Prescription Drug Take Back Event

I keep forgetting to post this - but there's a prescription drug take-back event happening today. The organizers say, "This statewide turn in event is an opportunity for your community to take their unwanted drugs to a central location for incineration. The Take Back Event is sponsored and spearheaded by the Oregon Medical Association Alliance, CARSA, Oregon Partnership and other community groups."

The link to the event is here.

This group is concerned about the danger of prescription drug abuse, but there's also several groups concerned about the danger of flushing these drugs down the toilet, where they can get into our water system.

Until the Oregon Board of Pharmacy releases the rules for the Charitable Prescription Drug Program, this incineration is a better way to get rid of your unwanted prescription drugs. I have two or three prescriptions that I need to get rid of . . .

One take-back site is in Albany, at the Albany City Hall. The other is in Eugene - we're heading to Eugene today for the Home and Garden show, so I think that I will take my own drugs there . . .

Happy Saturday - the sun is peaking through clouds for the first time in several days, so I hope to get out and get some Vitamin D.

Update on Charitable Prescription Drug Program

As I noted a few months ago, the drug repository bill passed here in Oregon. The Oregon State Board of Pharmacy is currently in the rule-making phase and I met with their director. She wanted to know if I had any suggestions or wanted to give her any feedback about any rules that might be written. She also explained all the research she's done in order to implement this rule.

There are over 30 states that have a drug repository laws on the books. Only 14 are operational, but of those, only 4 states really have a repository in which drugs are donated and prescription drugs are dispensed. The best of these is in Iowa and the only reason why it works as well as it does is that it gets state funding to the tune of $1 million a year.

The upshot is that states must follow federal law with regard to prescription drugs. Under federal law, once a prescription drug leaves a licensed pharmacy or other licensed medical facility, the drug is considered "adulterated" and it is against federal law to dispense adulterated drugs. In other words, once a person has received a drug, even if they have not opened the package (even if it is bubble-wrapped), it is considered adulterated and therefore it is illegal to give to another patient.

She (Paige Clark) talked to pharmacy boards in the four states and all note that the majority (98% or something) of the donated drugs in their repositories come from nursing homes or other care facilities (licensed medical facility). And, they also noted that they usually don't even accept meds from individuals even if their rules allow for it.

Well, crap. I'd hoped I could donate drugs that I was prescribed but didn't use. It's time to think outside the box here . . . if you think of what we can do, I'm all ears! One thing is to try to change the federal law with regard to the definition of "adulterated prescription drugs". Probably a long shot . . .

In the meantime, this law does give a mechanism through which nursing homes and other medical facilities like it can donate their unused medications and it creates a repository that can dispense these meds to uninsured or underinsured individuals.

I guess that there's an organization in Portland (called Inside Out) that has managed to get pharmaceutical companies to donate medications to their facility that they then make available to indigent populations free of charge. I wondered if we can use a similar mechanism so that the same companies could donate medications to a drug repository throughout the state.

Paige also wanted to know that with regard to the "storage" issue (after a patient receives a drug, they aren't sure how it's stored - remember some meds must be refrigerated, etc.), if it would be a problem for patients receiving drugs to undergo a brief consultation about the proper way to store a drug. In other words, would it be too onerous for me, as a patient, to have the pharmacist give me clear instructions about how to store the medication. I told her that I wouldn't mind and I don't think most patients would mind at all.

So, that would solve the storage problem. But it still leaves the problem of adulterated drugs under federal law.

Another idea would be to create an informal matching service in which patients with unused prescription drugs could be paired with patients needing those drugs ... and while this may be happening informally anyway, it would be nice to make it a more formal kind of service. Unfortunately, I think there are laws against this . . .

Okay, I think that sums up the conversation. A bit frustrating . . . but it seems like something good will come of it at some level.

I also wondered if there was a way to match up patients with unused prescription drugs with patients who need them. A kind of "match.com" for patients. I'm sure it's illegal somehow, but wouldn't that be great if we could work that out safely?

This is pretty cool!

