How to Safely Dispose of Your Old Medications
National Prescription Drug Take Back Day
On Saturday, Oct. 29, 2022 - 10AM to 2PM local time, communities will team up with law enforcement to host the next National Prescription Drug Take-Back Day.
The U.S. Drug Enforcement Administration (DEA) hosts a no-questions asked National Prescription Drug Take-Back event twice per year. On this day, collection sites are set up in local cities throughout the nation for safe disposal of prescription drugs, including opioids. Collection sites may be found at retail, hospital, or clinic pharmacies, or law enforcement facilities.
Drug overdoses have skyrocketed over the COVID-19 pandemic crisis. Over 107,622 drug overdose deaths were reported in 2021, an increase of almost 15% from 2020. Opioids were responsible for 80,816, or 75% of these deaths, an increase of 8.6% compared to 2021. Disposing of unneeded or expired medications can help to fight this crisis, as many abused prescription drugs are found in the home.
The DEA wants to ensure the public that there are safe ways to dispose of unwanted prescription drugs, including at-home disposal and year-round collection sites.
- The best way to dispose of most types of unused or expired medicines (both prescription and over the counter) is to drop off the medicine at a drug take back site, location, or program immediately.
- If this is not possible, and your medicine is on the FDA Flush List found here, you should flush this dangerous and possibly life-threatening medicine down the toilet. Don’t flush your medicine unless it is on the flush list.
- If the medicine is not on the Flush List, follow these instructions to safely dispose of the medicine in your trash at home.
What is National Prescription Drug Take Back Day?
Opioid abuse in the U.S. remains 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.
During Take-Back Days collection sites are set up in local cities throughout the nation for safe disposal of prescription and over-the-counter (OTC) drugs you have at home, including opioids. Other items accepted usually include pet medicines and OTC vitamins. Take Back Days occur each October and April.
Consumers should dispose of expired, unwanted, or unused medicines as quickly as possible to help reduce accidental or intentional overdoses or illegal abuse.
- You can call the Drug Enforcement Agency's (DEA's) Office of Diversion Control’s Registration Call Center at 1-800-882-9539 or check the DEA's website for authorized collection sites in your area.
- DEA provides a list of permanent (year round) Controlled Substance Public Disposal Locations for use when Take Back Days are not available. Your local pharmacy or law enforcement may have one in your neighborhood.
- Consumers should utilize the guidelines Disposal of Unused Medicines: What You Should Know as posted by the FDA if they are not able to attend a scheduled Take-Back Day or find an authorized drop off location.
- Beginning with the October 2019 campaign, DEA started accepted vaping devices and cartridges in addition to medications at all of its drop-off locations.
- The disposal services are free and anonymous for consumers, with no questions asked.
DEA began hosting National Prescription Drug Take-Back events in 2010. At the last Take-Back Day in April 2022, over 5,000 sites across the nation collected unwanted or expired medications totaling 721,093 pounds (360 tons). The total amount of prescription drugs collected by DEA since the fall of 2010 is close to 16 million pounds (almost 8,000 tons).
Which items are not accepted?
Check with the collector ahead of time to determine what items are not accepted. Certain items generally are not accepted at the drop box, such as:
- Syringes, needles or other sharps
- Inhalers, such as those for asthma
- Aerosol cans
- Mercury thermometers
- Iodine-containing medications
- Illegal drugs or substances (including marijuana which is still a schedule 1 drug under federal law), and any prescription medications obtained illegally.
DEA will collect vape pens or other e-cigarette devices from individual consumers only after the batteries are removed from the devices.
Can I throw medicine in the trash?
Follow your healthcare provider's instructions specifically for disposing of medicines if these were provided.
Be aware that some medicines should only be flushed when drop off facilities are not available because they are too dangerous to leave in the trash. See the list of drugs that SHOULD be flushed here. Be sure to follow your local community regulations for flushing of medications.
Many medications can be thrown in the trash but you should follow the below steps before disposing of them. Medicines include prescription and over-the-counter (OTC) drugs in pills, liquids, drops, patches, and creams. Look at the package insert of your medication to see if special instructions exist for disposal.
Inhalers for asthma or other breathing conditions could be dangerous if punctured or thrown into a fire or incinerator. To properly dispose of these products and follow local regulations and laws, contact your trash and recycling facility.
If no DEA-authorized collection sites 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. Do not crush tablets or capsules before mixing.
- Place the mixture in a sealed container (sealed plastic bag or empty can) to prevent the drug from leaking into the garbage.
- Throw the container in the trash.
- When disposing of empty prescription bottles or packages, be sure to mark out identifying personal information to make it unreadable.
Can I flush medicines down the toilet?
