How to Safely Dispose of Your Old Medications
Medically reviewed on Apr 12, 2018 by L. Anderson, PharmD.
National Drug Take Back Day
On Saturday, April 28, 2018 - 10AM to 2PM local time, communities will team up with law enforcement to host the next National Prescription Drug Take-Back Day. You can call the Drug Enforcement Agency's (DEA's) Registration Call Center at 1-800-882-9539 or check the DEA's website for collection sites in your area. The website will be continuously updated with new take-back locations.
Consumers may also continue to utilize the guidelines How to Dispose of Unused Medicines as posted by the FDA if they are not able to attend a scheduled Take-Back Day.
DEA began hosting National Prescription Drug Take-Back events in 2010. At the previous 14 Take-Back Day events, millions of pounds of unwanted, unneeded or expired medications were surrendered for safe and proper disposal.
At the last Take-Back Day in October 2017 over 5,300 sites spread across the nation collected unwanted medications totaling over 900,000 pounds (456 tons). The disposal service is free and anonymous for consumers, with no questions asked. Keep in mind that needles, sharps, asthma inhalers, mercury thermometers, iodine-containing medications, and illicit drugs (including marijuana which is still a schedule 1 drug under federal law) are not accepted at the drop box.
Opioid abuse is at epidemic levels in the U.S., and a top public health concern. The DEA’s “Take-Back” initiative is one of several strategies to reduce prescription drug abuse and diversion in the nation. Additional strategies include education of health care providers, patients, parents and youth; establishing prescription drug monitoring programs in all 50 states; and increased enforcement to address illicit methods of prescription drug diversion. In 2018, the U.S. government allotted $4.6 billion in the federal budget towards the expanding opioid crisis.
Can I Throw Medicine in the Trash?
Yes, with certain precautions, most, BUT NOT ALL, medications can be thrown in the trash. These include prescription and over-the-counter (OTC) drugs in pills, liquids, drops, patches, and creams. However, some medicines should be disposed of by flushing down the toilet as they can be very dangerous.
If no DEA-authorized collection sites (pharmacy, hospital, or law enforcement location) are available, and no Take Back Days are scheduled in your area, you can follow these steps to dispose of most medicines in the household trash:
- Mix medicines with an unpalatable substance such as dirt, used coffee grounds, or kitty litter. Take them out of their original container first.
- Place the mixture in a container like a sealed plastic bag or empty can to prevent the drug from leaking in the garbage.
- Throw the container in the trash.
- When disposing of empty prescription bottles, be sure to mark out identifying personal information to make it unreadable.
As noted above, some medications should be flushed down the toilet because if even one dose is accidentally consumed it could be fatal. These medications may be especially harmful or fatal to children and pets. Deaths have been reported in toddlers. An example is fentanyl (Duragesic) patch, a powerful narcotic pain medication. Instead of placing used or unwanted fentanyl patches in the trash where they could be accidentally ingested, patients should dispose of them by flushing down the toilet as described in the patient leaflet. You can access the FDA list of medications that should only be flushed down the toilet at this link.
Be sure to read your prescription information that comes with any medication from the pharmacy. Many medications have specific directions for disposal of unwanted to expired medications explained in the patient leaflet. Ask your pharmacist for specific directions if you aren't sure.
Some pharmacies or other sites also have mail-back programs and disposal "drop-boxes" for unused medicines.
Other Important Points for Safe Drug Disposal
- Inhalers and aerosol products can be dangerous if punctured or thrown into a fire or incinerator. Read the handling instructions on your inhaler. As recommended by the FDA, contact your local trash and recycling facility to confirm local laws about disposal of inhalers and aerosols.
- Residents of assisted living communities and skilled nursing facilities and their family members should check with their community health care management team to learn the best way to dispose of used or unneeded medicines. Here are additional directions for safe disposal in assisted living communities
- Protect your identity, too. Before you throw away the medication container or bottle, fully mark out any personal information such as your name, address, and prescription number to protect your privacy.
Why Should I Be Concerned About Safe Disposal of Medicines?
Prescription medications play an important role in the health of millions of Americans. However, expired medications or unused drugs often stay in the back of cabinets for months or even years. These expired drugs can pose significant health hazards to toddlers, teens, and even family pets who may inadvertently consume medications. Some medications are so potent that even one dose could be fatal if accidentally ingested.
There are other important safety issues: misuse of prescription narcotic drugs (opioids) is a major public health concern. In fact, over 115 people die each day from opioid (narcotic) overdoses. Death from prescription opioids, drugs like oxycodone, hydrocodone, and methadone, have increased fourfold since 1999, as noted by the CDC.
A U.S. government report shows that more than half of all people who first misuse prescription drugs get them from their friends, relatives or simply take them without asking.
A 2018 report found that the number of children hospitalized for opioid poisoning increased by 3-fold between 1997 and 2012, and the largest overall increase was among toddlers and preschoolers, according to the American Academy of Pediatrics. These statistics magnify the need for proper disposal of unused or expired prescription medications from the home to help prevent misuse -- or accidental overdose -- of dangerous drugs.
