Drug disposal deserts: An assessment of receptacle availability in Kentucky community pharmacies

Dustin K. Miracle, Noah Smith, Svetla Slavova, Laura K. Stinson, Monica F. Roberts, Peter Rock, Sharon Walsh, Patricia Freeman

Research output: Contribution to journalArticlepeer-review


Purpose: The purpose of this study was to describe the county-level availability of drug disposal receptacles in Kentucky community pharmacies and show the relationship between installed receptacles and opioid analgesic (OA)/controlled substance dispensing rates, stratifying where possible by urban-rural classification. Methods: Using 2020 data from the Kentucky All Schedule Prescription Electronic Reporting program and disposal receptacle data from the US Drug Enforcement Agency, county-level comparisons were made between number of receptacles and OA/controlled substance dispensing rates. Logistic and negative binomial regression models were used to assess for differences between rural/urban county designation and odds of ≥1 disposal receptacle and compare the rates of receptacles per dispensed OA dose in rural/urban counties. Findings: While rural counties saw higher OA and controlled substance dispensing rates, the majority (55.6%) of disposal receptacles were in urban locations. The odds of having at least 1 receptacle were higher in urban counties (OR 2.60, 95% CI: 1.15, 5.92) compared to rural. The estimated rate of disposal receptacles per million dispensed OA doses was found to be 0.47 (95% CI: 0.36, 0.61) in urban counties compared to 0.32 (95% CI: 0.25, 0.42) in rural counties, with an estimated rate ratio of 1.45 (95% CI: 1.01, 2.10). Conclusions: A mismatch between the availability of county-level disposal receptacles in community pharmacies and the volume of dispensed OAs/controlled substances exists, resulting in fewer receptacles per dispensed OA in rural counties compared to urban counties. Future efforts are necessary to increase access to convenient disposal receptacles located in community pharmacies, particularly in rural communities.

Original languageEnglish
JournalJournal of Rural Health
StateAccepted/In press - 2023

Bibliographical note

Funding Information:
This research was funded by the National Institutes of Health through the NIH HEAL (Helping to End Addiction Long‐term) Initiative under award number UM1DA049406. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the NIH HEAL Initiative. SM SM

Publisher Copyright:
© 2023 National Rural Health Association.


  • community pharmacies
  • medication disposal
  • opioid epidemic
  • prescription drug diversion
  • prescription drug misuse

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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