Pharmaceuticals are an essential component of our healthcare system. They save lives and improve quality of life for many of us. Yet, as the number of prescriptions written increases, so too do the problems related to unwanted pharmaceuticals in the home.
Allowing unwanted pharmaceuticals to accumulate in homes increases the likelihood of accidental overdose, illegal diversion, and environmental contamination. It’s time to commit to a solution that works.
The Take Back Solution
Take-back programs provide a safe way for people to remove unwanted medications from their homes.
Existing take-back programs vary widely as to how they are organized and funded. Many happen only a couple days each year. Some local law enforcement agencies have installed permanent drop boxes in their buildings. With the recent withdrawal of federal DEA support, many programs are struggling to find funding to continue this important public service.
A new federal rule for the disposal of unwanted controlled substances allows pharmacies to run their own take-back programs, a convenient option for consumers. However, the new DEA rule does not provide any funding to make participation easier.
Both law enforcement and pharmacy-based take-back programs are severely limited by a lack of consistent funding. While voluntary take-backs are a step in the right direction, these programs simply aren’t enough.
Extended Producer Responsibility (EPR), also known as product stewardship, describes a system where the life cycle costs of a product become part of the cost of manufacturing. EPR is a proven method to sustainably fund the recycling or disposal of fluorescent lights, mercury thermostats, paint, mattresses, household batteries, and other products.
Why, then, is EPR the best solution for pharmaceuticals?
EPR is already being successfully implemented for pharmaceuticals in many European countries as well as some Canadian Provinces. In British Columbia (BC), for instance, 97.5% of pharmacies participate in a drug take-back program due to a solid EPR foundation. These locations collected a total of 112,888 pounds of pharmaceuticals in one year alone, equaling out to 0.02 pounds of meds collected per person. For comparison, Oregon, a state with a similar population but without an EPR program, collected only 0.004 pounds of meds per person in one year, a rate five times lower than British Columbia’s.
A coordinated EPR approach lowers collection and disposal costs per pound. The pharmaceutical EPR program in France, for example, collects an average of 16,237 tons per year, at a cost of just $0.0022 per box. Funded entirely by pharmaceutical manufacturers and run by the non-profit group Cyclamed, this French program is highly effective in collecting unwanted pharmaceuticals. In a recent survey, 77% of French residents claimed to have disposed of unwanted medication via these take-back sites, while 70% said they “always” dispose of pharmaceuticals in this way.
Unlike the current patchwork of funding used by U.S. programs, an EPR program provides secure, long-term funding. The aforementioned program in British Columbia started their mandatory Medications Return Program in 1996 with a program revamp in 2004. The pharmaceutical industry, therefore, has been funding the entire cost of the program for over 19 years.
4. Ready to Go
Momentum is growing: Alameda County, CA; King County, WA; and San Francisco, CA have all adopted EPR laws. Despite having been willing EPR partners in other countries, pharmaceutical manufacturers have challenged the Alameda law in court. Considering the narrow grounds of the appeal and improvements made to subsequent iterations of the law, other communities will soon be passing pharmaceutical EPR laws.
Please consider promoting an EPR bill in your county or state. Each new EPR law brings us one step closer to a national program.
Ed Gottlieb is the Chair of the Coalition for Safe Medication Disposal in Tompkins County, NY. Ed can be contacted at firstname.lastname@example.org.
OK, I am dreaming. It has been hot and steamy in Boston, and it was even hotter and steamier in Florida on my parental check-in visit last week. I am dying to jump into a giant cool pool. But instead, I find myself reflecting…on the year behind and the year ahead…over the EPR landscape in the U.S.
As an organization, PSI has hit its stride. As we approach our 15th year, we are moving from adolescence and the Constant Present to implementing our fourth long-range plan for the future. We have a solid new board of directors that includes a balance of geography (East, West, Midwest, South), politics (red, blue, and purple), and skill sets – all 100 percent committed to advancing product stewardship programs across the U.S.
We have an equally committed staff of 9 dynamic individuals, supported by over a dozen interns and consultants, who juggle multiple projects, fundraise, promote our accomplishments, and assist in passing and implementing product stewardship laws and programs on about 20 product categories!
