Winston-Salem, NC—Only about 30% of the $3.8 billion controlled medications dispensed by pharmacies—such as hydrocodone, oxycodone, Valium, and Adderall—are actually used by the patients for whom they are intended.

So what happens to the other 70%? That question is the reason that a new report points out that  nonmedical use of prescription drugs is the second most common form of illicit substance abuse in the country, after use of marijuana.

The article, published online by The American Journal of Drug and Alcohol Abuse, also raises questions about the effectiveness of efforts to “take back” controlled drugs to help curb misuse.

The study, led by Wake Forest University researchers, notes that community-wide take-back events and permanent drop boxes are widely employed across the United States, but might not be having the desired result.

“Similar to other studies, we found that only about 5% of the collection from take-back events and drop boxes consisted of controlled medications susceptible to abuse,” explained  lead author Kathleen Egan, MS, research associate in social sciences and health policy at Wake Forest School of Medicine, which is part of Wake Forest Baptist Medical Center.

“The remaining 95% consisted of non-controlled substances, such as vitamins and over-the-counter medications, but unlike previous studies we then compared the number of controlled medications to the number dispensed by pharmacies,” Egan added. “And what we found surprised us–less than 1% of dispensed controlled medications were collected by the disposal programs.”

For the study, researchers measured the quantity and type of controlled medications collected during three federal Drug Enforcement Administration–sponsored take–back events and in permanent drop boxes in five Kentucky counties in 2013-2014. That was then compared to the number of controlled medications dispensed in the participating counties over the same time period.

Results indicate that, while 21,503 units of controlled medications were collected at take-back events and drop boxes, they accounted for only 0.3% of the more than 20 million units prescribed.

Specifically, 46.9% of the controlled substances prescribed were opioid analgesics, 13.1% were tranquilizers, and 37.3% were classified as “other”; but of the controlled medications collected, 39.9% were opioid analgesics, 2.7% tranquilizers, and 57.4% “other,” according to the report.

“Controlled medications collected by take-back events and permanent drug donation boxes constituted a miniscule proportion of the numbers dispensed,” study authors conclude. “Our findings suggest that organized drug disposal efforts may have a minimal impact on reducing the availability of unused controlled medications at a community level.”

Egan emphasized that the research doesn’t prove that the take-back programs have no positive effects, adding, “The study was limited in both time and scope; the results might be different in different communities, and over time these programs may influence community norms and behaviors related to storage, disposal and abuse of controlled medications.”

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