Recycling Drugs

Jerry Gustafson must travel a bit out of his way to pick up the potentially life-saving cargo, but it's worth it.

"I'll fill up the whole minivan," Gustafson said, describing trips to long-term care facilities east of Claremore and Owasso as well as in Tulsa.

Every month, he picks up medications from nursing homes, including blister packages that only a few years ago would have been slowly and methodically emptied out, with their contents thrown away rather than recycled. Gustafson and other retired doctors now pick up the drugs and drop them off at the George Prothro, MD Pharmacy of Tulsa County, 2401 Charles Page Blvd., where needy patients with a prescription can get the medication for free.

Last year alone, the recycled drugs program filled 20,573 prescriptions for people struggling financially. This year, the program celebrated a milestone: topping the $10 million mark in the value of all drugs recycled since the program began in 2004.

But the program's existence came about only after the efforts of the Tulsa County Medical Society's Committee on Concerns of Older Tulsans.

Prothro, a former executive director of the Tulsa City-County Health Department, served on the committee.

"One of our concerns always was the inability of people to buy the drugs they needed when they were so expensive," said Prothro, who retired in 1978.

He recalled a committee member bringing up the idea of unused drugs in nursing homes.

"We thought. 'What a terrible waste,'" Prothro said. But the law was quite clear about how unused medication should be handled. Drugs were to be thrown out -- in practice, flushed down the toilet -- in the presence of medical professionals who had to keep a record of the disposal.

Prothro and Gustafson, also a member of the committee, said there was skepticism directed at their early attempts change the status quo.

"The immediate response was, 'No, it can't be done,'" Prothro said, recalling how the thinking was that law enforcement, as well as the state's pharmacy board, would oppose a redistribution of drugs.

"We worked over several years getting the laws changed," Prothro said. Included in that effort were several trips made to Oklahoma City to discuss the issue with lawmakers.

Prothro credited the committee and Gustafson, also a committee member, with pushing for change. Gustafson, a former general surgery specialist who retired in 1998 after about three decades working at Saint Francis Hospital, summed up the motivation for their efforts: "We were doing the right thing."

Many years before recycling began the Tulsa County Pharmacy was established to help poor patients, Gustafson said. "What Tulsa County did was they purchased these medicines at wholesale price then sold them at wholesale price," Gustafson said. But even that cost might prove to be too much for people in need, so sometimes donors would step in to make up the difference.

The way Gustafson sees it, the recycling program has freed up Tulsa philanthropists to focus on other projects. Not all medications can be recycled, however; state law forbids the recycling of narcotics that might have been prescribed as pain medication, for example.

The concept has since spread beyond Oklahoma. The National Conference of State Legislatures states that at least 38 states have some similar laws on the books, with many of these laws enacted after the Oklahoma law took effect. Prothro said a film crew from Canada once visited Tulsa to document the program.

According to Tulsa County, 58 nursing homes or assisted living facilities donate unused medications as part of the program. Gustafson said that facilities are glad to be freed of the time-consuming practice of disposing medications, so most are happy to participate.

Despite the growing popularity, Prothro and Gustafson noted that many places in Oklahoma still don't have a pharmacy that will take in the recycled medication, despite all recycled drugs being checked to ensure they haven't expired as part of the law.

"There's still too many places right here in Oklahoma that are still punching it out by thumb and flushing it down the toilet," Prothro said.

Recently, focus has been put on how drugs flushed down the drain can potentially contaminate water supplies, though the U.S. Food and Drug Administration maintains that the largest source of such contamination occurs through human waste.

Along with the prescription drugs, the Tulsa program also collects non-prescription medication. Prothro said some of these drugs are donated to medical missions that travel the world.

Heart medication and blood circulation drugs certainly are commonplace in the loads picked up by Gustafson, but he noted that the drugs can have value for a wide range of patients. For example, children diagnosed with leukemia can benefit from anti-blood clot drug Lovenox.

Gustafson said he sometimes gets boxes of unused medication donated at this doorstep, but such drugs don't wind up at the county pharmacy. State law spells out that such transfers can only happen from a facility like a nursing home with a pharmacist to another pharmacy.

"You can pick things up from mental health agencies, you can pick things up form a nursing home, but it has to have a pharmacy there," Gustafson said.

He's one of the group of retired doctors known as the Golden Oldies who volunteer to pick up the unused medication, though it isn't a requirement of the law that a doctor pick up the drugs for recycling.

Prothro praised Linda Johnston, head of Tulsa County Social Services, for her work as an advocate for the program as well as overseeing pharmacy operations. He also said the program wouldn't have been possible without support from county commissioners and the Tulsa County Medical Society, a professional organization for doctors.

"This is a good example of the private side ... and public side" working together to "bring about something helpful," Prothro said.

According to a news release issued by Tulsa County, the program has only cost taxpayers less than $6,000 since its inception.

Prothro added: "It's one of those things where you just win everywhere you go," Prothro said.

Patients interested in checking the abailability of free or discounted drugs may call 918-596-5560.

Send all comments and feedback regarding City to jadame@urbantulsa.com