Does Flushing Medications Down the Toilet Pose a Risk to the Environment?
FDA has stated that disposal of these select few medicines by flushing down the toilet would only contribute to a small fraction of the total amount of medicine found in surface and drinking water. FDA environmental authorities claim most medicines in water are a result of elimination via the body from urine or feces. The FDA and EPA state there has been no indication of environmental effects due to flushing medications.
FDA also states that based on available data, the risk to humans from accidental exposure to these potent medications far outweighs the environmental risk.
What Is Being Done to Address the Opioid Epidemic?
In March 2016 two federal agencies proposed measures to try to rein in prescription painkiller overprescribing. A guideline published by the Centers for Disease Control and Prevention (CDC) -- Guideline for Prescribing Opioids for Chronic Pain, 2016 -- and new boxed warning label changes from the U.S. Food and Drug Administration (FDA) highlight the need to educate health care professionals to address overprescribing of narcotics. Although the addiction epidemic has been deemed a public health crisis, individual health care providers must take action, too.
The DEA announced mandates to lower the production of powerful prescription opioids that are fueling the epidemic of addiction, overdose, and fatalities. Since 1999, overdose deaths including prescription narcotics and heroin, have increased four-fold. The manufacture of drugs such as oxycodone (Oxycontin), hydrocodone (Vicodin), hydromorphone (Dilaudid, Exalgo, Palladone), fentanyl, and morphine will be reduced by 25 percent or more. The DEA states these initiatives are needed because legal prescribing of these drugs has declined while illicit use has risen. Increased surveillance of prescribers, distributors, and pharmacies is increasingly utilized.
Abuse-deterrent formulations are being developed, too. However, it's important to remember that the most common way that drugs are abused — simply by swallowing a handful of them — can’t be always stopped with abuse-deterrent opioids.
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- Protect Your Child From Opioid Poisoning. Drugs.com. March 29, 2018. Accessed April 12, 2018 at https://www.drugs.com/news/protect-your-child-opioid-poisoning-69220.html
- Drug overdose deaths in the United States continue to increase in 2016. U.S. Centers for Disease Control and Prevention (CDC). Opioid Overdose. Understanding the Epidemic. Accessed April 12, 2018 at https://www.cdc.gov/drugoverdose/epidemic/index.html
- US Food and Drug Administration (FDA). Where and How to Dispose of Unused Medicines. October 25, 2017. Accessed April 12, 2018 at https://www.drugs.com/fda-consumer/where-and-how-to-dispose-of-unused-medicines-180.html
- Walmart Launches Disposal Solution for Opioids, Rx Meds. Drugs.com. Jan 22, 2018. Accessed April 12, 2018 at https://www.drugs.com/news/walmart-launches-disposal-solution-opioids-rx-meds-72631.html
- Mulvihill G. Federal budget deal includes $4.6 billion to combat opioid epidemic. The Washington Post. March 25, 2018. Accessed April 12, 2018 at https://www.washingtonpost.com/politics/federal-budget-deal-includes-46-billion-to-combat-opioid-epidemic/2018/03/25/0c65bd16-3082-11e8-94fa-32d48460b955_story.html?noredirect=on&utm_term=.e51cb8fb4471
- US Dept. of Justice. DEA. Office of Diversion Control. National Take-Back Initiative. Accessed April 12, 2018 at https://www.deadiversion.usdoj.gov/drug_disposal/takeback/
- US Food and Drug Administration (FDA). Medication Disposal: Questions and Answers. Last Updated: 03/03/2016. Accessed April 12, 2018 at http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm186188.htm
- Center for Behavioral Health Statistics and Quality. (2015). Behavioral health trends in the United States: Results from the 2014 National Survey on Drug Use and Health (HHS Publication No. SMA 15-4927, NSDUH Series H-50). Retrieved from http://www.samhsa.gov on April 12, 2018.
- Substance Abuse and Mental Health Services Administration. The CBHSQ Report. Nonmedical Use of Prescription Pain Relievers Varies by Race and Ethnicity. June 26, 2015. Accessed April 12, 2018 at http://www.samhsa.gov/data/sites/default/files/report_1972/Spotlight-1972.pdf
- National Institute on Drug Abuse. Monitoring the Future 2017 Survey Results. Updated Dec. 2017. Accessed April 12, 2018 at https://www.drugabuse.gov/related-topics/trends-statistics/infographics/monitoring-future-2017-survey-results
- Disposal of Unused Medicines: What You Should Know. US Food and Drug Administration (FDA). Last Updated: 3/10/2017. Accessed April 12, 2018 at http://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm186187.htm#Flush_List
- How to Dispose of Unused Medicines. FDA Consumer Health Information. Accessed April 12, 2018 at https://www.drugs.com/fda-consumer/how-to-dispose-of-unused-medicines-180.html