PSI’s membership and partnership programs have steadily increased from 150 in fiscal year 2009 to over 400 today, representing an active, vibrant, and expansive product stewardship professional network of individuals from agencies, businesses, organizations, universities, and non-U.S. governments. PSI’s finances have also improved slowly but steadily over the past 14 years, and this past year was the first time we broke through the million dollar revenue mark. Our funding strategy has always been to diversify, and we have been successful in maintaining a balanced portfolio of memberships, partnerships, private and public consulting, foundation funding, and other revenue.
The EPR movement in the U.S. has also matured. There are now 82 EPR laws on 11 product categories, with at least one law in 33 states. Over the past six months, there have been many EPR “firsts”:
- Vermont passed the nation’s first primary battery law.
- Colorado passed its first product stewardship law (the eighth paint law in the nation).
- Two major household battery industries representing single-use and rechargeable markets jointly developed draft legislation, preparing for the introduction of bills in several states in 2015.
- There has been acknowledgment by carpet manufacturers that they have a responsibility nationally to fund the recycling of their post-consumer scrap carpet.
- And, as our colleague Matt Prindiville of Upsteam pointed out on our recent Annual Membership/Partnership Conference Call, the consumer packaged goods companies have also acknowledged their responsibility to recycle their packaging.
Moreover, several additional EPR laws have a chance of passing by the end of the year.
PSI has had a hand in all of these developments, at times to a significant degree, and has been instrumental in fueling the movement. And by PSI, I mean the large coordinated network that makes us who we are today (believe it or not, we’re not just a bunch of capable staff in a hip office in Boston’s South End :) !). We, collectively with all of you, are able to experience this social change because we have built a strong coalition among government officials, businesspeople, environmental activists, academics, and the general public.
This change is inevitable. It makes sense. Manufacturers make stuff, so they should be responsible for managing that stuff. But we all benefit from that stuff, so we have roles too. Defining those roles and providing a vision for the End Game is what PSI does well. We know how to involve others, and we know that all stakeholders have important interests, unique technical information, and experience.
We have all done a good job at starting new EPR programs. We need to do a better job at recognizing that new programs will always need corrective action. Product stewardship programs are new in the U.S. and globally. We need to learn from our experiences and apply what we’ve learned to make our programs better.
Last, my trip to Japan in June to present a summary of the EPR programs in the U.S. to 130 global EPR experts at the Organization of Economic Cooperation and Development (OECD) was eye-opening, and a great privilege. I came away with an understanding that all of us—those in developed as well as developing nations—hold the pieces to a giant waste management puzzle. But we are not always connected. For example, while some in the U.S. want to ban the export of scrap electronics, government officials in India, China, and Malaysia want to build capacity through education and training to move the informal recycling sectors in their countries to healthy formal sectors – keeping desperately needed jobs. These are two pieces to the puzzle – our e-scrap and their recyclers – that so far have not been adequately connected.
I hope that you all get a chance to kick back a bit this summer, recharge, and reconnect to the people and things you love. Rest assured that, somewhere in our vast EPR network, there is the hum of activity, advancement, and accomplishment. This engine of product stewardship will never rest. But you should.
After 14 years, I have a newfound appreciation for PSI’s dialogue process.
The first time I put it to use was in the 1990s while serving as the Director of Waste Policy and Planning for the Massachusetts Executive Office of Environmental Affairs. I was on a mission to increase the recycling of used motor oil in the state. To accomplish this goal, I did what made the most sense to me at the time:
- I developed a technical background document on the issue;
- I met individually with key stakeholders;
- I brought all stakeholders together for a structured dialogue; and
- I mediated a bill with full stakeholder input.
As it turned out, the Massachusetts Petroleum Council (MPC) honored me not long afterwards as “Bureaucrat of the Year.” (They had actually intended that to be a compliment!). It was one of the first times that the MPC had come to an agreement with the state’s two leading environmental groups – the Massachusetts Public Interest Research Group (MassPIRG) and the Environmental League of Massachusetts (ELM).
