The Need for a Secure Medicine Return Program in Washington State

pills spilling from a bottle

The pain was constant, excruciating, and came out of the blue. I woke up on a Sunday morning and felt like someone had jabbed an ice pick in my left shoulder blade. The pain radiated down my left arm ending with an off-putting numbness in my fingers. As those with chronic back pain will attest, you can usually ride it out with massage, ice packs, and a handful of ibuprofen – but not this time. The pain was insidious and there was nothing I could do.

As I sat nervously in the doctor’s office with my wife awaiting my diagnosis, I just wanted the pain to go away, even if just for a fleeting moment. The doctor broke the news that one of the discs in my neck had deteriorated to the point where my vertebrae were compressing a nerve. It was nothing I had done – it was just old age. The orthopedic doctor suggested surgery and promptly referred me to a surgeon.  He also prescribed me a copious amount of pain medication, including a heavy dosage of Oxycontin and a bottle of Percocet thrown in for “breakthrough pain.” Whatever that is. In any event, the pills didn’t work.

Fortunately, my orthopedic surgeon told me to immediately stop taking the opiates since they do very little for the relief of nerve pain. He even asked for the name of the well-meaning but stuck-in-the-stone-ages doctor who prescribed them to me in the first place. The surgery went well and the “ice pick” was deftly replaced with a steel plate in my neck. Things were looking up as and I was sent home with nothing more than a little soreness – and a big bottle of 120 Percocet tablets. A week later, at a post-surgical check-up, the doctor prescribed me another 30 pain pills for good measure.

Now if this isn’t the perfect recipe to start a budding opiate addiction, I don’t know what is. Fortunately, I’ve been a supporter of getting a secure medicine return program bill passed in the Washington State Legislature for many years. Steeped in the statistics surrounding the insidiousness of opiate addiction in Washington State, I wisely chose to dispose of the rest of my pain medication at the free drop-box collection site at the Kirkland Police Department before it became a problem. Unfortunately, many people take the other fork in the road, opening the door to a spiral into prescription opiate addiction and ultimately a heroin habit.

Addiction: From Prescription Drugs to Heroin

Oxycontin

Photo by Michael Tam

Here’s one example of how the spiral of addiction progresses. Teenager Timmy finds a bottle of Oxycontin in his dad’s medicine cabinet. As teenagers are wont to do, he and friends decide to experiment a bit. After a couple weeks, the experimentation has become a habit and he begins to crush up the pills to circumvent the built-in time release function to get a better high. Timmy overdoses after snorting one of the crushed pills but survives to live another day. Timmy now finds that he needs a higher dose to avoid withdrawal symptoms, but his supply of prescription pills from his dad’s cache and from friends has dried up. Black market rates for Oxycontin are about $1 per milligram, with dosages from 10 mg all the way up to 160 mgs. On the wages Timmy earns at his part-time job, he can no longer afford to buy expensive high-strength Oxycontin pills on the street to feed his addiction.

Enter heroin.

Timmy’s friend points him in the direction of heroin, which costs around $15-$20 for the same high as an $80 Oxycontin pill. The economics of addiction are obvious. Timmy now becomes reliant on cheaper heroin instead of Oxycontin. The potency of heroin purchased on the street can vary widely depending upon how much it’s cut with a bulking agent or if it’s mixed with stronger, deadlier opiates like Fentanyl to boost the high. Timmy is one of those addicts who purchases and injects a batch of high-grade heroin laced with Fentanyl and his life comes to an abrupt end.

Sadly, this disturbing story is repeated every day across Washington State:

  • Seven percent of 12th graders have used prescription meds to get high in the last 30 days.
  • Four out of five heroin addicts began their addiction with the abuse of prescription opiates.
  • Overdoses occur when people crush up pills to circumvent the time release function.
  • Prescription opioid deaths in Washington State have decreased by 38% since 2006 (2015 data).
  • Heroin deaths have increased 188% since 2006 (2015 data).

Still Needed: A Prescription Medicine Return Program for Washington State

Kirkland Justice Center secure medicine return drop box

Residents can safely dispose of prescription medication at the Kirkland Justice Center during building hours.

The effort to establish a state-wide secure medicine return program has failed largely due to a divisiveness along party lines in the legislature and a sustained lobbying effort from the pharmaceutical industry. In 2013, the King County Board of Health took a bold step by passing legislation to establish a Secure Medicine Return Program in King County to give residents the opportunity to responsibly dispose of their unwanted prescription and over-the-counter medicines at no cost at drop-boxes throughout the County.  After clearing the hurdle of a lawsuit from the pharmaceutical lobby, the new program went into effect in 2016 with several drop-off locations in Kirkland.

We’re hopeful that King County’s Secure Medicine Return program, along with other local programs like the one in Snohomish County, will inspire legislators to recognize that this is a dire public health issue and cross the aisle to pass legislation to establish a much-needed state-wide program. Addiction does not observe borders and opiate addiction, overdoses, and death are become increasingly prevalent throughout the state. If you support a statewide program, we encourage you to call or write your state representatives and senators.