Short History and Description of Drug Recycling from LTC to Tulsa County Pharmacy

Tulsa County, Oklahoma has operated a full service pharmacy for non-controlled medications for decades where the indigent can present a prescription, then buy the product at cost. How does an indigent buy something? They don’t, but family members, agencies, religious groups, and other Guardian Angels pay the bill.

Over ten years ago, George Prothro, MD, the Executive Director (now retired in Tulsa) of the Tulsa City County Health Department had a vision. It was to transfer unused, unexpired, packaged medications from LTCs to the Tulsa County pharmacy for re-dispensing to indigent patients of Tulsa County to improve health care.

Michael Lapolla, working in research projects at Oklahoma State University did significant studies, concerning the legality of the vision, a survey of states having such a program, and the benefits of the vision, especially cost savings.

This vision has become a win-win-win-win situation, as it (1) lowers the cost of medication for indigents for Tulsa County, (2) removes pollutants from the sewer system, (3) lessens labor at the LTCs and (4.) relieves family, friends, agencies, etc. of paying for the medications, allowing their funds to be applied elsewhere.

At that time, Oklahoma Statutes required the State Board of Health to establish rules and regulations for LTCs, including medication disposal with input from the Oklahoma Board of Pharmacy. A supplying pharmacist joined with the director of nurses (DON) to record a disposal manifest, then oversee employees flush the medications. Later, "blister packs" made the job more difficult as they had to cut or punch out the medications, a more difficult and time consuming job.

To arrive at our present status took four legislative sessions, extensive talks with LTC owners, administrators, and director of nurses, pharmaceutical suppliers, regulators, legislators, media, etc.

The vision disposes of some medications via recycling. To establish high safety levels, the transfers are from pharmaceutical supplier to LTC pharmacy to Tulsa County pharmacy.

We support community disposal of other medications via the Metropolitan Environmental Trust (MET) of Tulsa household pollutant collections.

We are very pleased with our effort. One special aspect is that a member of the "Golden Oldies", the retired physicians of the Tulsa County Medical Society, volunteer to transfer the medications and a transfer manifest from the LTC to the Tulsa County pharmacy.

There has been one unintended consequence, that being the transfer of non-prescription medications. One could not imagine the unopened bottles of antacids, aspirin, vitamins, etc. that the Director of Nurses ask us to also transfer. These items were shipped to areas hit by the hurricanes and the shelters for those removed from the storms. Charity clinics are supplied with these items.

Linda Johnston, Director of Social Services, This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

Jerry Gustafson, MD, Golden Oldie, This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

January 2, 2008