How to Safely Dispose of Your Old Medications
Medically reviewed on Oct 11, 2017 by L. Anderson, PharmD.
National Drug Take Back Day
On Saturday, October 28, 2017 from 10:00 am – 2:00 pm 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.
SPECIAL NOTICE: NEVADA - Carson City, Washoe County, Lyon County, and Churchhill County ONLY - Take Back Day is OCTOBER 21, 2017 10:00 AM TO 2:00 PM
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 13 Take-Back Day events, millions pounds of unwanted, unneeded or expired medications were surrendered for safe and proper disposal. At the Take-Back Day in April 2017 over 5,400 sites spread across the nation collected unwanted medications totaling over 900,000 pounds. The disposal service is free and anonymous for consumers, with no questions asked. Keep in mind that needles, sharps, asthma inhalers, and illicit drugs are usually 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 under the Secure and Responsible Drug Disposal Act of 2010 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.
Can I Throw Medicine in the Trash?
Yes, with certain precautions, for most, BUT NOT ALL, medications; some medicines should be flushed down the toilet. 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; however, do not crush tablets or capsules 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.
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.
- 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 is increasingly a major public health concern. Over 46,000 Americans die each year from drug-related deaths, with more than half being from heroin and prescription opioids. The abuse of prescription narcotics is second only to the use of marijuana.
A U.S. government report shows that more than 70 percent of people who first misuse prescription drugs get them from their friends, relatives or simply take them without asking. A 2017 report in Pediatrics revealed that a child's risk of a potentially fatal drug overdose more than doubles if a parent brings home a prescription opioid painkiller like oxycodone, codeine or morphine. In fact, researchers at Johns Hopkins University found that nearly 70 percent of prescription opioids in homes with children are not stored safely. 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.
In October 2016, 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 in 2017. The DEA states these initiatives are needed because legal prescribing of these drugs has declined while illicit use has risen.
Abuse-deterrent formulations are being developed, as well. 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 stopped.
In October 2017, the Cigna health insurance company revealed it would no longer cover most OxyContin (oxycodone) prescriptions starting in January 2018. Even though Oxycontin has some abuse-deterrent properties, Cigna has included Xtampza ER (oxycodone) on their formulary. Xtampza ER is a pain medication with abuse-deterrent properties that allows the product to maintain its extended-release profile even when cut, crushed or chewed.
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- US Dept. of Justice. DEA. Office of Diversion Control. National Take-Back Initiative. Accessed October 12, 2017 at https://www.deadiversion.usdoj.gov/drug_disposal/takeback/
- Medication Disposal: Questions and Answers. US Food and Drug Administration (FDA). Last Updated: 03/03/2016. Accessed April 17, 2017 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 October 12, 2017.
- 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 October 12, 2017 at http://www.samhsa.gov/data/sites/default/files/report_1972/Spotlight-1972.pdf
- National Institute on Drug Abuse. Monitoring the Future 2016 Survey Results. Updated Jan. 2016. Accessed October 12, 2017 at https://www.drugabuse.gov/related-topics/trends-statistics/infographics/monitoring-future-2016-survey-results
- Disposal of Unused Medicines: What You Should Know. US Food and Drug Administration (FDA). Last Updated: 3/10/2017. Accessed October 12, 2017 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. Updated June 4, 2015. Accessed October 12, 2017 at https://www.drugs.com/fda-consumer/how-to-dispose-of-unused-medicines-180.html