Of course, the agreement was not my doing. It was only possible because experts from MPC, ELM, MassPIRG, and other key stakeholder groups were so skilled at representing their constituencies and understanding the issue of used motor oil recycling. They just needed a conductor.
Fast forward to today, in my role of Chief Executive Officer of PSI, and I still follow the same process that I first developed and put to use in the 1990s! It made the most sense to me then, and it makes the most sense to me, now. PSI is, after all, more of an orchestra leader than a virtuoso performer. We blend the range of stakeholder interests to achieve a solution that is sustainable – it’s all about money, jobs, and the environment.
What we want
Yes, PSI has an agenda – we support a strong role for producers. We believe that, in cases where post-consumer products have a negative value – where the cost of collecting and managing that product is greater than the value derived from its resale – legislation is the best way to create a level playing field that is fairest for all market competitors. However, we are pragmatists who seek negotiated solutions within the parameters of a large product stewardship arena.
PSI takes its cue from the expert “performers.” We attempt to meld progressive environmental group interests with risk-averse business interests – all while operating under the auspices of an organization that represents state and local government agencies that serve the public interest. We identify waste management problems, define a product-focused problem jointly with other stakeholders, seek joint goals, determine barriers to achieving those goals, identify possible solutions, and facilitate discussions to seek a common solution. Our understanding of waste management, bolstered by our network of members and partners, runs wide and deep, equipping us with both a bird’s eye perspective of the “big picture” and a unique knowledge of on-the-ground issues.
As it turns out, a state and local government forum offers one of the best opportunities for a fair and balanced discussion among divergent stakeholder groups. It excels at raising and resolving issues – resulting in reduced waste, more recycling, new jobs, and lower costs for governments and taxpayers.
The secret ingredient
The reason is fairly simple. PSI has an essential element: 47 state member agencies and hundreds of local government members that are on the front lines of managing waste. We take our lead from these officials, and many are in a position to impose legislated solutions on manufacturers. This unique political dynamic benefits not only governments, but also companies that wish to avoid having to juggle compliance with 50 different programs in 50 states. Over the years, I have watched other stakeholder meetings fall short of achieving their goals, and most times, it was for one or more of the following reasons: 1) not all key stakeholders were represented; 2) not all key issues or viable solutions were discussed; 3) the problem was ill-defined and/or the goals were not well-articulated; or 4.) the meeting did not foster the necessary political dynamic.
On June 11-12, PSI will convene a forum of stakeholders to increase the recycling of single-use and rechargeable batteries by developing model legislation. PSI’s effort will begin the nation’s first attempt at developing a model legislative solution for both battery types, with the support of both battery industry associations. Although there are many tough issues to resolve, all battery manufacturers share the desire to increase the recycling of their batteries. How we do it is key, and finding the right path will require the blending of multiple interests.
On May 11-12, PSI will convene a similar first-time forum to increase the recycling of scrap carpet by developing model legislation. Although carpet manufacturers fully support the goal of increasing recycling, they prefer a voluntary approach and oppose legislation. Increasingly, however, PSI is gaining the support of other product manufacturers for an EPR legislative solution—perhaps because of our ability to integrate their interests with those of our government members. The paint industry was the first to recognize the benefit of working with a national organization to develop a state-based model that could be rolled out nationwide. We hope to replicate that success with carpet, batteries, and other industry groups.
What does the future hold?
As the years go by and companies understand that money can be saved, jobs can be created, and waste can be reduced through EPR laws, opposition will surely erode and support will grow. It is inevitable because that is the writing on the wall. The only question is how painful or prosperous that journey will be along the way. Will poor laws be created that result in fewer benefits, or will strong collaborative efforts lead to effective laws with maximum benefits for all?
I will put my eggs into the collaborative basket, not because of blind faith, but because of the public and private conversations that I have every week with corporate officials who want to address the real waste management problems of our society. They want to do whatever it takes to change our world for the better, for their kids and grandkids, and for themselves. But this will require more product manufacturers to seriously engage in EPR legislative discussions.
