The Assertive Cancer Patient

A Sink Full of Empties

When I finish a prescription, I throw the empty bottle to the back of the top shelf of my bathroom cupboard. Then, every so often, I gather up all the empty bottles for disposal.

This sink-full is probably a year's worth.

I don't have anything particularly profound to say about the sink full of empties, except that it leaves me bemused.

I'd like to take the bottles and create a piece of art, but I probably won't. I will save one bottle for each prescription drug that I am still taking so that I can put a week's worth of each drug in my disaster preparedness kit.

Until then, the bottles will stay in the sink (my bathroom has two sinks), reminding me how much my life has changed.

@ Jeanne Sather 2008.

Drug Repository: Guest Editorial in the Seattle P-I

I have a guest editorial in the Seattle Post-Intelligencer this morning:

Drug repository would help low-income folks

I'm happy the P-I ran it, of course, but wish they had included the link to my blog.

Recycle Drugs: Great Minds and Other Cliches

Meet Pat Chandler.

Pat has prostate cancer and he writes a blog. He lives just across Puget Sound from Seattle, on Bainbridge Island. Recently he wrote a post about wanting to give away some cancer drugs that he wasn't going to use because his doctor had changed his treatment.

I'll admit I'm predisposed to like someone who thinks like I do on the important issues, and these issues include passing on expensive, unneeded prescription drugs to those who need them but can't pay for them.

I found out recently that the term for this is drug repository, and quite a few states already have them. So it's not like this is a particularly revolutionary idea, but it sure would help some of the 600,000 people in Washington who don't have health insurance, not to mention the hundreds of thousands (I'm guessing here) more who don't have adequate prescription drug coverage.

(Do you know how much your health insurance pays for prescription drugs? On many policies it is only 50 percent--doesn't take long to run up a huge bill if you are in cancer treatment.)

So after Pat put up his post, he was asking around, and someone steered him to my blog. (Thanks for that, whoever it was.)

We are going to put our heads together and see if we can get the ball rolling (there's the second cliche, in case you were watching for it) in Washington state on establishing a drug repository. I already talked to the folks I know at WashingtonCAN about this, and they weren't interested in adding it to their legislative agenda for this session--but I'm going to see if I can change their minds.

I've also written an opinion piece for the Seattle P-I that should run next Monday.

Here's what Pat wrote:

All you need to know is that I spent a boatload of money for a cancer drug that didn’t do me any good and yesterday I was taken off of it and switched to a different one that probably will. It was somewhat of a surprise, so I had about a full month’s worth on hand, worth more than you will be getting from your economic stimulus package check. ...

I’m not stupid, I didn’t put it on eBay or craigslist under "drugs for sale." Selling prescription drugs is a no no. I want to give them away so I called a Rite Aid Pharmacist and explained that I would like to give these life-saving drugs to someone unable to afford them. ...

So, can’t be done, she said.

I can donate an organ but I can’t donate unused pills? Doesn’t make sense does it? Prescriptions are changed all the time. People die all the time with a 3-month supply and yet people are dying because they can’t buy next week’s supply. We can help.

Read the entire post.

Read more:

Don't Dump Those Drugs!

An Alternative to the Government's Kitty Litter Drug Disposal Plan

@ Jeanne Sather 2008.

Don't Dump Those Drugs!

I was outraged when I read that the government recommends that people who have leftover prescription drugs mix those meds with dirty kitty litter and throw them in the trash. (See An Alternative to the Government's Kitty Litter Drug Disposal Plan)

It seems to me that there should and could be a legal way to pass these expensive meds on to people who need them. And it turns out there is. The magic words are DRUG REPOSITORY.

A few states have them, and a few more are working to set them up.

In the state of Wisconsin (three cheers for Wisconsin!), for example:

Cancer and chronic disease patients may donate unused or discontinued medications and supplies to a participating pharmacy or medical facility. Those items will be given to individuals with cancer or chronic disease that do not have insurance or are underinsured.

Go to this link to learn more: Wisconsin drug repository

And in Ohio (also three cheers!):

Any person, including a drug manufacturer or any health care facility as defined in section 1337.11 of the Revised Code, may donate prescription drugs to the drug repository program. The drugs must be donated at a pharmacy, hospital, or nonprofit clinic that elects to participate in the drug repository program and meets criteria for participation in the program established in rules adopted by the state board of pharmacy under section 3715.873 of the Revised Code. ...

A pharmacy, hospital, or nonprofit clinic eligible to participate in the program shall dispense drugs donated under this section to individuals who are residents of this state and meet the eligibility standards established in rules adopted by the board under section 3715.873 of the Revised Code or to other government entities and nonprofit private entities to be dispensed to individuals who meet the eligibility standards. ...