The chair of my department requested some information about the Charitable Prescription Drug Program (which goes into effect Jan 1, 2010, although I don't know yet of any pharmacies that have agreed to participate) and found a copy of the bill online:

Charitable Prescription Drug Program

My name is on the bill:

Sponsored by Representatives GELSER, BARTON; Representatives BUCKLEY, GREENLICK,
MAURER, STIEGLER, THOMPSON, WITT (at the request of Deanna Kingston)

How cool is that? : )

Remember to ask your pharmacy to participate and maybe work with charitable organizations in your home town to set up "charitable prescription drug program" funds to help defray the "handling fee" that might be charged to patients. And, ask your pharmacies to start dispensing meds in individual-dose sealed packages!

Drug Repository Is Signed Into Law!

I just found out today that Kulongoski signed the bill into law! I don't know when, but apparently, there wasn't a signing ceremony so I didn't get notified. I will, however, get a signed parchment copy of the law when it's available. She's kinda shy about appearing on a blog, so I took out her reply, which I posted earlier. I apologize for that!

The gist of her reply was that we will need to encourage pharmacies to participate as it is a voluntary program. Also, there will be the "handling fee" that the pharmacies can charge, which would be billed to the person who needs the drug, but Sara's assistant wondered if we could get charitable organizations to donate some money to offset that cost somehow. I'd hope that they wouldn't pass that fee on to the patients who are requesting the medications - these are the patients who cannot afford these meds to begin with. However, there are legal and liability reasons why pharmacies can't charge the donor. Sooo . . . let's put our heads together and see how we can encourage pharmacies to participate - and strongly encourage that they waive the fee - and maybe also encourage charitable organizations to donate money for patients if they do need to pay a "handling fee".

[Note: I found out that Kulongoski signed it on June 17, 2009. It passed the Senate unanimously.]

And the Drug Repository Bill Passes the Senate!

I picked up today's paper from my porch today and as I scanned the front page headlines, I saw this:

"Senate approves bill that allows patients to donate prescriptions"

I thought, "Is this the drug repository bill?" I scanned the article - Yes, it is! There's my name! Here's the article:

http://www.gazettetimes.com/articles/2009/05/23/news/community/2aaa04_prescriptions052309.txt

I'm so very pleased that Sara Gelser took the ball and ran with this! Now it awaits Gov Kulongowski's signature. Thank you, Sara! I'll be invited to the bill signing ceremony, too!

Good News - Oregon's drug repository

Here is a quote from my representative, Sara Gelser, about the drug repository bill:

Deanna,

I just wanted to let you know that your fantastic Charitable Pharmacy/Drug Repository bill just passed the House with no dissenting votes. From here it goes to the Senate, where I think it has a promising future.

If the bill passes the Senate, would you be interested in attending a bill signing ceremony for this bill? It would be great for you to meet the Governor, and get a pen. I'll also get you an official parchment copy of the bill with all the fancy seals when (knock on wood) it is enacted into law!

Thank you so much for your tremendous work on this!

Sara

Representative Sara Gelser

I responded by saying that I would most certainly enjoy attending the bill signing! Yippee!

If anyone has a chance, please email your Oregon state senators asking them to support the bill. I will keep you posted as things progress!

My Budding Politician?

As I mentioned last Monday, I gave testimony on drug repositories to the Health Committee for the Oregon State Legislature. We got there a few minutes early and went to Sara Gelser's office. She was great - she immediately took Eddie and gave him a pin and then took us to the House Chambers, which were empty at the moment. There, she brought Eddie to the podium and let him pound the gavel.

Sara Gelser asked Eddie if he wanted to go into politics and he said, "no, I don't think so." But, he does look rather handsome up there on the podium, doesn't he? : )

The Oregonian Article

The Oregonian ran the story today about drug repositories. The article was by Don Colburn - he interviewed me last week. Here's the link:

http://www.oregonlive.com/health/index.ssf/2009/02/oregon_legislation_considers_r.html

Please help support the bill!