Some medications should be flushed down the toilet when Take Back Day or permanent Controlled Substance Public Disposal Locations are not accessible because even one accidental dose could be fatal. These medications may be especially harmful -- or fatal -- to children and pets. They are also sought after by people who are looking to abuse these potent, and possibly deadly, medicines.
You can access the FDA list of medications that should be flushed down the toilet at this link. One example is the fentanyl skin patch. The patch delivers strong pain medicine through the skin. After the patch is used it still contains a lot of powerful medicine that could be deadly. That’s why the drug comes with instructions to flush used or leftover patches.
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 state 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.
Other 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.
- Protect your identity. 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. Do not place prescription bottles with personal information in collection receptacles or mail-back packages.
What is being done to address the opioid epidemic?
In 2019, over 20 million people misused or abused prescription drugs, including opioids, sedatives and stimulants. Federal agencies have proposed measures to try to rein in prescription painkiller overprescribing.
- The 2022 updated guideline published by the Centers for Disease Control and Prevention (CDC) -- CDC Clinical Practice Guideline for Prescribing Opioids for Pain, United States, 2022 -- and Boxed Warnings from the U.S. Food and Drug Administration (FDA) highlight the need to educate health care professionals to address overprescribing and safe discontinuation of opioids.
- The FDA has updated labeling and recommends healthcare providers discuss the use of naloxone (for example: Narcan Spray) with patients who receive prescriptions for opioids or treatment of opioid use disorder. Naloxone is an opioid receptor antagonist that can be used by families, caregivers, or the general public to help reverse an opioid overdose. In the U.S., it is accessible without a prescription at pharmacies and it is usually covered by insurance.
- The U.S. government continues to fund the federal budget towards the ongoing opioid crisis, including for treatment. Visit here to find local treatment facilities in your area.
- In April 2022, the FDA announced it is considering use of prepaid mail-back envelopes for opioid analgesics used in outpatient settings and that pharmacists provide patient education on safe disposal of opioids.
The DEA also announced mandates to lower the production of powerful prescription opioids that are fueling the epidemic of addiction, overdose, and fatalities. 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.
Abuse-deterrent formulations of opioids have been developed, too. It's important to remember that the most common way that drugs are abused — simply by swallowing a handful of them — can’t be stopped with abuse-deterrent technology. That's one reason why it's so important to dispose of prescription medicines quickly and safely, as recommended.
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- Dowell D, Ragan KR, Jones CM, Baldwin GT, Chou R. CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022. MMWR Recomm Rep 2022;71(No. RR-3):1–95. DOI: http://dx.doi.org/10.15585/mmwr.rr7103a1
- FDA Considers New Approach to Improve Safe Disposal of Prescription Opioid Analgesics, Decrease Unnecessary Exposure to Unused Medication. US Food and Drug Administration (FDA). April 20, 2022. Accessed Nov. 5, 2022 at https://www.fda.gov/news-events/press-announcements/fda-considers-new-approach-improve-safe-disposal-prescription-opioid-analgesics-decrease-unnecessary
- Drug Overdose Death Rates. National Center for Drug Abuse Statistics. Accessed Nov. 5, 2022 at https://drugabusestatistics.org/drug-overdose-deaths/
- U.S. Overdose Deaths In 2021 Increased Half as Much as in 2020 – But Are Still Up 15%. May 11, 2022. CDC, National Center for Health Statistics. Accessed Nov. 5, 2022 at https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/202205.htm
- Drug Enforcement Administration (DEA). Take Back Day (online). Accessed Nov. 5, 2022 at https://takebackday.dea.gov/
- Drug Disposal: FDA’s Flush List for Certain Medicines. Revised Oct. 1, 2020. Accessed Nov. 5, 2022 at https://www.fda.gov/drugs/safe-disposal-medicines/disposal-unused-medicines-what-you-should-know#Flush_List
- Khan U, Bloom RA, Nicell JA, et al. Risks associated with the environmental release of pharmaceuticals on the U.S. Food and Drug Administration "flush list". Sci Total Environ. 2017 Dec 31;609:1023-1040.
- Disposal of Unused Medicines: What You Should Know. US Food and Drug Administration (FDA). Revised Oct. 1, 2020. Accessed Nov. 5, 2022 at https://www.fda.gov/drugs/safe-disposal-medicines/disposal-unused-medicines-what-you-should-know
- US Food and Drug Administration (FDA). Where and How to Dispose of Unused Medicines. Accessed Nov. 5, 2022 at https://www.drugs.com/fda-consumer/where-and-how-to-dispose-of-unused-medicines-180.html
- US Dept. of Justice. DEA. Office of Diversion Control. National Take-Back Initiative. Accessed Nov. 5, 2022 at https://www.deadiversion.usdoj.gov/drug_disposal/takeback/
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.