title: Prescription Disposal Practices: A 2-Year Ecological Study of Drug Drop Box Donations in Appalachia.
abstract: OBJECTIVE
  We quantified controlled substance donations via permanent drug donation boxes over 2 years in a region with high prescription abuse, assessing medication characteristics, time between dispensing and donation, and weight of medications donated per capita.
  
  
  METHODS
  In partnership with Drug Enforcement Administration and local law enforcement, we analyzed permanent drug donation box collections in 8 Northeast Tennessee locations from June 2012 to April 2014. We recorded controlled substance dosage units along with the product dispensing date.
  
  
  RESULTS
  We collected 4841 pounds of pharmaceutical waste, 4.9% (238.5 pounds) of which were controlled substances, totaling 106,464 controlled substance doses. Analysis of dispensing dates for controlled substances indicated a median of 34 months lapsed from dispensing to donation (range = 1-484 months). The mean controlled substance donation rate was 1.39 pounds per 1000 residents. Communities with fewer than 10,000 residents had a statistically higher controlled substance donation rate (P = .002) compared with communities with 10,000 or more residents.
  
  
  CONCLUSIONS
  Permanent drug donation boxes can be an effective mechanism to remove controlled substances from community settings. Rural and urban community residents should be provided convenient and timely access to drug disposal options.
authors.affiliation: Jeffrey Gray and Nicholas Hagemeier are with the Department of Pharmacy Practice, Gatton College of Pharmacy, East Tennessee State University, Johnson City. Arsham Alamian and Billy Brooks (DrPH candidate) are with the Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Gray
authors.affiliation: Jeffrey Gray and Nicholas Hagemeier are with the Department of Pharmacy Practice, Gatton College of Pharmacy, East Tennessee State University, Johnson City. Arsham Alamian and Billy Brooks (DrPH candidate) are with the Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Hagemeier
authors.affiliation: Jeffrey Gray and Nicholas Hagemeier are with the Department of Pharmacy Practice, Gatton College of Pharmacy, East Tennessee State University, Johnson City. Arsham Alamian and Billy Brooks (DrPH candidate) are with the Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University.
authors.forename: Billy
authors.initials: B
authors.lastname: Brooks
authors.affiliation: Jeffrey Gray and Nicholas Hagemeier are with the Department of Pharmacy Practice, Gatton College of Pharmacy, East Tennessee State University, Johnson City. Arsham Alamian and Billy Brooks (DrPH candidate) are with the Department of Biostatistics and Epidemiology, College of Public Health, East Tennessee State University.
authors.forename: Arsham
authors.initials: A
authors.lastname: Alamian
mesh_terms: D001061:Appalachian Region / Q000453:epidemiology; D061891:Controlled Substances; D006801:Humans; D055553:Prescription Drugs; D012037:Refuse Disposal / Q000379:methods* / Q000706:statistics & numerical data*; D012111:Residence Characteristics; D019966:Substance-Related Disorders / Q000517:prevention & control*; D013714:Tennessee / Q000453:epidemiology
chemical_list: D061891:Controlled Substances; D055553:Prescription Drugs