A Story From One of My Students

Danee' Lee Cliver is a student in my Natural Resouces and Community Values class this term. I told them via email that I'd testified for drug repositories in Salem on Monday and here is what she said:

I think a drug repository is an excellent idea. About 4 years ago my grandpa passed away from lung cancer and we wondered what to do with all his pain medication that was left. A few of them were very powerful and expensive. It would have been nice to be able to donate them to someone else...or a drug repository. It was such a waste of medicine and money.


Danee' gave me permission to share that story on my blog. Thank you, Danee'!

Testimony

Believe it or not, I am normally a shy person. I always tend to get nervous during public speaking events. I remember my voice shaking a lot during the first class that I taught. That doesn't happen too much anymore, but the times when I have to address new audiences - like my peers at OSU or colleagues at NSF - my voice still shakes.

Well, today, my voice was shaky and I almost started crying when I reported that I was a breast cancer patient. I got through my testimony, though, and said that while I've been fortunate because I do have insurance, I also have a couple thousand dollars in medications and durable medical supplies at home that I won't use and would like to pass on to someone that doesn't.

During the hearing, one rep, apparently a Republican, stated that they should go ahead and approve the bill and get it out of committee already. Other committee members had stories to tell: the chair had had lymphoma and was left with $600 in drugs in his fridge; the vice-chair may have worked in a nursing home or some other care facility and he said that they would throw away bags full of unused medicines. He then commented, "why haven't we done something about this before?"

The Board of Pharmacy also testified and stated that they have talked about this issue before and that they are generally in support of the bill.

The republican rep had questions about implementation - about making sure that rural residents have access, too - but that part wasn't really discussed.

I think, in the end, that this bill was approved to go out of the Health Committee - it looks like it's going forward to the whole legislature for a vote.

How cool is that?

Testifying Today

My state representative, Sara Gelser, introduced a bill to create drug repositories here in Oregon. They are hearing testimony on the bill today in Salem and she asked me to attend . . . so I guess I am! I'm feeling up to it. I'm a bit nervous because it's a new public speaking venue for me . . . but I'm gonna try to pretend that these folks are my students. Plus, I'll have my statement prepared already . . .

Wish me luck!

An Interview with the Oregonian

Yesterday morning, I chatted for awhile with Don Colburn, a health reporter at The Oregonian. He wanted to know how I became interested in drug repositories and what drove me to contact my state rep, Sara Gelser. I hope that I was coherent. I think it's a good solution to unused drugs. I hate wasting things - I'm definitely of the "reuse/recycle" mode. It's a shame that drugs, which are so expensive, just get thrown away if they can't be used.

I have had prescriptions in the past and even now that I probably won't use - one prescription costs $3000/month! I also have some "durable medical equipment" - some dressings from the wound pump and also other dressings I had for that open skin wound. Those dressings are probably worth about $1000. I'm loathe to get rid of them. It would be wonderful if there was a place that I drop them off so that someone else could use them - especially if that someone did not have the financial means.

Right now, with prescription drugs, the recommendation for unused drugs is to mix it with kitty litter or coffee grounds and send it to the landfill. It used to be to dump them into the toilet, but antibiotics have gotten into our ground water, so that's not a good alternative. I've heard, too, that you can return drugs to pharmaceutical companies, where it is said they will incinerate them, but imagine the air pollution that that might cause. I'm also cynical enough about pharmaceutical companies - and one of my colleagues has said that there has been proof - that I think they would take the drugs and then turn around and resell them in third world countries.

I'm not sure when the article will run in the Oregonian . . . when it does, I'll post a link. I think it's important to get support for Sara Gelser's bill in the Oregon state legislature . . . if I can get my act together, I'll contact people and ask them to send letters of support to their legislators! If I'm feeling up to it, I may go testify on this bill on Monday in Salem.

Thank you to Don for reporting on this important issue!

Drug Repositories

Last spring, I found out about drug repositories in other states (google drug repositories) and when I mentioned it to the local breast cancer support group, several women thought it was a good idea. I wondered how I could get our Oregon state legislature and a colleague said to contact my local rep, Sara Gelser.