The pharmacy, hospital, or nonprofit clinic may charge individuals receiving donated drugs a handling fee. ... Drugs donated to the repository may not be resold.

Read more: Ohio drug repository

Nebraska has had a program for cancer drugs since 2003 (Go Nebraska!)

Read more: Nebraska drug repository

Maryland: Maryland drug repository

Illinois: Illinois drug repository

Missouri's program isn't as good as some of the others, from the patient's point of view, because the only drugs that may be donated are drugs that were dispensed and used at nursing homes or hospitals:

For safety reasons, donated drugs must have been under the control of a healthcare facility or healthcare professional, and cannot have been in the possession of the individual owner.

Still, it's a start.

Read more: Missouri drug repository

Also, Georgia: Georgia drug repository

New York: New York drug repository

New York's law says the drugs must be in their original, sealed package, which means if I had a half bottle of zofran (worth more than $20 per pill), I couldn't donate it. I'm not sure how many of the other states have the same rule.

These states also have drug repositories in existence or in the works: Indiana, Hawaii, Minnesota, North Dakota, and Vermont.

Meanwhile, back here in Washington, my home state, no one seems to have heard of such a thing. We've got to get working on that one. Washington is home to 600,000 people without health insurance.

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@ Jeanne Sather 2008.

An Alternative to the Government's Kitty Litter Drug Disposal Plan

I’m a long-time cancer patient (nine years and counting), and I have dozens of bottles of leftover drugs clogging up my medicine cabinet.

I know it's dangerous to keep them around--kids could poison themselves, as could our Golden Retriever (who eats anything from rocks to homemade brownies). Drug abusers could steal them. I like to think that no one who visits my house would snoop in the bathroom searching for drugs, but do I know that for sure?

In the old days, the rule was to flush unwanted drugs down the toilet. But it's not a good idea: Antibiotics, hormones, and other drugs are being found in waterways, raising questions about harm to the environment and to human health as well.

A year or two ago, I read somewhere that the thing to do was to return the unused drugs to a pharmacy for proper disposal.

So I did this. I sorted through my medicine cabinet, gathered up a dozen or more pill bottles, and took them to the pharmacy at my cancer center.

The pharmacist looked surprised, as though she had never heard of such a thing. She took the drugs, but I wonder to this day if she didn't just turn around and throw them in the trash.

Just the other day, I was looking at a recent issue of Martha Stewart Living magazine, and read that Martha suggests putting unused meds in a brown paper bag and then dumping them in the trash.

Not a good idea. You might as well gift-wrap them. ("Add a bow in seasonal colors to the brown paper bag to make it stand out among the rest of the trash ...") Dumpster divers are everywhere, and there are probably more people going through the dumpsters in the neighborhoods where Martha and her readers live than in other parts of town.

Now, a project under the government’s Substance Abuse and Mental Health Services Administration suggests a new disposal method: mixing unwanted meds with used kitty litter and dumping them in the trash. Some 6,300 pharmacies nationwide will distribute fliers urging their customers to dispose of unused meds in this way.

I have a better alternative.

How about allowing people who have unneeded drugs to pass them on to someone who needs them but can't afford to buy them? Recycle them, in other words.

I think it’s a felony to do this on your own, although I know of one social worker who does this to get prescription drugs for his clients. And I applaud him for it. And people have told me stories of doctors' offices that do it, but very much on the QT. I applaud them as well.

I'm sure there would be liability issues, and bugs to work out, but think of the benefit to the millions of people in this country who are doing without the prescription drugs they need because they don't have adequate insurance.

Meanwhile, people who have expensive, perfectly good leftover drugs are being advised to mix them with kitty litter and throw them away!

I can remember waiting to pick up prescriptions at a cancer center in Seattle, and watching cancer patients and family members go up to the window, ask how much a drug was going to cost, then go off in a corner and huddle, and return to the window to say that they weren't going to fill the prescription.

I saw this exact scenario on a number of occasions, and it made me want to cry. It also made me want to whip out my credit card and offer to pay for the drugs, but I probably couldn't have afforded them either.

This is so wrong. No one with a serious illness like cancer should have to walk away from the pharmacy window empty-handed because they can't afford the drugs that were prescribed for them.

There has to be a way to get those leftover medicines to the people who need them. A program to legally recycle prescription drugs might just be the answer.

A note on the photo: That is one day's dose of Tykerb, my new cancer drug. Five pills a day, at a cost of $23/each. That's about $130/day--who can afford that without insurance?

I have more than $7,000 worth of Tykerb in my medicine cabinet. If my doctor decided to change my meds, the government thinks I should mix this $7,000 worth of perfectly good drugs with kitty litter and throw them away--that's outrageous!

See also: Don't Dump Those Drugs!

@ Jeanne Sather 2008.