Proponents of pharmaceutical stewardship in Washington State are celebrating a new law to help reduce medicine misuse, poisonings, overdoses, and that will also help reduce pharmaceutical pollution – the WA Secure Drug Take-Back Act. This pharmaceutical stewardship legislation was championed by Representative Strom Peterson (D-Edmonds) and the bill passed the WA Legislature with broad bipartisan support. Governor Jay Inslee signed the bill on March 22, 2018, making it the first law in the nation requiring the pharmaceutical industry to provide a comprehensive statewide drug take-back program.
ESHB 1047 requires that drug manufacturers provide a statewide system of secure drug drop boxes in every city and town across Washington for collection of unwanted prescription and over-the-counter medicines. The drop boxes will be located at drug stores, grocery stores with pharmacies, medical clinics, hospitals, and police stations as allowed by the DEA’s Rule for Disposal of Controlled Substances. Prepaid mailers will also be available to residents upon request. In any areas of the state that are underserved by secure drug drop boxes, manufacturers will need to provide either mailer distribution locations or collection events operated by law enforcement. The WA State Department of Health will oversee the program, including reviewing program proposals from drug manufacturers. The law lays out other key requirements including public education, security requirements, use of environmentally sound disposal facilities, and program evaluation. A more detailed policy summary is at the end of this blog post.
The WA Secure Drug Take-Back Act builds upon the policy success of local Secure Medicine Return ordinances that have been enacted in 7 counties in Washington state (in order of passage): King, Snohomish, Kitsap, Pierce, Clallam, Whatcom, and Skagit. The requirements of the state law are well aligned with those of the local pharmaceutical stewardship ordinances. Counties may enforce the local ordinances, which are grandfathered under the state law, until one year after the manufacturers’ statewide drug take-back program begins operations. During that one year transition period, the manufacturers’ stewardship organization will work to transition the local programs into the statewide program.
This state law is the culmination of many years of policy development, coalition-building, and advocacy. The success of the bill is due to the tenacious support of a wide array of organizations, including substance abuse prevention advocates, public health leaders, law enforcement, nurses, doctors, dentists, pharmacists and pharmacies, suicide prevention advocates, community health clinics, hospitals, hospice organizations, water quality agencies, environmental organizations, and more. It took all of us working together effectively to overcome the pharmaceutical industry’s opposition and pass this good law. See some of the amazing supporters of this policy on this Supporters List.
It’s been a long journey, as well as a great experience, for me to work on and advocate for this policy at the state and local levels in Washington State. I’m pleased to have played a central role in leading efforts to pass the state legislation, including working closely with Rep. Peterson on the policy development. The success of the state law build off the success of our county-level ordinances, and it was great to work to develop those policies with dedicated local health agency staff and their local elected Boards of Health.
Policy Overview of the WA Secure Drug Take-Back Act
A statewide drug take-back program for prescription and over-the-counter medicines must be financed and coordinated by pharmaceutical manufacturers selling medicines into WA. Sec. 3, 5, 9.
Medicine manufacturers design their program to meet the bill’s requirements and standards, and manage their costs for drop boxes, collection supplies, prepaid mailers, collection events, transportation, disposal, and promotion.
In-kind contributions from pharmacies, clinics, hospitals, and law enforcement agencies that volunteer to host and staff secure drop boxes.
Estimated program costs to drug manufacturers are about 0.1% of annual medicine sales of $5.7 billion in WA.
Convenient access to secure medicine drop boxes at pharmacies, hospitals and police stations in all cities and towns. Sec. 6.
The manufacturers’ program must include any qualified pharmacy, hospital/clinic, or police station that volunteers to host a secure drop box as a collection site.
All collectors participate voluntarily.
At least 1 collection site provided in every city/town’s population area (defined as including a 10-mile radius around each city or town), plus 1 additional collection site for every 50,000 residents.
For islands and unincorporated areas outside population areas, collection site must be provided at every authorized collector open to the public, unless the collector is unwilling or unqualified.
In any areas underserved by collection sites, as determined by WA Dept. of Health and local health agencies, mailer distribution locations or periodic collection events must be provided for residents.
Prepaid return mailers provided on request to any resident and to any retail pharmacy that offers to distribute mailers. Sec. 6.
Local input on program services from health agencies, law enforcement & stakeholders. Sec. 5, 6.
Acceptance of all medicines used in the home, both prescription and over-the-counter, including legally prescribed controlled substances like OxyContin, Vicodin, and stimulants. Sec. 2.
With logical exemptions for personal care products regulated as drugs, like lip balm, toothpaste, and sunscreen.
Public education and outreach on safe medicine storage and using the drug take-back program. Sec. 7.
Manufacturers must provide a website, toll-free number, and distribute educational materials.
State agencies and pharmacies help promote the program. Local governments are encouraged to promote.
Secure drug collection and handling procedures per the DEA’s Rule, and all other applicable federal & state laws and regulations. Sec. 5, 6.
Environmentally sound disposal of collected medicines at properly permitted high temperature incineration facilities, using hazardous waste facilities when feasible or using a large municipal solid waste combustor (e.g. WTE) as recommended by the EPA. Sec. 8.
WA Department of Health oversight for security, safety, and compliance. Sec. 5, 7, 10, 11, 12, 19, 20.
WA DOH will review and approve the manufacturers’ drug take-back program plan. DOH oversight includes monitoring the program, reviewing annual program reports, and conducting periodic public awareness surveys.
Program evaluation will be conducted by WA Department of Health, an academic institution, and by the WA Poison Center to assess the program’s impact on resident awareness and behavior, rates of medicine abuse and poisonings, and proper disposal of drugs to prevent pharmaceutical pollution.
Much of WA DOH’s oversight costs will be recovered by a fee on approved drug take-back program(s).
Local Secure Medicine Return ordinances remain in effect until 12 months after the statewide drug take-back program begins operations. Sec. 16.
The state bill’s requirements are very similar to local ordinances enacted in a number of WA counties. Manufacturers must provide local programs under these ordinances until 1 year after the statewide program is launched.
Otherwise local laws regulating drug take-back programs are preempted under the statewide law.
The Act sunsets in January 2029. The Legislature can review and reauthorize the drug take-back program.
Find more policy resources on my WA Drug Take-Back Laws page.
Bill signing ceremony photo courtesy of Washington State Legislative Support Services.