Sara's assistant just contacted me on Friday, the day of my surgery, and told me that Sara's introduced the bill in the Oregon State legislature! How cool is that!

So, for all of you Oregon residents out there, email your local state reps and tell them you want to support this bill to create a drug repository here in Oregon!! It's better than dumping unwanted drugs down the toilet (where it gets into our groundwater) or mixing it with coffee grinds or kitty litter to be put into the landfill.

How cool is that!

Drug Repository Update

I forgot to mention that I met briefly with Sara Gelser last Friday, April 25. She says that the process will probably go forward as follows:

1) She drafted up a bill, which she sent to me earlier this week for comment. I made a suggestion to have the repository include more than just cancer meds.
2) She will then send the bill to the lawyers, who will fix it and make sure it has the correct legal language. This may take a couple of months.
3) Once it's ready, she will introduce the legislation for next year's legislative session. I think she said this will be in late fall/early winter.
4) This is when we mobilize support for the bill. This can take a lot of forms, like getting letters to the editor written, asking whoever (individuals and/or organizations) to write to their state legislators to support the bill, etc. This will happen next winter, most likely.

So, at the moment, things are out of our hands. I am just so happy that Sara is taking the ball and running with it on the legal/legislative side of things. I will keep people posted on its progress. I think, though, that we may want to advertise the proposed legislation during Jeanne Sather's talk here at OSU on May 20 and May 21. Jeanne is planning to talk about it.

Turmeric Experiment, Day 22

I keep forgetting to mention that Dr. Kenyon thought that the open wound was indeed healing. The white areas I saw are the upper layers of skin trying to form. I think he was happy that the wound was healing as quickly as it is. I mentioned this to the rad onc the other day - that I have an open wound, that I'm using turmeric and that it seemed like it was working, and her reply was that we may delay radiation for another week to allow the skin to finish healing there. I was relieved that she was willing to do that . . . now if I can just figure out how to keep another open wound from occurring, I'd be really happy!

A sunny day today - yay! Also, I'm meeting with Sara Gelser at 11am to talk about drug repositories, then I'm attending a lunch with a woman who does research(?) on narratives and illness, then a massage at 1:15pm. So, it should be a good interesting day! Have a good one out there!

Drug Repositories, Part III

A couple of days ago, my state representative, Sara Gelser, responded to my email about drug repositories. She said she is interested enough to put in legislation about it for 2009. Yeah! We're going to have coffee next Friday to talk about the issue more.

For those of you in the support group and my colleagues who said they were interested in the issue, I will soon email you. I meant to do it sooner, but my computer at work died and it's easier to find emails via subject line at work than at home. I want to compile all of your emails together to begin a conversation about the next steps. Once I talk to Sara, I hope that this takes a life of it's own. Jeanne Sather, over at www.assertivepatient.com, will be here in Corvallis May 19-21. She will do a blogging workshop on the 19th, a public talk at OSU on the 20th, and a noon talk in my department on the 21st. At her public talk on the 20th, Jeanne plans to bring up the topic of drug repositories. It was through her blog that I first heard of them. This may be a time when we can publicize the effort.

Just wanted to give you all an update!

Unused Prescription Drugs, Part II - Oregon Legislative Efforts

Here is what I have found out so far about this proposed legislation. First, this issue was brought to my attention by Cath at the support group, who read this letter to the editor by Lucy Noone, of Benton County Hospice Services. The letter to the editor can be found at:

http://www.gazettetimes.com/articles/2008/03/18/news/opinion/6edi02_letters0318.txt

Scroll down to "Take precautions with unused drugs". She says that "Legislation is pending to force drug companies doing business in Oregon to create and pay for a program to take back unused drugs".

