According to a report from Stop Oxy.com, federal agencies reported that OxyContin can bring as much as $80 in a street transaction, compared to about $6 if a patient purchases the drug with a valid prescription. Similar trends are reported for prescription painkillers hydrocodone and Vicodin, as well as Percocet.

OxyContin is at the top of black market drug demand, with an estimated 7 million people in the U.S. abusing prescription medications in 2009, representing a jump of 13 percent from the previous year. Black market sales are fueled by both addicts and people seeking to sell their own prescriptions for money, and the industry related to illegal sale of prescription painkillers may exceed $1 billion.

While marijuana used to be the typical starter drug, today, says Rusty Payne at the U.S. Drug Enforcement Administration, the gateway drug is typically prescription medications that can sometimes spark an addiction even after an initial use.

Methods for distributing black market drugs are also increasing. The drugs can be acquired from doctors who sell invalid prescriptions or from confiscated drug shipments. Family members have also been reported to steal and sell medications given to someone in their household.

Robberies at pharmacies are another indicator of rising black market sales, says the report, with more than 1,800 pharmacy break-ins or robberies reported by CNN.

Actually, there may be some that you’ll want to get rid of sooner than others. Still, how do you do so in the most efficient and safe manner? Believe it or not, there are right ways and wrong ways to dump your old meds. Here are some tips from the experts.

Round Up All Meds and Analyze

The first step in properly disposing of unwanted or no longer usable prescription medications is to gather them all in one place and take an inventory and analyze. What you’re looking for are expiration dates (any that are already expired are no good to anyone and need to be disposed of), warnings (some medications may have special disposal instructions), name, type, and dosage.

Why is all this important? You need to understand what you’re dealing with. Even more important, you don’t want to inadvertently toss out or dispose of medication that you still need to take. This may happen when someone arbitrarily decides that they don’t want to take meds any longer, and they just pitch everything in the trash or flush it down the sink. Not only is this practice hazardous to others, it also jeopardizes the individual. There could be a gap in medication use that may be quite harmful or cause unwanted rapid-onset withdrawal symptoms.

Maybe you’re not quite sure about some medications that you haven’t taken for a while at the direction of your doctor. They haven’t reached their expiration date and your doctor may have you on a different medication or different dosage as a trial to see which medication works better for you. This is often the case with prescribed drugs to help control symptoms of depression, anxiety, bipolar disorder, schizophrenia or other mental health disorders.

The best way to proceed is to make a complete list of all the medications. Write down the name of the medication, the dosage, how frequently taken, who it is prescribed for, and for what purpose. Also write down the prescribing doctor’s name, prescription number, and expiration date of the medication. Now you have a complete inventory and can proceed to the next step.

Contact Your Doctor

Remember that you never want to just get rid of prescription medications that your doctor ordered for your care without first talking with the physician to ensure that such medications are no longer needed. Even if you really want to stop taking them, you are not your best counsel – and you’re certainly not a doctor (in most cases, but even doctors aren’t always the best judge of what’s the right course of action when it comes to their own health).

Call your doctor or make an appointment and go in with your list of medications. Have a candid discussion about your desires and ask when and if you are ready to stop taking certain drugs. You may be concerned about side effects, or feel that you no longer need the drugs or that they’re not working properly. These are things that you should be discussing with your doctor on an ongoing basis, but many people neglect to do so following treatment. Granted there are a lot of things occupying your time when you are in recovery, but taking care of your health and seeing your doctor and therapist regularly are right up there in importance – at least they should be.

If your doctor concurs that you can begin to stop taking certain medications, circle or highlight those with bright or bold marker so you know exactly which ones are okay to discontinue. The ones you don’t circle are the ones you still need to take. Remember that you can’t just stop taking some drugs cold turkey. This action may precipitate nasty withdrawal or even life-threatening reactions. Your doctor may need to prescribe a different medication or one of stepped-down dosage in order to safely wean you off the medication. Always be guided by your doctor’s recommendations and follow them as directed.

Safeguard Medications that are Still Required

While you are preparing to dispose of medications that your doctor has agreed you no longer need, it’s also important that you safeguard all medications that you are still supposed to take. This means locking them up, keeping them out of reach of children or others who may take them by accident or on purpose.

Many instances of unintended poisoning occur each year because people fail to secure prescription – and over-the-counter (OTC) – medications. This is a tragedy that is totally preventable. Just install a lock on a medicine cabinet or place prescription medications in a lockable credenza, drawer, or other storage area. Be sure that the temperature in the location doesn’t exceed what is recommended for safe storage however, since extreme heat or cold may cause the medication to deteriorate and lose effectiveness.

Why Not Flush Meds Down Plumbing?

