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AMWA submitted comments to the Food and Drug Administration (FDA) on potential modifications to the Opioid Analgesic Risk Evaluation and Mitigation Strategy (OA REMS) to require that mail-back envelopes be dispensed and education on safe disposal provided with opioid analgesics dispensed in an outpatient setting. AMWA supports efforts to reduce pharmaceuticals in waters and discourages the practice of flushing unused medications.