An Ecological Study of Drug Drop Box Donations in Appalachia

Prescription drug abuse is a major public health problem in United States. Research showing 70% of nonmedical prescription drug users obtain drugs from friends and family has sparked discussion over disposal of unused or expired medications. Tennessee experienced a 250% increase in overdose deaths from 2001 to 2010. In response to this increase, permanent drug donation receptacles have been installed in multiple law enforcement offices across the state; however, the extent to which the public utilizes these receptacles is not well known. In partnership with Drug Enforcement Administration and local law enforcement, drop box donations were analyzed in six Northeast Tennessee locations from June 2012 to October 2013. The objectives of this research were to: 1) quantify controlled substances (CS) donated, and 2) evaluate time lapse between dispensing date and donation across CS schedules as well as potency rankings for opioids. Over the 18-month collection period, 3,113.5 lbs. of pharmaceutical waste was donated; 5.14% or 160lbs were CS, totaling 65,430 individual doses.  Analysis of dispensing dates for CS medications indicated a median of 34 months lapsed from dispensing to donation (range 1 to 484 months). Comparison of means between Schedule II and Schedule III/IV indicated that Schedule II drugs were donated within fewer months than Schedule III/IV drugs (t-test = -4.37, p-value <0.0001). These results quantify the potential impact of permanent drug donation boxes on the prevention of CS diversion in Northeast Tennessee.  Further study is warranted to examine the effect of targeted public health messages on increasing CS donation.