A teen goes to a party and a friend offers him a pill to take. He swallows it with an alcoholic beverage, and soon decides it would be fun to jump off the roof into the pool.
An elderly woman with a large collection of prescriptions feels ill and calls 9-1-1. When she arrives at the hospital, she’s in congestive heart failure because her medication expired and she wasn’t getting the full dose.
These are just two examples of things that can go wrong with prescription medications that Patrick Broderick, M.D., has seen in his 17 years at Danbury Hospital, where he is chairman of the Department of Emergency Medicine.
Problems like these are why the federal Drug Enforcement Administration is holding a second annual Prescription Drug “Take-Back” Day at local police departments this Saturday, April 30, from 10 a.m. to 2 p.m. The service is free and anonymous – no questions asked. All medications will be accepted, but not needles.
“We’re going to have our parking lot wide open for people to come in to drop off their prescription medications,” said Chief Michael Kehoe of the Newtown Police Department. “If you leave them in your medicine cabinet, they can fall in the hands of the wrong person.”
Collections are taking place locally at police departments in Newtown, Bethel, Monroe, Brookfield, Redding, Danbury, Middlebury, Woodbridge and Ansonia, and at the resident state trooper’s offices in Southbury and Woodbury. There are 4,700 locations nationwide and 500, up from 400, in New England. Other collection sites can be located by ZIP code.
Monroe is holding its event at the Senior Center on Cutlers Farm Road.
The DEA will pick up the collected drugs and, said DEA Spokesman Anthony Pettigrew, “They’re incinerated. From what I’m told, they’re incinerated in a certain way.” At least two companies, Wheelabrator and Covanta, he said, have volunteered to do this.
“The primary concern in New England is that we have a major issue with prescription drug abuse,” says Pettigrew, who is based in Boston. “Any time you can get the temptation away from kids, that would be the primary goal. A secondary benefit is that you don’t have people flushing them and contaminating the water supply.”
Out of about 1500 patients who go to the Danbury Hospital Emergency Department each week, Broderick estimates that eight or 10 “have in some capacity taken medications that were not prescribed to them, and they had an adverse reaction.”
“They come in because of an automobile accident or because a friend could not wake them up,” he said. “They take (prescription drugs) recreationally, often mixed with alcohol. They come in very ill, and you find the metabolites in their urine, and they don’t even know what they took.”
“Say they want to grandma’s medicine cabinet, and she has some Valium the doctor prescribed for anxiety, and then they bring them to a party where young people take them with alcohol,” Broderick says. “It’s very important that teenagers don’t experiment with these medications, which puts a big responsibility on family members in managing their active and their expired medications.”
Overdosing can lead not just to trauma, which is the top cause of death among 18 to 30-year-olds – and controlled substances play a role in half of these accidents – it can also lead to unintended sexual activity. A young person under the influence can either have impaired judgment in consenting to sexual acts, or they can be molested.
“Often the person doesn’t even remember what happened,” Broderick said. He has seen cases where parents bring their child in to be treated, and they say, “I fell asleep at a friend’s party and when I woke up my pants were down.”
Locally, substance abuse prevention groups are applauding the “Take-Back” Day.
“We as parents forget that we need to clear out our medicine cabinets,” said Newtown Parent Connection co-founder Dorrie Carolan. “The teens who experiment with prescription drugs, they check out to see what’s in the medicine cabinets. We need to be more attentive, and make sure that if we have any narcotics – percocet, vicodin – they’re locked up, and not leave them visible for someone to take.”
Inappropriate use of prescription drugs seems to be on the rise.
“Over the last 25 years, I think it’s become more common for people to access prescription medications from family members,” Broderick said.
Is it an epidemic? “We’re really concerned,” says Police Chief Kehoe. “I think it’s getting to that point where we have to consider that.”
Recently after one of the teens gave some of his prescribed oxycodone pills, a pain medication, to another, who then gave it to the third teen. The charges included failure to retain the original container of a prescription medication and distribution of a controlled substance.
For young experimenters, both Kehoe and Carolan said, prescription drugs can be a gateway to illegal drug use.
“We’ve heard of situations where a kid goes to have their wisdom teeth pulled, and the doctor gives them meds, and the other kids are saying, if you have any pills left, I’ll take them. Or they’re going into their parents’ medicine cabinets and taking them,” said Carolan. “When they’ve gone through all their friends’ parents’ prescriptions, the prescription drugs on the street are very expensive. That’s when they go to heroin, which you can buy for four or five dollars a bag.”
More experimentation means a greater chance of addiction, she says: “Every time they experiment, they run the risk of enjoying it, liking it and continuing, and once you get into that pattern, you tend to try other things.”
State Representative Christopher Lyddy (D-Newtown) said that in Hartford, he is working on “barriers to treatment with regard to addiction” such as private insurance companies that will not pay for adequate treatment.
Lyddy, who is trained as a social worker, recently discussed this problem in an interview on Fox News.
The problem is huge: Lyddy noted that the state has spent more than $1 billion on substance abuse treatment in the past five years through state programs and employees. This doesn’t include people using private insurance.
And for those with private insurance, he said, “It’s so expensive for families to get a loved one into treatment, that they may be re-mortgaging their home.”
“My mantra as a social worker and as a legistator is that prevention is the best intervention,” Lyddy said. “The Police Department take-back program is paramount, so that we can literally remove those products from our kids’ reach.”
As compelling as these scenarios are, they are only half the story about the consequences of having too many prescription medications, expired or active, around the house.
In terms of medication issues, says Broderick, “The most common problem is that elderly people not managing their medications well. A lot of times people accumulate a lot of prescriptions in their medicine cabinets, which leads to confusion.”
People with chronic illnesses may also underdose themselves unknowingly with an expired medication, or knowingly by reducing their doseage to save money. Those patients, he says, need to dispose of expired and unneeded medications. They also need to be sure all of their doctors know all of the medications they have been prescribed so that medications do not interact in a harmful way.
Collecting and incinerating prescription drugs also brings the added benefit of keeping them out of waterways. Allison MacKay, an assistant professor of civil and environmental engineering at the University of Connecticut, has for several years been researching the Pomperaug River in Southbury, downstream from the Heritage Village wastewater treatment plant, because residents there consume so many medications, to determine the concentration of prescription drug material in the water.
She says she is still working on analyzing her data, and has not published it yet. But as an expert on wastewater treatment, one thing she notes is that the effects of flushing many different medications down a toilet not entirely clear.
There have been well-documented studies of the negative effects of artificial hormones, such as those found in birth-control pills, on wildlife, but MacKay cannot yet point to similar findings about other medications.
“What I am interested in is, what happens once the compounds are released into the environment,” she said. “There’s a lot of information missing on the toxicological response for organisms. That field is growing.”
As for the drug take-back day, she is supportive because it will prevent youths from taking prescription medications recreationally. The environmental benefit, she notes, is secondary.
“If we run drug take-back programs, we’re not going to reduce drug concentrations at wastewater treatment plants to zero,” MacKay says. “It will reduce the amount, but I can’t really put a number percentagewise.”
“We don’t have a good feeling for how many drugs are in the wastewater treatment plant because somebody took them versus someone flushed pills down the drain,” she added. “The process basically is the same.”