The Problem The mismanagement of leftover household pharmaceuticals poses significant health, safety, and environmental risks. Storing unwanted and expired medications in the home increases the risk of misuse and puts children, seniors, and pets at risk for accidental poisoning. However, when drugs are improperly disposed, they end up in the environment where they contaminate our waterways. Vermont’s Response The Lamoille County Sheriff’s Department (LCSD) approached the Vermont Department of Health (VDH) Division of Alcohol and Drug Abuse Programs (ADAP) with an idea: to reduce the impacts of household waste pharmaceuticals across the state of Vermont (VT) through a drug take-back program. LCSD and VDH together established a statewide drug take-back pilot program (“pilot”) funded through VDH and implemented by law enforcement, one piece of the state’s multi-pronged safe drug disposal system. PSI’s Evaluation Project The VDH ADAP hired the Product Stewardship Institute (PSI), a national expert on pharmaceuticals stewardship, to evaluate the pilot to determine whether it increased law enforcement participation in drug take-back. Broader goals of the evaluation project included recommendations to improve the pilot and help VDH with future planning and decision-making regarding its safe drug disposal system at large. The approach of the evaluation combined a literature review, ethnographic study (observations and interviews), and data analysis. Key Results of Evaluation The pilot successfully increased law enforcement participation in drug take-back across VT, reduced the burden on VT law enforcement participating in drug take-back, increased the amounts of drug waste collected, and helped protect VT’s public and environmental health. Approximately 79% of the VT population lives within 10 miles of a participating law enforcement location, and 99% lives within 20 miles. The biggest challenges to the pilot were: • Finding space for collected material; • Amount of time required of law enforcement to participate; • Liability to pilot organizers in handling drugs turned in anonymously; and • Improper deposit of medical sharps (“sharps”) in drug take-back receptacles. Key Recommendations Ways to improve the pilot include added incentives for law enforcement participation (e.g., increased hourly reimbursement rates, recognition opportunities); benchmarking additional measures of success (i.e., public awareness and percent of collection material that is controlled substances); encouraging more disciplined recording of data from law enforcement; ensuring all relevant federal regulations are met; systematizing yearly protocol refresher trainings; adding more specificity to the protocol; coordinating program promotion; developing a state-wide solution for sharps disposal; establishing a channel through which law enforcement staff can make suggestions anonymously; and setting aside dedicated funding to maintain and improve the program as it grows. Finally, VT should consider funding its drug take-back program through manufacturer funding only, instead of partially through taxpayer funds.