Sad to say, far too many people think the simplest and safest way to get rid of unwanted prescription medications is just to flush them down the plumbing, either a sink or a toilet. This is extremely hazardous for a number of reasons. Chief among them is the fact that sewage plants are designed to treat biodegradable organic waste, not pharmaceuticals. The chemicals that are in the consumer products (prescription medications) can and do slip past the treatment and stay in the effluent that then spills out into lakes, rivers, streams, and oceans. In addition, the contaminated material may also make its way into the heavy sludge that is used as landfill cover or in farmland fertilizer.

Various studies of fish have shown a number of reproductive abnormalities caused by medications flushed into waterways. Such medications range from concentrations of endocrine-disrupting chemicals from birth-control pills to toxic reactions from many other kinds of prescription medications. Flushing medication down plumbing has another unintended effect. It may wind up in your community’s water supply – and create potentially serious health problems for others.

Don’t Toss Meds in the Garbage

Another no-no when it comes to disposing of most old or unwanted prescription medication post-treatment is tossing it in the garbage. The worst danger is that children or pets can get into the trash and ingest the medication accidentally – with potentially fatal results.

Another reason not to toss meds in the garbage is that despite the fact that many medications are still in prescription containers, such medication may eventually make its way into the soil in landfills. This can create an environmental hazard.

Some people believe – and it was long considered safe – that they can just pulverize the medications, place the powder back in the original prescription containers, wrap in several layers of thick zip-lok bags or plastic containers and then throw out in the trash. While plastic doesn’t degrade quickly (or at all), it doesn’t help landfills, And the problem again with this method is that there’s no guarantee the hazardous material won’t leak or somehow make its way into the soil or groundwater.

If you can’t flush these meds down the plumbing or toss them in the garbage, how can you safely dispose of them?

Safe Medication Disposal Suggestions

You have a few choices when it comes to the safest ways to dispose of unwanted or unusable prescription medications.

1. Check the instructions included with your prescriptions or medication labeling. Always check the instructions for proper disposal of medications that are included with your prescription or on the product labeling.
2. Contact your pharmacy. Call the pharmacy where your prescription was filled. They may be able to take back the medication and safely dispose of it for you or they may give you a referral to an organization that provides this service. Some pharmacies advertise or will tell you if you ask about their drug recycling programs. Some pharmacies will take back drugs at any time, while others may only accept drugs for disposal at certain predetermined times during a period drive to collect expired medications. If the first pharmacy you call either doesn’t have a drug recycling program or doesn’t have any recommendations for, contact another pharmacy. You’ll eventually find one that will be able to help.
3. Ask if your doctor takes back medication. Some doctors may offer this service, but many more will not. Just as some pharmacists will have "take back medication days," some doctors may wish to provide such a service to their patients. If you don’t already know whether or not your doctors will do so, contact his or her office to find out for sure.
4. Check your city for organized safe medication disposal days. Some cities and communities have annual or semi-annual organized safe medication disposal days. Often these organized disposal days list numerous hazardous or potentially hazardous materials – including prescription medications – that you can bring to a central location on a given date for proper disposal.
5. Check with your trash disposal service. Since expired medication is considered a hazardous waste, your trash disposal service may offer collection at certain times. This is often published in flyers that arrive with your trash disposal bill or appear as a notice in the local newspaper.
6. Check websites. If your city or town has a website, or if your local trash disposal service has a website, check them to find out about hazardous waste disposal. Specifically look for medications in the listing of types of hazardous materials that will be disposed of or how to properly dispose of medications. If nothing is listed, contact the city, town, or trash disposal service for recommendations.
7. Donate to organizations that accept unexpired medication for use in third-world countries. Finally, there are some organizations that accept certain medications that have not yet expired for use in third-world countries. And, in some cases, even though the medication may be expired, such organizations may be able to utilize some of them – since expiration date is a generalized time-frame and some medications remain usable well beyond printed expiration date. Only a professional can determine this, however, so don’t guess about it. Contact the organization either through their website or by telephone (often, a toll-free number will be listed).

Remove Personal Identification from Medication Containers

Before you take unwanted or unusable medication to a disposal site or service, or donate to an organization, be sure to safeguard your privacy by removing any personally identifiable information from the container. Use a heavy black marker to darken the area that has your name, and that of your doctor. If the medication is to be disposed of, also blacken out the name of the prescription drug and dosage strength. This will prevent potential misuse of the medication by anyone who comes in contact with it.

Never Give Your Prescription Meds to Someone Else

Just because you no longer need or want to take medication that’s been prescribed for you, even if your doctor okays your discontinuing it, never think you can give these meds to someone else – even if they ask you. This is a dangerous practice that can be illegal, especially if you give it to or allow underage minors to obtain it for their own use.

