused medications, but Hayes emphasizes the need to raise awareness about such programs and make them convenient enough that people will take advantage of them.

Funding is an issue, as it can be expensive to engage and coordinate all of the parties needed to hold a medicine take-back, including pharmacists, state police and incineration facilities.

Disposal of packaging also has to be considered. “The amount of packaging involved, especially in the samples offered by pharmaceutical companies, is amazing,” says Monack. “At the medicine take-back I participated in, we separated out all of the cardboard and plastic for recycling. It's a lot of work, but that's the way it should be done if we want to protect the environment.”

According to Hayes, drugs returned at medicine take-backs run the gamut from pain killers and anti-depressants to hormones and antibiotics. The latter pose a special environmental issue, as they can kill beneficial bacteria needed to keep drinking water pure.

In Delaware, four medicine take-back events have been held since 2008, the first two funded by the Department of Natural Resources and Environmental Control and the more recent events hosted and funded by Christiana Care Health System. Hayes and Monack would like to see a future take-back sponsored by and held at the University of Delaware.

“We have a large, diverse, and self-contained community here,” Hayes says, “and I think we have an obligation to the larger community not only to raise awareness but also to set an example.”

Article by Diane Kukich