U.S. Drug Problem Is Not Just Opiates—We Are Over-Prescribed Everything

Saturday was “National Prescription Drug Take Back Day.” For four hours, from 10 a.m. until 2 p.m., Americans could take a bottle or a bag full of unwanted prescription medication and hand it over to local law enforcement, no questions asked. 

The pills were then handed over to the DEA for safe disposal—and quantification of just how much superfluous prescription medication is floating around America. 

Like gun buy-backs, drug take-backs are a recent innovation, a non-punitive way of fighting an overwhelming problem. Doing this empties medicine cabinets and bedside tables of expired or unwanted drugs rather than sending them into the water supply, but it also—hopefully—keeps people alive.

More than 50,000 Americans died from drug overdoses in 2015, according to the National Institutes of Health, a crisis similar in proportion to the AIDS epidemic at its nadir in the mid-1990s. 

Overdoses are now the most common cause of accidental death in much of the country. Prescription pills kill more people than auto accidents and guns—and, according to the DEA, eight out of 10 heroin users started with prescription pills and took up the needle when the pharmaceutical supply was either turned off or became too expensive.

By sheer weight, this year’s take-back was a resounding success.

Across the country, police reported receiving record amounts of unwanted or expired pills. Here’s a brief but representative roll call: In Morris County, New Jersey (population 500,000): 724 pounds. In Marion County, Florida (340,000 people): 800 pounds. In Hoover, Alabama (population, 85,000): 800 pounds. In Roswell, Georgia: 241 pounds. And in the small town of Wolfeboro, New Hampshire (population 6,269): 150 pounds.

Five places in five different states, fewer than a million people and more than two tons of extra drugs, for which their owners saw no purpose (including, for the less scrupulous and weaker-willed among us, illicit resale).

This would suggest that the U.S. is on its way to surpassing the million-pound mark for unwanted pharmaceuticals.

Last year, the DEA collected almost 900,000 pounds of “unwanted medicines” across the country—or 447 tons, a record haul that handily beat the previous year’s total of 390 tons (itself a record).

That’s staggering, and even more so when put into context.

Pills are not heavy. A 30-milligram tablet of Oxycodone is just that: 30 milligrams. Since pills vary wildly in size—common antibiotics like Cipro come in 750-milligram doses; while hydrocodone, the most-prescribed drug in 2011, is about 325 milligrams—let’s assume 500 milligrams (half a gram) is an “average”-sized pill.

So, if there are 453.592 grams in a pound, there are about 900 pills per pound of prescription drugs. At 900 pills per pound, 900,000 pounds of unwanted drugs means 810 million superfluous pills.

According to the Kaiser Family Foundation, pharmacies doled out more than four billion “products filled by pharmacies,” a figure that includes “new prescriptions and refills,” in 2016.

Determining what exact percentage of those pills goes to waste would require data we don’t possess—some drugs are thrown away in the trash, some are lost, some are stolen—but it’s clear that there are far more prescription drugs in America than any reasonable person would declare necessary.

Medical experts have said for some time that prescription pills should be the treatment option of last resort, and that doctors may have more luck prescribing massage or meditation to pain-sufferers. But opiates are now obviously not the only problem.

If the DEA is receiving anywhere near 20 percent of what pharmacies dole out on one day in April—810 million out of four billion—the over-prescribing of everything in America is at crisis-level.

It’s madness, all of it. We’re sick, but the malady is neither pain nor pathogen.

This is highly profitable madness.

Pharmaceuticals are a $333 billion annual industry. The average American spends more than $1,000 a year on prescriptions, whether or not they’re necessary, whether or not they just end up in the trash, whether or not they might be more needed somewhere else.

Weaning the country from this capital-fueled habit, whose dividends make their way to Washington in the form of campaign contributions to leading policy makers (including Donald Trump’s incoming drug czar), is a bigger job than anyone is prepared for.