Brandon Billard was only 15 when he started stealing prescription painkillers from his parents' medicine cabinet. Soon he started taking medications from his grandparents, then friends' parents -- he would take Oxycontin, Klonopin, even cough medicines with opiate painkillers like Tussionex, and replace them with similar-looking over-the-counter drugs.
"My mom or dad was prescribed Vicodin for surgery, so I started taking Vicodin. Then I started to have anxiety from all the drugs I was using, so I started getting [the anti-anxiety medication] Xanax from a friend's parents' medicine cabinet," Billard says. Now 18, he says he has overdosed and been hospitalized "a bunch of times" and has been in and out of several in-patient rehab programs. Currently, he is in the drug abuse treatment program at Daytop Village in Mendham, N.J.
Billard's story illustrates the often-overlooked danger of keeping leftover prescription drugs in the home -- a public health concern that Dr. William Shrank of Brigham and Women's Hospital in Boston highlights in the New England Journal of Medicine. "One glimpse" into the medicine cabinet of an elderly relative is all it takes to realize how dangerously accessible many prescription medications are, he says in an opinion piece published Wednesday.
"I think I was going to try to get high either way, but it didn't help that these drugs were so readily available. They were right there -- parents don't think to hide or lock up medicine," he says.
Millions of pounds of prescription medications go unused each year in the U.S., according to the American Society of Consultant Pharmacists. While most people leave these extra pill bottles in the back of the medicine cabinet, growing concern over prescription drug abuse, especially among teens, has led doctors like Shrank and the U.S. Drug Enforcement Agency (DEA) to urge the public to "take back" unused drugs.
This Saturday, April 30th, the DEA is holding a Prescription Drug Take-Back day to allow people to drop off their unused meds, no questions asked, at over 5,200 sites nationwide. The first nationwide take-back day, last September, collected 242,000 pounds of prescription drugs. These Take-Back days will be held periodically until, in accordance with the 2010 Secure and Responsible Drug Disposal Act, 24/7 drop off locations can be established for safely disposing of leftover meds, says David Levey, a DEA spokesman.
"It's hard to strike a balance to make sure that people who need it have access to these medications," says Dr. Richard Weisler, a psychiatrist at Duke University Medical Center, "but that when they are no longer needed, they are properly disposed of."
"Accidental prescription drug overdose, largely in the elderly or in teens using recreationally, killed 27,500 people in 2007. This is more than the U.S. casualties of the war in Iraq and Afghanistan combined. This is not acceptable," he says.
It's not just prescription pain meds that pose a problem for abuse. Oftentimes unfinished antibiotics are kept around and then "self-prescribed" for later coughs and colds. This can lead to antibiotic resistance and is "one of the big drivers of drug resistant infections in antibiotic misuse," says ABC News Chief Health and Medical Editor Dr. Richard Besser.
Though 40 percent of all prescription medications go unused, according to the Henry Kaiser Foundation, most people hold onto them for years, because they don't think to dispose of them or don't know how to do it safely. Often, following the many examples in TV and film, people will flush unwanted pills down the toilet, but this may have dangerous ramifications for the environment, says Shrank.
"In one systematic evaluation of the drinking-water supply for 28 million Americans, researchers detected antihypertensive, anticonvulsant, anti-inflammatory, antibiotic, lipid-lowering, or estrogen-containing compounds in more than half the samples of source water and in some, albeit a smaller proportion of, samples of finished drinking water," he writes. It is unknown whether these traces come from improper disposal of pills or substances that are excreted after consumption.
The Food and Drug Administration recommends that an unused medication be taken out of its original container, mixed with an "undesirable substance, like cat litter or used coffee grounds," put in a sealed container, sealed and thrown away with the trash.
"Once a year go through your medicine cabinet and get rid of those drugs that have expired, prescriptions you never finished, and any prescription pain medicines. It's also a good time to check and see if any of your over the counter medications have been recalled," says Besser.
Waiting for a designated prescription drug "take-back" day is another option for disposal, Levey says. He says these take-back days will be held periodically until permanent drop-off locations for unused drugs can be established nationwide.