The worst thing I’ve seen suggested at one of the Drug Enforcement Administration’s biannual Prescription Drug Take Back days is that this one, April 30, will be a family-friendly event where kids play with trucks.
Take Back Day’s whole thing is that unused or expired prescriptions “can be just as dangerous as street drugs.” It leans pretty hard into the stats describing how most people using controlled substances off-label, especially young people, get them from family or friends for free. Over the years, the DEA spent so much time hyping a youth overdose crisis that didn’t exist that it helped to create one. Teen overdose deaths are now finally catching up to the adults, and Take Back days are being written up as cheery springtime traditions.
They’re supposed to be environmentally friendly solutions to our problem of too much medicine, since less of it’s flushed into our waterways. Instead, it gets trucked hundreds of miles to the nearest hazardous waste incinerator—an expensive process that discourages local organizations from participating but which cops can always solve by buying their own incinerator with funds leftover from drug busts. Or they can call it “household waste” and dump it into municipal incinerators, which they sometimes own, with fewer emissions regulations.
The only metric used to show how much danger has been taken off the streets is how much the pills and bottles weighed.
The DEA doesn’t allow anyone to inspect the contents of its Take Back Day bins, which are contracted out to “reverse distributors” and thrown into incinerators without anyone seeing inside. The only metric used to show how much danger has been taken off the streets is how much the pills and bottles weighed, and whether the total was heavier than whatever was incinerated six months ago.
There is really no part of Prescription Drug Take Back Day that isn’t a lie. Prescription drugs are supposed to have expiration dates arrived at through stability studies, but that’s not the DISCARD AFTER displayed on the packaging of most Schedule II medications you might have lying around your home. The discard date is just six months or a year from the day the pharmacist filled it, depending on where you live. It’s the prescriptions that expire, not the drugs.
Suboxone comes with an expiration date that corresponds to its lot production number in a way that looks like it makes more sense. But despite the instructions to flush it after that date if no Take Back Day is readily available, there are no stability studies assessing the medication’s effectiveness over time. Even the company that manufactures it doesn’t know.
Pharmaceuticals aren’t deli meats. They don’t turn poisonous after the sell-by date. They stay the same, and weaken in potency over a period of many years. Stored at room temperature out of direct sunlight, the kinds of medications the DEA is after here likely remain effective for decades after being manufactured.
Beginning in the mid-2000s, the CDC accidentally doubled its prescription drug mortality data by classifying illicitly manufactured drugs with the same code as pharmaceutical versions. Most people overdosing with fentanyl in their systems weren’t being written prescriptions for it, but their deaths were shown to the public as evidence of our worsening overprescribing crisis.
We built a whole new drug war on this: billions of dollars funneled to the DEA to drive pharmaceutical use down and overdose and suicide up.
The CDC was aware its prescription-involved overdose statistics were drastically inflated for a decade before acknowledging it; some of the errors in the classification system may still be used today.
We built a whole new drug war on this: billions of dollars funneled to the DEA to drive pharmaceutical use down and overdose and suicide up. When it had spent so much money cutting off access to quality-controlled pharmaceuticals that it ushered a counterfeit pill market into the void, it made a crackdown campaign for those too.
No one ever runs out of things to say about the ethics of providing controlled substances to minors or anyone else not already familiar with them, but we don’t hear much about the ethics of providing them to the people who are.
There’s a pile of clonidine and hydroxyzine that doesn’t mean anything to you, but does to someone trying to switch over fully from dope to methadone and can finally do it with something to help the anxiety. I’ve been written hydrocodone refills without even realizing it, which a stable shelf life allows me to save for someone who couldn’t get codeine if they’d been hit by a bus, because their race or track marks or something in their PDMP prompts health care workers to question whether being hit by a bus actually hurts.
Seroquel above 200 mg puts me into a coma, but that might be a desirable effect for someone whose pharmacist chose to not refill their Suboxone at 5 pm on a Friday. Painkillers and ADHD meds that weren’t used by the person they were prescribed to doesn’t make them higher risk for someone whose opioids and stimulants are unregulated. Maybe their one good vein gets a day off.
The reason that people who are inexperienced with drugs often start with pharmaceuticals they got from someone they know, for free, is because that was obviously the least risky way to do it. The DEA is not health care. It is a xenophobic PowerPoint, perpetually manufacturing new reasons to exist, burning the safer versions of drug sand leaving only the riskier ones in easy reach of the kids.
Photograph by Kastalia Medrano