If there’s anything the pandemic has taught us, it’s that we have a lot of excess stuff in our homes — including bottles and bottles of expired or no-longer-needed medications.
That’s a problem, according to Elizabeth Skoy, an associate professor at North Dakota State University’s School of Pharmacy. “In recent years, there’s been a spotlight on medication disposal, because of the opioid epidemic,” she said. “It’s important to get rid of any medication when you are done with it to prevent misuse or having it fall into the hands of others.” Plus, having old medications in the home increases the chances of accidental poisoning of children or pets.
But while many of us might be aware that we shouldn’t toss pill bottles in the trash or flush medication down the toilet, we’re less knowledgeable about safe alternatives. And there haven’t been many options beyond the Drug Enforcement Administration’s semiannual National Prescription Drug Take Back Day.
In the past decade, however, pharmacies, hospitals and law enforcement agencies have been stepping up to help clean out medicine cabinets year-round. One of the most accessible solutions is medication collection bins, which are being added to convenient locations such as retail stores, health clinics, police stations and other easily accessed sites.
“We decided in 2016 we wanted to be part of the solution,” said Kurt Henke, ambulatory pharmacy manager for Colorado’s Denver Health hospital system, which has collection bins in each of its eight pharmacies. Drugstore chain CVS began putting units in police departments in 2014 and adding them to its more than 9,000 retail locations in 2017; so far it has deployed more than 4,000 of the bins. States are taking the initiative, as well. In North Dakota the state’s Board of Pharmacy provides MedSafe, a take-back box, to any pharmacy that wants one; at this point, about 120 are participating.
The DEA maintains a searchable database of controlled-substance collection sites. Simply type in your Zip code or city to find the nearest one.
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The bins work much like library or post office drop boxes, and the procedure is the same for most sites. “You open the bin, drop the medication in, and you are done,” said CVS District Leader Carol Sinopole, a licensed pharmacist who manages 17 stores in the Augusta, Ga., area. A pharmacy manager routinely checks the bin and, when it’s full, the contents are securely shipped to a disposal site where they are incinerated.
If you opt to use a drop box, ideally you should return the medication in the original bottle. Scratch out any personal information on the label. Put any bottles in sealable bags. Instructions about what can and can’t be accepted are clearly posted on the bins, but in general these are the rules:
Accepted for disposal:
* Over-the-counter medications
* Prescription medications including opioids and other controlled substances
* Prescription patches
* Prescription liquids
* Creams and ointments
CANNOT be disposed:
* Syringes or sharps
* Illicit drugs such as marijuana, cocaine, LSD and heroin
* Chemotherapy drugs
* Inhalers or aerosol cans
As an alternative, almost all medications can safely be thrown into household trash if you do so properly. Remove drugs from the original container and mix them with an undesirable substance such as coffee grounds, dirt or used kitty litter. This makes the medicine less attractive to kids and pets and unrecognizable to someone who might be digging through trash. Place the mixture in a sealable bag or other container.
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Henke suggests putting used needles and/or syringes into empty, opaque plastic laundry bottles. Then, throw the bottle into the garbage. Typically, inhalers are on the nondisposal list because they can prove dangerous if they still contain even a small amount of medication and are punctured or thrown into an incinerator. It’s best to remove any personal information and toss them into the trash or contact your local trash and recycling facility for their advice.
If you can’t get to a collection bin, there is even a strategy to dispose of opioids at home, said Skoy, using products such as DisposeRx or Deterra. A packet may come with your prescription; if not, you can ask your pharmacist for a free one. Simply combine water, the packet contents and the drugs and shake. Then, dispose in the trash.
Flushing medications down the sink or toilet isn’t recommended, because trace levels of drug residue have been found in drinking water supplies. But, if you are unable to get to a medication disposal site, some drugs — such as narcotic pain medicines or fentanyl — should be washed down the drain as a last resort, said Skoy. This helps reduce the danger of overdose from unintentional or illegal use. The FDA maintains a list of flushable medications or you can call your local pharmacist.
Tempting though it may be, it’s not a good idea to hang onto a partially used prescription for rainy days. “Antibiotics, eye drops, and pain meds are prescribed for a specific condition and course of treatment. As soon as done with a prescription medication dispose of it immediately,” says Skoy. You also want to check expiration dates for any medication you have prescribed to “take as needed.” Sinapole said, “Once a medication is past its expire date, we worry about efficacy.” Another concern is that patients won’t seek treatment when they should, “because they are self-treating” with the expired medication.
Pharmacists advise that each of us should pick a date — New Year’s Day, our birthday, the first day of spring or whenever, to inventory our medications and dispose of the ones we no longer need or that have expired. Help your elderly parents, relatives or friends do the same. said Henke, “If everyone does their part, takes the time and takes action, it will help keep our families and our communities safer.”