The good news is that history tends to repeat itself. Much in the same way that PSI has experienced growing success with the same dialogue process that I started more than 20 years ago, I am confident that industries will, one by one, come to the table the way MPC did in the 1990s. The way the paint industry did in the 2000s. The way the battery and mattress industries are doing right now.
When the day comes that PSI orchestrates an open dialogue with all industries and government, well… you’ll have never known a happier (former) Bureaucrat of the Year.
I stared at the faces – perhaps one hundred individual photos, side-by-side – of all ages, sizes, and colors – cut down by the ravages of prescription drug abuse.
For the most part they were ordinary people, like you and me. A few fit the stereotype drug addict depicted on TV – disheveled, worn beyond years, tired, and glazed. But most were the epitome of success, gleaming with promise and potential.
As I gazed into their eyes in the lobby of the Omni Orlando Resort at ChampionsGate, which hosted the 2013 National Rx Drug Abuse Summit, the importance of our work on leftover pharmaceuticals solidly hit home. I can help prevent a death. I can help save a life. In fact, we can all help prevent drug abuse, and the death and destruction that appear in its wake.
I understand the over-simplicity in my statements. Every person carries historical baggage, and for some people, it may seem just too complicated, too heavy, too difficult, and too much to bear. All the support in the world might not help at times. But we can remove barriers to the chance for a healthy life, and provide needed support. One of those barriers is that too many drugs are lying around the home when they should be cleaned out and safely destroyed. I do not want to overlook the environmental and aquatic impacts of leftover medications in our waterways. But make no mistake: drug abuse drives the issue of pharmaceutical take-back.
Prescription drug abuse is the fastest growing drug problem in America and has been classified as an epidemic by the U.S. Centers for Disease Control and Prevention. Nationwide, unintentional prescription opioid overdoses kill more Americans than cocaine and heroin combined. A host of federal agencies, including the Drug Enforcement Administration, Environmental Protection Agency, and the Office of National Drug Control Policy, recommend that leftover medicine be brought to take-back programs for safe collection and disposal. So do 43 states.
We know the problem, and we know at least part of the solution. But we also need a way to pay for the means to educate people about the problem of drug abuse, make them aware of the need for safe disposal, and increase the availability of take-back programs. To date, the pharmaceutical companies that make the drugs, particularly addictive opioids like OxyContin and Percocet, have refused to take any degree of responsibility for safely disposing of leftover medications from the home. Not only is there a lack of convenient options to safely dispose of leftover medicine, there is an epidemic of over-prescription.
Two counties have stepped forward to lead a national effort to reverse this trend – Alameda County, California, and King County, Washington. PSI is supporting both of these agencies in their efforts to hold pharmaceutical companies responsible for financing and managing programs to safely collect and destroy leftover home medicines. Thousands of U.S. government agencies support this approach. Provinces in Canada and countries in Europe already successfully and cost-effectively run take-back programs financed and managed by pharmaceutical companies.
PSI is fortunate to have sensed the rise of this issue seven years ago. With the help of many of you, we began the slow, deliberate process of building national support for leftover drug take-backs, changing the federal Controlled Substances Act and associated Drug Enforcement Administration regulations (still in draft form). We are helping to implement the King County law and are setting up voluntary collection sites and raising awareness in rural counties in Washington and Oregon as pilots for national replication. We also finished a three-year project in the Great Lakes, where our coalition developed a model producer responsibility program, created a comprehensive online resource for anyone looking for more information about what to do with their leftover medications, compiled a series of “Lessons Learned” to assist communities nationwide, and created a consumer-friendly info sheet to educate people on what to do with leftover medicine. For these efforts, PSI was honored with a “A Million Thanks” award from Covanta Energy. Personally, I find it rewarding to take part in such worthy efforts, and feel fortunate to have the opportunity.
Please help PSI do more by joining our effort. I have never solicited funds on this blog post before. But the devastating effects of drug abuse are happening right now, right before our very eyes, insidiously belying normalcy. Please consider becoming a PSI partner, making a donation*, or offering a sponsorship* to help us reverse this growing trend. Neil Young sang about every junkie being “like a setting sun.” Together, we have the power to let them see the sunrise.
