ONE FACE OF THE OPIOID CRISIS IS IN OUR BATHROOM MIRROR

By William F. Alden and Stephen E. Murphy

The bipartisan legislation to address the opioid crisis signed by the President last week is sweeping in scope, all at once targeting prevention, treatment, recovery and curbing the flow of illegal drugs into our country.

As retired Drug Enforcement Administration (DEA) agents long involved in stopping diversion of dangerous drugs, we know how important it is to have effective drug law enforcement at our borders and through the mail. But that’s only one side of the diversion problem; the other is, in some ways, even more challenging because it hides right inside our own homes.

Approximately 1.2 billion opioid prescriptions were written between 2012 and 2016; but an estimated up to 70% of the pills covered by those prescriptions were leftover and unused. More than half of individuals in their most recent episode of opioid prescription misuse received or took the drug from a friend or relative. To read these numbers is to realize that the face of this opioid crisis too often is in the bathroom mirror of homes across America.

To prevent this misuse, we have to destroy and dispose of these unwanted drugs. And we can – in two straightforward steps:

First, we must recognize that getting permanently rid of these drugs isn’t an option – it’s a societal imperative that comes down to an individual duty-to-dispose safely and applies to each and every one of us. Second, it’s incumbent upon the experts to make our exercising that duty – our ability to dispose safely – as simple and effective as possible. Programs like take backs and kiosks are an excellent part of the answer, but not a complete one because millions don’t live near such an option or are of limited mobility.

We need access to an in-home option as well – and one that really works. Anyone who has had their personal financial information picked right out of the trash, knows that simply “throwing it out” isn’t good enough – particularly so with these left-over drugs, which need to be deactivated, destroyed and disposed of – forever. The DEA, which regulates controlled substances, makes this clear in its standard of “non-retrievability” for safe disposal. And it has also made clear that three current and commonly used in-home methods – “… by flushing down a toilet or sink and … mixing controlled substances with undesirable items such as kitty litter or coffee grounds … do not meet the non-retrievable standard.” Fortunately, in-home deactivation-and-disposal options (like the Deterra pouch) are widely available and essential to preventing opioid misuse.

Among many forward-looking provisions in the just-signed law is the requirement that makers of controlled substances start “owning” the problem of excess prescription opioids: by providing patients with unit-dose packaging, such as 3- or 7-day limited-supply blister packs, and/or “safe disposal systems for the purpose of rendering unused drugs non-retrievable.” We applaud the move, but because un-finished blister packs can lie around the home too, we urge the Food and Drug Administration to implement this provision by having manufacturers offer both packaging and disposal systems that ensure what’s left-over is safely destroyed, forever.

Moreover, while that requirement will help curb future unused supply, it won’t remove the billions of excess opioid pills, patches and liquids in America’s medicine cabinets now. We have to do that for ourselves. Let’s commemorate the signing of this new law with a new, personal commitment to deactivate, destroy and dispose of these dangerous drugs among us today.

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William F. Alden is a retired DEA agent and chairman and CEO of the DEA Educational Foundation in Washington, D.C.

Stephen E. Murphy, also a retired DEA agent, was one of the lead investigators in the manhunt of Colombian drug lord and Medellín Cartel leader Pablo Escobar.

Mr. Alden and Mr. Murphy are both members of the Deterra Advisory Council.