New Jersey pharmacists are embracing an efficient solution for complying with Charlie’s Law, which was passed in March in an effort to curb the opioid overdose epidemic in the state.
Opioid overdoses and deaths continue to rage throughout the country this year. COVID-19’s stress has led, in part, to increases nationwide, including 1,030 overdoses in New Jersey through April 30, the Centers for Disease Control and Prevention reports.
In March, New Jersey became the first state to take major legislative action against the epidemic when it passed Charlie’s Law, named in memory of Charlie Van Tassel, a beloved son and brother who battled addiction for many years before his passing because of an overdose at age 33.
State Sen. Robert Singer.
State Sen. Robert Singer’s (R-Lakewood) bipartisan bill, S3933, mandates that pharmacists supply instructions to patients regarding proper drug disposal procedures, along with a warning of potential risks if the medication is not discarded safely.
The law states that, “A pharmacy … that dispenses prescription drugs … must provide the patient with written informational materials advising that when unused, unwanted or expired drugs and medications are not properly, safely and promptly disposed of, patients often keep the leftover medicine in their homes and it can fall into the wrong hands.”
DisposeRx is the leading national solution for proper drug disposal, and more than 1,600 New Jersey pharmacies have embraced it. North Carolina-based DisposeRx is used in more than half of the 66,000 pharmacies in the country and growing.
The kit is handed out by the pharmacist when patients pick up their medicine, and does not cost the patient anything.
It takes less than 60 seconds to use and involves only a small vial, a few ounces of water and formulated powder. After combining the unneeded medicine with the powder and water, the patient shakes the vial for about 30 seconds, which breaks down the medicine so it is no longer dangerous, and then tosses the vial in the trash. It is safe for household disposal and reduces risks to the environment.
“Pharmacists are always happy about opportunities to speak to their patients, especially regarding issues related to the opioid crisis,” Brian Oliveira, executive director of Garden State Pharmacy Owners, based in Hamilton Township, said. “Charlie’s Law is an example of community pharmacy stepping up to provide more assistance in order to stem the deadly tide of addiction.”
Oliveira described DisposeRx as an easy, affordable and accessible at-home product. “Pharmacists find it easy to educate the patient about its use. Most patients appreciate being presented with a solution that does not require another activity (such as going to a drop-off day) as part of their already-busy schedules.”
With almost half a million licensed health care workers and 66,000 locations, pharmacies “are our community health centers,” DisposeRx President William Simpson said: “There’s an elegant simplicity to our process. We believe that it’s vital to educate and remove the risks of illicit medication misuse use. This is a problem that has not gone away, but is only adding to our community and home risk.”
Dr. Lewis Nelson.
Removing any unneeded drug from the street or out of the medicine cabinet “is generally a good thing,” said Dr. Lewis Nelson, professor and chair of the Department of Emergency Medicine at Rutgers New Jersey Medical School and University Hospital in Newark.
“Getting drugs out of these matrices is not well studied, but, like with tamper-resistant opioids, it is likely that, if there is a will, there is a way,” Nelson said. “These products are more like a lock, and not a deadbolt, in that they keep honest people out. An even better approach would be to prescribe opioids more judiciously, so there are no leftovers to discard.”
Flushing opioid medicine down the toilet requires no extra equipment and definitively removes the product from the household, Nelson said, “but doing so does carry a negligible risk for the environment and people.
“Take-back programs and commercial disposal methods require extra steps and add extra costs (paid by someone somewhere down the line), and it’s not known how often they are even utilized when available.”
Ben Donaldson, senior vice president of government and corporate relations for DisposeRx, said state legislatures nationwide are beginning to line up to create laws with regulatory language to address this crisis.
“Charlie’s Law is being used as a footprint to craft legislation in their states,” Donaldson said. “People should not have to wait for ‘drug disposal days’ to come to their neighborhood, or put their unwanted medicines in a nearby disposal box. They should be able to get rid of them the moment they stop taking them.”
The disposal product’s expense today is being covered by pharmacies and their stewardship programs, Simpson said, and DisposeRx is working with several payors, including government agencies, to share in both the education as well as the packet costs of the disposal vial.
Singer writes on his website: “We’ve all heard stories about extra or expired medications in a family medicine cabinet falling into the wrong hands, leading to a drug addiction or even death. My legislation (can) prevent these all-too-common tragedies. This legislation will prevent opioid abuse and save lives.”
In 2019, there were 203 overdose deaths in the state, including 36 in Essex. In 2018, New Jersey had the seventh-most opioid overdose deaths among U.S. states.
The product was developed in 2017 by its founder and CEO, John W. Holaday, who in 1966 was commissioned at Walter Reed National Military Medical Hospital to study opioid abuse by returning Vietnam veterans.