*To make a donation to PSI or offer a sponsorship, contact Amanda Nicholson at 617.236.4833 or by email at amanda(at)productstewardship(dot)us.
For those of us in the environmental movement, it might seem as if we are on a long hike, which keeps going and going and going, from peak to peak, and valley to valley. The landscape looks familiar, the challenges commonplace. There are times to rest, and times to move, times to seek shelter, and times to book it across wide open fields. And then there are times when you sit back and notice that you have come a long way, and that the process was enjoyable, and that the long days of trudging in mud got you to a place of beauty, and that the view is nothing like you could have imagined.
On July 1, I attended an event at a Sherwin Williams paint store in Branford, Connecticut, to mark the start of Connecticut’s paint stewardship program. Before Governor Dannel Malloy placed the first gallon of paint into the collection container, he spoke of the importance of keeping paint out of our storm drains and the Long Island Sound, and praised the industry for their product stewardship efforts. Dan Esty, Commissioner of the Department of Energy and Environmental Protection, talked about the “new world of product stewardship” and how the paint program kick off represents the “next step in Connecticut’s move to building the waste management system of the 21st Century.”
One after the other, speakers walked to the makeshift podium at the corner of the paint store, amidst the colored strips of lavender and mauve, and praised the new paint program and its ability to save resources, save money, and create jobs.
There was a good feeling, and rolling out right in front of me, like a video documentary, was a paradigm shift of immense proportions, as Important People, from the Governor and his Administration, to key legislators, retailers, and paint manufacturers, praised the collaborative nature of this innovative program.
Tom Kelly, Sherwin Williams District Manager, mentioned the calls he already received on the first day of the program from residents seeking a place to bring leftover paint. “They come in just to drop off paint, but then see a clean store, and that we have what they need, and they leave a customer,” he said. Andy Doyle, President of the American Coatings Association, pledged the “support and backing of America’s paint industry” to recycle all the state’s leftover paint. The two chief bill sponsors – Sen. Ed Meyer and Rep. Patricia Widlitz – applauded the Governor and his team, as well as the industry, for their collaborative approach to finding a solution to a significant environmental problem, calling it “something really special.” They talked about the “terrific concept of producer responsibility” in which “paint manufacturers come up with their own plan to recycle.” State Rep. Lonnie Reed said that “…building in recycling and end-of-life elements into all of our products is important, and a sign of things to come.”
As I stood there listening, it struck me that product stewardship has become commonplace in Connecticut. PSI laid the groundwork for paint product stewardship in Connecticut and across the nation by convening paint manufacturers, retailers, state and local governments, and others in national meetings to hash out the agreements that led to this very moment. But the paint program in Connecticut would not have happened if each of the local stakeholders at that press event did not seize on the opportunity they were presented. The paint industry has now transformed itself from an industry that once saw consumers as the reason for leftover paint to one that has taken a leadership role to make sure leftover paint is recycled.
As our nation debates immigration reform, marriage equality, and voting rights, we can all sense shifts in public opinion that represent sea changes of immense proportion. This year marks a watershed moment in the product stewardship movement. To date, eight producer responsibility laws have passed this past year on four products in eight states: pharmaceuticals (Alameda County, CA; King County, WA); paint (Maine, Minnesota, and Vermont); mattresses (Connecticut and Rhode Island); and thermostats (New York). No, the entire country has not embraced producer responsibility; that will take decades. But we now have Governors and Commissioners speaking about an industry’s responsibility to manage its own waste, and an industry speaking glowingly about its partnership with regulatory agencies that allow it to assume its rightful responsibility.
This is the paradigm shift that many of us predicted in 2000 when the Product Stewardship Institute was created on that cold December day in Boston when over 100 government officials assembled to talk about a little known concept called product stewardship.
The times have changed. Sometimes it is nice to sit back and enjoy the show, and revel in the enjoyment that your hard work has provided to others. For many of us, now is that time.
Last weekend I had the joy and good fortune to watch my daughter graduate from college. Few of my previous life experiences have matched that prideful day.
At Wesleyan University, on commencement day, a commitment to social justice dripped from each graduate’s gown. A stream of red and black marched by the round-topped star-gazing observatory as African drummers pounded soulful renderings under a tent. Professors and other dignitaries mingled around lawn chairs, and flags whipped in the cold wind.
