Medication

Managing unused and leftover medications

According to the 2019 National Survey on Drug Use and Health, 9.7 million people misused prescription pain relievers, 4.9 million people misused prescription stimulants, and 5.9 million people misused prescription tranquilizers or sedatives in 2019. The survey also showed that a majority of misused prescription drugs were obtained from family and friends, often from the home medicine cabinet. (1)

To help address this issue, drug take back programs are available at many locations.

What is a medication take back program (Drug take back program)?

Medicine take-back programs are the only secure and environmentally sound way to dispose of leftover and expired medicines (2).

  • Ongoing drop-off programs are usually at a pharmacy or a law enforcement office.
  • Take-back programs use secure equipment and procedures to prevent theft or diversion.
  • Collected medicines are destroyed in a way that protects our environment.
  • Community demand for medicine take-back programs is high, but most communities do not have a program.

Take-back programs can be (2)

  • Ongoing drop-off programs.
  • One-day collection events.
  • Mail-back programs.
  • Combinations of these approaches.

US Drug Enforcement Agency (DEA) will hold their National Prescription Drug Take Back (NTBI 21) on Saturday, October 23, 2021 – 10AM to 2PM (3)

  • The National Prescription Drug Take Back Day aims to provide a safe, convenient, and responsible means of disposing of prescription drugs, while also educating the general public about the potential for abuse of medications. (3)

To find a site near you, and for year round drop off locations, go here.

For research on drug take back programs go here.

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

 Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

 References:

  1. https://takebackday.dea.gov/
  2. https://www.takebackyourmeds.org/why/how-medicine-take-back-works/
  3. https://www.deadiversion.usdoj.gov/drug_disposal/takeback/

Study: Are you paying too much for generic medications?

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Medications for mental health can be helpful for some people when combined with healthy lifestyle habits, healthy psychological skills, and support through counseling.

As of 2013, about 1 in 6 individuals in the United States reported taking prescription medications for mental health (1).

A recent study looked at the cost of medications across various pharmacies (2).

What was the study?

  • The study authors (2) looked at the cost of 3 commonly prescribed medications at 175  pharmacies across 55 zip codes in a 2 state region.
  • 153 of 175 pharmacies were chain pharmacies.
  • The authors also looked at dose, supply, pharmacy type and zip code, and zip code median annual income.

What were the results? (2)

  • Only 1 chain pharmacy had consistent pricing across all its stores in the study region (2).
  • They found that even within the same chain, medication prices could vary based on the pharmacy.
  • The main driver of cost was the retail pharmacy—and not the variables of drug dose, duration of therapy, pharmacy ownership, pharmacy location, or median income (2).
  • For one of the medication combinations, study authors found almost a 40 fold difference in price (2), and a 33 fold difference for another.
  • Counter intuitively, the study authors also found the oldest generic medication to be most expensive (2).

What are some caveats?

  • This was a small study looking at 3 generic medications in a 2 state area in the Midwest.
  • So the results may not be applicable to all medications, as well as all regions.
  • Further study is needed.

How can I ensure that I am NOT over-paying for my prescription medications?

  • Many pharmacies have stopped discount or $4 pricing.
  • Check with your insurance about a preferred pharmacy.
  • Call pharmacies in your area or download an app that can compare prescription drug prices in your area.
  • Talk to your prescriber about prescription discount cards, vouchers, or a 90 day supply. These may be available for brand name medications, sometimes generic ones too.
  • Look into Charitable pharmacies in your area.  For example, CD4AP runs a Charitable Pharmacy on the South Side of Columbus Ohio, which offers free or reduced fee prescriptions for those in need:https://charitablepharmacy.org/SitePages/home.aspx

If you are having difficulty filling or affording your prescription, it may be best to talk to your prescriber without delay.

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1.  Moore  TJ, Mattison  DR.  Adult utilization of psychiatric drugs and difference by sex, age, and race  [published online December 12, 2017].  JAMA Intern Med. doi:10.1001/jamainternmed.2016.7507
  2. Hauptman PJ, Goff ZD, Vidic A, et. al. Variability in Retail Pricing of Generic Drugs for Heart Failure.  JAMA Internal Medicine. 2017;177(1):126-128.

Improving your likelihood of antidepressant medication response

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

As of 2014, about 15.7 million people in the US had at least 1 major depressive episode in the last year, and about two thirds of the individuals had a severe impairment in their ability to manage at home, work/school, or relationships with others (1).

Treatment options for major depression include counseling, medications, life-style, and other strategies. These options can be used alone or in combination with each other.

A recent study looked at a major factor impacting your response to antidepressant medication for major depression.

How do you define depression?

A major depressive episode is defined as an episode of depressed mood or loss of pleasure in daily activities lasting 2 weeks or longer in the past 12 months and at least some additional symptoms, such as problems with sleep, eating, energy, concentration, and self-worth (2).  Additionally there must be some impairment in a person’s ability to function at home, work, relationships or social settings.

What was the study? (3)

792 patients receiving usual care for depression in 83 clinics for at least six months between 2008 and 2010 (4).

How was depression measured?

Depression was measured using, Patient Health Questionnaire–9, a validated instrument to measure the severity and treatment response to depression (3,4).

Was there a key finding?

According to the study article, patients reporting fair or poor health were significantly less likely to improve depression compared with patients with good, very good, or excellent health (3).

What do the results mean?

In my practice, I often discuss the mental health benefits of healthy lifestyle habits such as healthy eating habits, healthy (not excessive) exercise, adequate sleep, avoidance of alcohol, illicit drugs; yoga, meditation, etc.

This study suggests that individuals suffering from Major Depression with good overall health had a better chance of benefiting from antidepressant medications than those with depression who reported fair or poor health.

In other words, while good overall health might help many people with depression, if you are still depressed, having good overall health improves your chances of responding to medications.

This is a small study and further studies would be helpful.

What are some resources regarding health improvement?

What are some of OSU’s campus resources that might help with reducing depression?

What are some resources regarding depression?

• Counseling at the OSU Student Life Counseling and Consultation Service
• Mindfulness and Body scan techniques at the OSU Wexner Medical Center
• Depression information at the National Institute of Mental Health
• Anonymous mental health screen
• Depression and Bipolar Support Alliance

National Alliance on Mental Illness (NAMI)

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Retrieved from http://www.samhsa.gov/data/
  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
  3. Rossom RC, et. al.  Predictors of Poor Response to Depression Treatment in Primary Care.  Published online: July 15, 2016. Psychiatric Services in Advance (doi: 10.1176/appi.ps.201400285)
  4. Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: Validity of a Brief Depression Severity Measure.J Gen Intern Med. 2001 September; 16(9): 606–613.