I tried to find said legislation and was unsuccessful so far. But I did find a report online:

http://www.oracwa.org/

The name of the report is "Drug Take Back Report". There are two .pdf files, one for the two-page executive summary and the other 100+ page report. The report is authored by Monica Hubbard, a Ph.D. candidate here at OSU. The report is fairly detailed and gives reasons for not having drugs flushed down the toilet and it also goes into various laws that apply and mentions programs in a couple of different states that do this. But I didn't quite find out what the drug companies then do with the drugs after they receive them from various drop-off agencies. I emailed her about this issue and when she writes back, I will post about it.

My initial thinking, open for discussion, is to figure out how one can collaborate on this issue. There was a whole task force here in Oregon committed to this issue and devising this report. So, there's already a system in place that maybe we can capitalize on. I'll let you know . . .

More thank yous!

I have received more cards from folks expressing that they're pulling for me, Norma Vega continues to give me dinners every Thursday, and I received some jokes - most of which I have already posted. I also have received replies from folks who are interested in the drug repository idea.

So, thank you to my neighbor, Mike Wolf, for sending me that newspaper clipping. Lisa at Hair, Body, and Sole gave me a gift certificate for a free pedicure - which I am using on Saturday! I decided to get my hair trimmed there while I was at it. Court Smith, who served on my master's degree committee and now a retired colleague, saved me a copy of the GT article.

Thank you to Theresa Hogue for writing that article, too. My average number of hits to my blog rose from 25/day to 40/day! Overall, I think my readers may have doubled! I decided to go ahead with the article in case it might help other people going through treatments and also to try to get more boob jokes. Also, to let people know that even though that dreaded cancer word, "metastases" now applies to me, it doesn't mean that I will die soon. I don't want to mislead people because not alll "mets" are alike - some are more aggressive and less treatable. I think that my mets are manageable and will allow me to live for a long time.

Joke givers included David Carlisle, Elena Maus, and there was one or two more.. . sheesh. Chemo brain!

As for the drug repository idea, I have had about 8-10 people respond and say they were interested in helping somehow. I've also sent an email to Sara Gelser to ask her how to proceed. I will write an email to you all in the next few days suggesting a plan of action. I also thought that we could start another blog, devoted to this issue. Cath from the support group mentioned that in there was a letter to the editor in Tuesday's GT regarding unused drugs. I will post about that later today, since there is apparently some proposed state legislation on the matter, having to do with requiring drug companies to take back unused prescription drugs. I want to look into it more because I'm not sure exactly what that means. But my cynical take on it is that this might allow drug companies to "double-dip" - people returned unused prescriptions to them, which they can then redispense and make more money off of it. But I don't know that for sure so if someone wants to enlighten me about that, I'm all ears! I shouldn't be so cynical and I hope that the "double-dipping" issue was already thought of by someone else!

Well, have a great day everyone! Thank you, everyone, again, for your support and your prayers!

Unused Drug Repositories

So, what are drug repositories? Apparently several states have created drug repositories which are places that people can donate their unused prescription drugs in order to give them out to those who cannot afford those drugs. I know that after my chemo treatments, I think I ended up with three different kinds of anti-nausea drugs because one or the other of them gave me weird side effects or because I no longer needed them. I think I ended up throwing out a whole month's supply of tamoxifen when I was diagnosed the second time because I no longer needed it.

Also, our local paper has recently published articles that relate to the amount of prescription drugs in our water supply. I think some people with unused drugs are advised to flush said drugs down the toilet. The article on drugs in our water supply is at: http://www.gazettetimes.com/articles/2008/03/11/news/community/7aaaloc02_water.txt

I cannot take credit for this idea. Jeanne Sather at The Assertive Cancer Patient (www.assertivepatient.com) wrote about this recently and I am finally wanting to do something about this, partly because various members of our local breast cancer support group seemed very interested in the topic last night. Rather than reinventing the wheel, Jeanne's posts on the matter are at the following website:

http://www.assertivepatient.com/recycle_drugs/index.html

I am going to contact colleagues on campus today and I've also contacted our support group to see how we can begin to get a drug repository here in Oregon. I figured we could write a letter to our local state representative, Sara Gelser, on the matter. And, I just thought that this might be something that local churches and social service agencies could involved with, too. Any other ideas would be appreciated!