Receiving an honorary degree was former Wesleyan graduate, Majora Carter, whose efforts to economically revitalize poor urban areas are profoundly “Wes.” So was her speech. Her message: Get ready to be uncomfortable. That’s right! Anyone who wants to shake up the status quo will have enemies, even brutal opposition. You will know who your friends aren’t, she said.
As someone who wears product stewardship lenses inside his glasses, the message resonated with what I say about PSI – we are comfortable in an uncomfortable space – occupying a crevice of real estate between government, industry, and environmental groups. Most of the time, the positions we take are downright uncomfortable, at times going head to head with some of our own government members; other times trying to motivate brand owners that are convinced they know the answer even when no data exist; and other times getting smashed by environmental activists for being too close to business.
Over the past 13 years, this space has yielded dividends. In the past two weeks, three new producer responsibility laws have passed – Connecticut’s first-in-the-nation mattress law, and paint laws in Minnesota and Vermont (the 5th and 6th states to pass paint stewardship legislation so far). These laws do not pass solely because of PSI. In many ways, they would never pass if it was all up to us, or up to any one stakeholder. It takes a strong coalition that gets built over time. Starting and maintaining those coalitions is what PSI does – and it often starts in a very uncomfortable place, where we need to convince all stakeholders that the heavy lifting needed to change the status quo is worth the effort.
Thanks to all of our partners for great success these past two weeks, and we hope for many more victories that result in resource savings, job creation, and taxpayer savings. I am starting to like this feeling of being a little less uncomfortable.
Last week swept through Boston like a year, a silent moving picture whose old-time footage crackled with age, but, bright with modern day color, was telling of the future. On the other hand, at times, the events in happened so painfully slowly, with an air of inevitability, waiting, on the table’s edge, as the glass shook and started to fall, down, to the, floor.
Being American allows us to have a sense that justice will be served, that the rule of law will prevail, that we will swallow the evil, find an antidote to the germ, spit it out, and keep moving forward. Boston showed the best of America, and the best of humanity. Lives were saved here by how people reacted. The media found people who gave voice to heroism and humanity: the pediatric medical resident who pleaded with police to let her back through the barricade after she finished running the marathon because she just had to help; the man who lost one son to Iraq and another to suicide who came to the marathon to support veterans and mental health advocates, then ended up saving the life of a man who lost both of his legs; the young Chinese women laying flowers at the makeshift memorial at Berkeley and Boylston Streets; the neighbor providing the vision of a little girl who lost a leg but will dance again in the future; and the proud grandmother with breathing apparatus blessing the memory of her granddaughter who died by telling us about her good nature and curly hair that she had filled with bows before sending her off to school when she was a child.
We now know who did this unthinkable act. We do not really yet know why. But it does seem to be about rage, like a pressure cooker bursting because no one was watching the stove. Was it because of a failure to succeed in the Land of Opportunity when one man’s timeframe reached its limit? Was it the treacherous path of a young man that led to a jihadist’s door behind which despair utters epithets in masked disgrace? We don’t yet know, and we may never. It does seem, though, that these two kids inflicted their own inner turmoil on our innocent people.
Last week marked the reaction of a healthy society. We are fortunate to have the freedom to enjoy races, to walk about without soldiers at every corner, without snipers and bombs, and without barbed wire to protect our homes. With all of our struggles over ideology and policy, the United States is functional, strong, and effective, and clearly knows right from wrong. It is a place where everyone has a chance to succeed – as the bombers’ uncle poignantly insisted – even as we struggle to level the playing field.
Boston is the medical capital of the world, and the reaction of its citizens and expertise of its medical professionals saved lives. But there is something else that makes me proud to live here – it is hard to express, but it was on display for the world, as we grieved while in pursuit, searched while we pondered, and cried while we functioned very effectively. I am comforted knowing that we each feel the obligation to watch the back of the other, to help when not called, and to bring us back quickly to a place of security.
I look forward to standing among the masses again at many future Boston marathons to cheer the endurance of our patriots.