What If There’s No Take-Back Drug Disposal Available?

The Office of National Drug Control Policy
lists guidelines for proper disposal of prescription drugs on its website. There are some prescription drugs that the U.S. Food and Drug Administration (FDA) recommends can be safely flushed. See the FDA website for the most up-to-date list of drugs that can be safely flushed. Note that the list includes the drugs OxyContin and Percocet.

Information about directions on how to safely dispose of specific marketed drugs can be obtained through the DailyMed website. After you search the drug name, disposal information for the specific drug can be found in one of the following sections: information for patients and caregivers, patient information, patient counseling information, safety and handling instructions, or medication guide.

If the prescription drugs are other than those recommended be flushed by the FDA, and no safe drug disposal service or take-back drug program is available, the federal guidelines from the ONDCP and the U.S. FDA include the following:

• Take prescription drugs out of their original containers.
• Mix the drugs with undesirable substances – such as cat litter or used cofee grounds.
• Place the mixture in a disposable container with a tightly-sealed lid, such as an empty margarine tub or cottage cheese container, or a tightly-sealed zip-lok or plastic bag.
• Remove or conceal any personally-identifiable information, either by using black marker or covering with heavy duct tape. This includes your name and prescription number.
• Then place the sealed container and its contents in the trash.

Be Safe, Not Sorry

It may take a little extra effort to properly and safely dispose of post-treatment medications, but doing what’s right is always better than leaving such an imporant task to chance. Learn all you can about the medications you’re taking that your doctor says you can discontinue. When it comes time to dispose of them, do the right thing and get rid of them safely – for all concerned.

Recently, Massachusetts passed legislation that requires all pharmacies within the state to provide prescription drug lock boxes for sale to the public at their locations. On August 9, Massachusetts State Senate and House of Representatives passed Chapter 283 to the Acts of 2010: An Act Adding Safeguards to the Prescription Monitoring Program and Furthering Substance Abuse Education and Prevention. The legislation is the first of its kind not just for the state of Massachusetts, but the entire U.S. The bill was sponsored by Governor Deval Patrick, Senator Steven Tolman, and the Massachusetts Pharmacists Association. Section 11(b) of the legislation states that all pharmacies that dispense Schedule II, III, IV, or V prescription drugs are required to make purchasable prescription drug lock boxes readily available to consumers in order to encourage the public’s safety efforts when handling over-the-counter and prescription medications.

Prescription drug lock boxes are safe and secure locking mechanisms that cannot be tampered with without extreme force and can only be opened through its combination lock. A combination lock ensures that only the prescribed patient will have access to their prescription medications as intended, and keeps these prescription drugs from falling into the wrong hands, particularly children. Most retailed prescription lock boxes are designed to hold up to four prescription bottles and can fit within the average medicine cabinet.

Prescription drug abuse has become a national epidemic in recent years, with an alarming rate of abuse among adolescents and older adults alike. On June 3, the Center for Disease Control and Prevention (CDC) reported that 20.2% of American teenagers (1 in 5) admit to having illicitly taken a prescription medication one or more times in their lifetime. Furthermore, the Substance Abuse and Mental Health Services Administration (SAMHSA) reports that 55.9% of prescription drug treatment admissions had illicitly obtained prescription medications from a friend or family member. Pain relievers, tranquilizers, stimulants, and sedatives are all highly potent drugs that can be just as toxic as street drugs when misused.

Teenagers who abuse pharmaceuticals most often obtain the drugs from their own parents’ medicine cabinets. Some teenagers may bring collections of prescription drugs to parties known as ‘pharm parties’ where multiple prescription drugs are shared among peers and often mixed with other substances such as alcohol, marijuana, or even cocaine. SAMHSA reports that the number of emergency room visits related to prescription pain relievers rose from an estimated 144,644 in 2004 to 305,885 in 2008—an increase of 111%. The abuse of opioid pain reliever medications has caused more overdose deaths in the U.S. than heroin and cocaine combined.

Even though pharmaceuticals are intended to help treat illness or alleviate pain, they are often misused for recreational purposes. Many Americans are unaware of pharmaceutical drugs’ potential for abuse, dependency, addiction, and overdose. The prevalence of prescription drug abuse has now become parallel with illicit substance abuse across the nation, affecting Americans of all regions and demographics. Prescription drug lock boxes are an effective tool for combating prescription drug abuse, and puts control right in the hands of parents to help keep their households safe. By mandating the sale of lock boxes, Massachusetts pharmacies are helping residents understand the dangers involved in handling controlled substances.

