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Bob Goldstein, MD, is a pain management specialist in the Department of Anesthesiology. He spends a majority of his time in the outpatient setting, in the operating room, and working with the palliative care team at the UVA Cancer Center. When he has made house calls, he has often seen “bottles and bottles of medications sitting on tables” in these homes, he says. Patients also come into the UVA Pain Management Center and “they say, ‘I have this bag of pills. What do I do with it?’”

“And that’s just one of the thousands of patients we see per year,” he says. “The point is that we have hundreds of thousands of people with millions of prescriptions that are either going in the trash or going into a landfills and waterways, and those need to be disposed of in a safe and environmentally responsible way.”

Unused medications are dangerous in two primary ways: They can be misused or consumed accidentally, and if they are flushed down toilets or sent to landfills, they cause damage to the environment and contaminate drinking water.

It’s clear to Dr. Goldstein that lack of education about medication disposal is a problem, and fortunately, he and his colleagues are ready to tackle it. 

UVA Health and the Department of Pharmacy have put much effort towards safe medication disposal since 2018 when they established a successful drug take-back program with three receptacles in the Charlottesville area. Since the original receptables were installed, the program has collected 657 cubic feet of medications weighing almost 8,000 pounds. That is equivalent to the weight of seven polar bears or nearly two cement mixer trucks! 

Dr. Goldstein wanted to build on that success by increasing the number of drug take-back receptacles, making them more accessible, and educating the community about the safe disposal of unused and expired medications.

“When the Spark program came along,” he says, “I thought I would propose the idea of additional recovery boxes, and fortunately, the Spark committee like the idea, too.”

The Spark Innovation Competition invites team members to submit ideas for making improvements and transforming the culture at UVA Health. The winning ideas are selected for funding and implementation. Out of nearly 300 Spark submissions, the expansion of the Drug Take-Back Program was one of the six winning ideas. 

Dr. Goldstein partnered with many stakeholders across UVA Health, including Justin Vesser, Director, Pharmacy; Jeff Lucas, Director, Performance Improvement; Kevin Fox, Director, Facilities Planning & Capital Development, Major Capital Projects; Dania Chastain, MD, Pain Management Clinic; Wendy Carlton, MD, Pain Management Clinic; Hannah Fitzhugh, Special Initiatives Lead; Lily Lei, UVA Special Initiatives Intern; Alysha Akhtar, UVA Special Initiatives Intern; Tyler Ericson, MD, Resident, Anesthesiology; Chelsea-Ann Patry, MD, Resident, Anesthesiology; and Grace Dusseau, Director, Executive Communications and Strategic Initiatives. With the team in place, they formulated a plan for implementation. 

How to Find and Use the Drug Take-Back Receptables

Six new boxes were installed for a total of nine at UVA Health locations. It was the project team’s priority to make sure there was at least one on Grounds for students, so the team placed one at the UVA Bookstore and one at Student Health. Here is the full list of locations:

• UVA Emily Couric Clinical Cancer Retail Pharmacy
• UVA Pantops Pharmacy
• UVA Pharmacy Ivy Road
• UVA Bookstore Pharmacy
• UVA Student Health Pharmacy
• UVA Augusta Pharmacy
• Outpatient Pharmacy at Education Resource Center (two previously existing receptables)
• UVA Zion Crossroads Pharmacy (previously existing receptacle)

When visiting these locations, look for the bright green bins labeled “Safe Drug Disposal.” Any type of medication is accepted; however, sharps are not accepted. The receptables are self-service, and all you have to do is drop your medications in the bin and go. Contents are securely picked up and destroyed by a third-party processor. 

“This is a no-questions-asked, judgment-free zone,” says Vesser. “We want individuals to be able to dispose of these properly without scrutiny. A foundational principle of this project is that it is an anonymous, safe place to dispose of medications.” 

As the new receptables are used, data will be collected on the volume of medications disposed.

Drug Take-Back Day

As a complement to the expansion of the drug take-back receptables, in April UVA Health also hosted a drug take-back event in front of the Education Resource Center on April 22, National Prescription Drug Take Back Day. 

“Even though we have a 24-hour location that’s available, we make this day as easy as possible with a hands free, drive-up event,” says Vesser. “We partnered with University Police, Pharmacy, Administration, volunteers, and Marketing. In the absolute torrential downpour, they still ran out there soaking wet, collecting unwanted medications through car windows.” 

Just like the receptables, the sole focus is safe disposal, and the medications were accepted anonymously at the event. 

“It is estimated that 70-80% of drug misuse and diversion is not happening on the streets but inside homes,” says Dr. Goldstein. “Just get it out of your cupboards, get it out of your house, and don’t flush it.”

Despite rainy conditions, the program collected nearly 100 pounds of medication for disposal. 

The team hopes to make this a yearly event. 

Visit the Spark Innovation Competition website to learn about other winning ideas and the next Spark competition launching at the end of 2023, which will look for ideas to improve the research environment. Stay tuned to Connect for more stories about the winners.