Like millions of people across the country, Strom Peterson has a personal connection to the opioid epidemic. The Washington state representative lost a cousin to a heroin overdose. That tragedy, he says, led him “to really dig in and see what could be done.”
Eventually he decided to champion a statewide drug take-back program. He sponsored a bill to create secure spots around the state for people to drop off their unwanted and expired prescription medicines. It was signed into law by Gov. Jay Inslee in March. But there’s a twist: Under the law, drug manufacturers themselves must fund and implement the program.
While Washington is the first state to create a statewide take-back program, the concept isn’t new. The Drug Enforcement Administration (DEA) got the go-ahead to establish safe disposal sites in 2010. Dozens of cities and counties nationwide have already created their own programs (there were three county programs in Washington state when Peterson’s bill passed), and last year CVS introduced disposal kiosks in 750 of its pharmacies. Once Washington state’s program gets up and running, pharmacies and law enforcement agencies are expected to be the primary sites for dropping off unused drugs.
The main idea behind the take-back programs is to encourage people to safely dispose of their unused medication and, thereby, help prevent overdoses, suicides and poisonings. The growth of the programs in recent years flows from a change in federal regulations: Until 2014, DEA rules allowed only law enforcement agencies to collect unused opioids. That authority has now been expanded to states, local governments and agencies other than law enforcement. Peterson says the expansion was key in getting his legislation passed.
While the bill received bipartisan support, there was a big obstacle in the way: the pharmaceutical industry. Lobbyists, objecting to costs and regulatory burdens, initially fought hard against it, but eventually worked with the legislature to produce compromises, such as allowing the drugmakers, rather than a government agency, to run the program themselves. “They told us that if they were going to fund it, they wanted to be able to run it, and I felt that was a fair compromise,” Peterson says. “Getting them to neutral was a big thing.” In the end, the cost of the program for the drug companies is expected to be negligible -- about one-tenth of 1 percent of their $5.7 billion in annual sales in the state.
Of course, getting unused and unwanted pills out of people’s homes won’t by itself rein in the nation’s roughly 65,000 annual overdose deaths. Washington’s health secretary, John Wiseman, calls the new take-back program just one piece in a huge jigsaw puzzle that will require action “from all of us, from mental health professionals to medical providers to law enforcement, and yes, the drug manufacturers.”
Initiatives like Washington’s aren’t the only way that governments are pushing back against the pharmaceutical industry. More than a hundred city, county and state governments have filed lawsuits against drug manufacturers and distributors, seeking reimbursement for their costs in dealing with opioid abuse. Experts say that this marks a new chapter in the opioid fight, one in which governments are increasingly putting pressure on drugmakers for their role in the epidemic. “There was some willful ignorance,” Peterson says, “and now there needs to be financial consequences to that.”