Source: PR Newswire, New Law Requires Pharmacies in Massachusetts to Carry Rx Lock Boxes, August 18, 2010

Brian Rokus of CNN writes that it can be surprisingly easy to get prescription narcotics that are highly addictive, and they’re highly profitable on the street. But detectives in Louisville, Kentucky, say most of the people they arrest aren’t in it for the money. Instead, they get pills to support their own habit, and police say they have a variety of methods for feeding their addiction.

A former nurse will use her medical training to impersonate a doctor to call in fake prescriptions to a pharmacy and simply go in and pick up her drug of choice. Others use prescription pads stolen from physicians or "doctor shop" by getting legitimate prescriptions from multiple doctors who are unaware of what other drugs their patients are already taking.

Watts sees his job as giving those he arrests a wake-up call. "If I can make this the worst day of her life so that tomorrow she will seek treatment, then I’ve won," he said. 

Kentucky is among the top states in the country for prescription pill abuse, according to the National Survey on Drug Use and Health.

"People think that, well, it’s authorized by my doctor, we can pick it up at any of the local retailers on the corner, and that prescription abuse is not really a problem," Watts said.

The vast majority of those Watts and his fellow detectives arrest start their addiction with legitimate needs for pain medication from something such as a car accident. But then they can’t stop.

That’s what worries physicians such as Dr. David Greene. "We know that narcotics are potentially addictive — we don’t know who might become addicted and who might not," he said.

Greene practices in eastern Kentucky, where he says prescription pill abuse is rampant. "It’s come to the point where there are few people who don’t have someone in their family or know someone who’s had problems with addiction, overdose or abuse," Greene said.

When patients come looking for a prescription for powerful pain medication, doctors like him are forced to determine whether the need is real or whether the patient might be an addict.

"There’s no test for pain," Greene said. "The only thing we have to go on is what they tell us, and I generally believe my patients. But most people who are going to lie to you are much better liars than you are at detecting."

One of those patients who Greene says fooled him was a 79-year-old grandmother who was selling her pills out of her nursing home.

If the patient is an addict, doctors refuse them at their own peril. In December, a man came into Dr. Dennis Sandlin’s rural clinic in Perry County, Kentucky, looking for a prescription. Sandlin demanded that he take a urinalysis test to check for drugs in his system. Later that morning, the patient returned and shot and killed Sandlin.

"My dad was writing in a chart at the nurse’s station. Someone heard my dad say, ‘You don’t want to do this. I take care of a lot of elderly people.’ And he said, ‘well you didn’t help me’ and that’s when he shot him," Sandlin’s daughter Danielle said.

Danielle is now working to raise awareness of the dilemma doctors face in prescribing pain medication. Her father, she said, was rigorous about prescribing pain medication. "He would drug test the pope if he came in asking for something."

Greene has encountered intimidating patients in his clinic as well. "Physical violence is a real fear. We have people who come in who are threatening and abusive," he said. After having one patient impersonate him, Greene no longer calls in controlled substances prescriptions into local pharmacies.

Some doctors, fearing either physical violence or contributing to addiction, have stopped prescribing pain medication altogether. That puts doctors such as Greene, who do prescribe, in a difficult position.

"No matter what you do, you’re going to have an unintended consequence," Greene said. "If you refuse to prescribe, you’ll end up with people suffering. And if you do prescribe, you’ll find patients diverting them, selling them, using them for recreation."

The solutions, police and doctors say, range from electronic prescriptions that would be difficult to forge to a national prescription database that would allow doctors to see what other drugs a pill-seeking patient is already taking.

Danielle Sandlin is pushing for some kind of reform in the wake of her father’s death. "He lost his life for something as silly as a pill."
 

Gary Hazen, 53, pleaded guilty to criminal possession and shared this with the court, "I apologize for the crimes I committed. And I would really appreciate any opportunity your honor could give me to continue my rehabilitation and to help others."

Original charges in this case included 10 felonies and eight counts of drug possession. Hazen faced the possibility of 51 years in prison and instead reached a plea agreement that resulted in the dismissal of eight of the charges.

This case first surfaced in 2007 when investigators turned their attention to Hazen after more than 50 people expressed suspicions about his interest in prescription drugs. Hazen was found to have taken hydrocodone and methadone – for which he did not possess prescriptions.

"It creeps up on you, and you don’t realize it," Hazen said. "You just don’t know it. It plays games with you. It starts with your mind. You think things differently, you start rationalizing things differently."

The toll his crimes have taken on Hazen are significant as his activities of the last 30 years were under public scrutiny. He also lost his profession and his standing in the community. For the public – they lost trust.

Hazen has a long history of serving the public in his community. From 1978 to 1998 he served as a Casper policeman. From there he spent five years as a campus supervisor for the Natrona County School District before joining the coroner’s office full time.