Little pills give San Francisco a big headache

Those little pills collecting dust in your medicine cabinet raise big health, safety and environmental concerns. Someone could find them, misuse them and get sick or worse. According to San Francisco’s Department of Environment, there are more drug overdoses annually from prescription medicine than cocaine and heroin combined. Flushing medicine down the toilet can pollute our Bay and harm aquatic life, especially fish. Of course, sending anything to a landfill is not a preferred option.

But a safe and easy way to get rid of unwanted medicine could be close. San Francisco just has to convince Sacramento to follow our lead.

After years of work, The City and six other California counties passed laws requiring pharmaceutical companies to design, fund and operate a drug “take back” program. Under the new law, San Franciscans will be able to drop off their unwanted medications at local pharmacies. Now the California Board of Pharmacy must issue its own regulations allowing pharmacies to participate. Unfortunately, there’s a problem.

“We’re worried the board could bring our local programs to a halt,” Guillermo Rodriguez at the Department of Environment told me.

In early drafts, the state’s regulations prohibit pharmacies from collecting certain medical products The City allows, such as unused EpiPens and inhalers. These regulations make it harder for San Franciscans to dispose of expired medication. People would have to go through the onerous process of dropping the unused products off at police stations or mailing them back to the manufacturer.

The state is also questioning San Francisco and other counties’ authority to require pharmacies to participate. Instead of supporting local mandatory programs, the Board of Pharmacy proposes to gives pharmacies throughout California discretion to participate. This conflict makes it hard for pharmacies to know which law to follow.

I asked Virginia “Ginny” Herold, the Board of Pharmacy’s executive officer, whether the state would preempt county law if the proposed regulations pass.

“We keep getting asked that question,” she admitted to me. “We believe that’s a matter that will have to be resolved in the court.”

Herold’s answer frustrates me. Counties have already spent taxpayer money and resources developing their take back programs. If the state passes a conflicting law, counties may have to spend more money and resources litigating it. Pharmacies also won’t have clear direction, which could discourage some from participating.

Basically, the state’s proposal limits the effectiveness of local take back programs, which plays to the benefit of the pharmaceutical industry and the detriment of San Franciscans. Big Pharm won’t have to fund a large disposal program if pharmacy participation is limited. But if pharmacy participation is limited, San Franciscans who care about The City’s health, safety and environment would have a harder time properly disposing of dangerous medicine.

Fortunately, Supervisor London Breed and our Department of Environment are working closely with the Board of Pharmacy to make sure these issues are resolved before the regulations become final. Earlier this month, Breed and elected officials from Alameda, San Mateo, Santa Clara and Marin counties sent a letter to the state detailing their concerns. Herold told me the state is looking at modifying the language.

“We’re getting close,” she said. “We’ll probably never be able to resolve everyone’s concerns, but we’re trying to resolve most of them.”

At the end of July, the Board of Pharmacy will consider finalizing the regulations. Until then, San Franciscans can drop off prescription and nonprescription drugs, as well as used and unused syringes at five Walgreens in The City that volunteered to participate. There are also 12 pharmacies currently accepting nonprescription drugs and unused syringes. Police stations accept all medicine, but not used syringes. More information is available on the Department of Environment’s website.

Ultimately, the success of drug take-back programs isn’t up to San Francisco or Sacramento officials — it’s up to us. We need care enough about our city to dispose of those dusty and dangerous pills safely.

Robyn Purchia is an environmental attorney, environmental blogger and environmental activist who hikes, gardens and tree hugs in her spare time.

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