As patients start to feel better with our treatments, we are often asked how to get rid of unused or old medication. Well, medication disposal is a hot topic in medicine today. The Environmental Protection Agency (EPA) has detected multiple pharmaceutical products in various ecosystems. Although these products tend to be present in relatively low levels, and the results of short term exposure seem to be minimal, the results of long term exposure to these low levels of pharmaceutical waste remain unknown. The presence of certain drug classes in particular have caused the greatest concern: antimicrobials, natural and synthetic steroids, antidepressants, and heart medication.
The majority of the concern relates to our drinking water. A 2008 Associated Press article reported both prescription and over-the-counter drugs were detected in the drinking water of at least 41 million Americans. Many water treatment systems are unable to remove all pharmaceutical products from tap water, and testing for these products is not a regular practice because it is not required by the federal government. While levels of drug contamination in tap water are considerably low, there remains much speculation as to what risk is associated with long-term, chronic exposure to these drug products.
The White House Office of National Drug Control Policy (ONDCP) released an official guide in 2007 (and updated in 2009) for proper medication disposal that advises the public to discard this waste in the trash rather than flushing them down the toilet or washing them down the drain. There are certain exceptions to the “no flush” rule, and the FDA’s website contains a list of drugs for which the FDA still does recommend flushing. Most of these drugs are narcotics or controlled substances, which are especially dangerous if accidentally ingested by children or pets.
The best way for medication disposal is through a community drug take back program. Fortunately, most areas (including Charleston’s Tri-County) have participated in national take back days, usually held in September and once again in the spring. This year, it is being held on Saturday September 29 from 10am-2pm. These events have a strict “no questions asked” policy where the public can simply drop off unused, expired, unlabeled medications at their local police station for collection.
If you do not participate in a drug take back program, then the ONDCP recommends removing prescription medication from their original containers and mixing them with an undesirable substance, such as cat litter, coffee grounds, or sawdust inside of a sealed container (a plastic bag or empty margarine container) and placing it in the trash. The original prescription bottles can also be placed in the trash, but remove all personal information from the container, including the prescription number. Liquid medications should be mixed with salt, flour, charcoal, or a nontoxic powdered spice (such as tumeric or mustard) to give the mixture an unappealing smell and texture.
For more information, please see the following resouces: