Managing Director, Texas Panhandle Poison Center
Director, Medication Cleanout
Assistant Professor, Texas Tech University Health Sciences Center School of Pharmacy
What Happens to Leftover Medicine?
Most any of us could walk through our homes and find unused, leftover medicines somewhere – the bathroom medicine cabinet, a kitchen cupboard or drawer, perhaps a bedside table. So, what happens to these medicines? There was a time when we wouldn’t think much about disposing of leftover medicines by either flushing them or placing them in the trash. However, as the message about environmental contamination with these agents has reached each of us through the media, we’ve become a society that no longer throws. What do we do with them? Unfortunately, we’re not provided with an easy answer and, as a result, many of us simply hold on these medications; storing them indefinitely in our homes. In fact, in a survey conducted by our poison center through our medication take back program, we have found that ~75% of participants state they would simply keep old medications if they could not have brought them to us for disposal.
Is Leftover Medicine Really a Problem?
Leftover medicine is a big problem that is only getting bigger. Many poisonings that occur in children are the result of children accessing the medicines on their own. This occurs when we leave medicines in unsecure places, or when we have them out for our use and fail to return them to a secure location. Small children like to explore, and they also mimic adults; so, if they see mom or dad taking medicine – they want to do the same. Most childhood poisonings that require emergency room visits are due to medicines rather than other products around the home.
An even bigger problem occurs when teens decide to experiment with medicines in an attempt to get “high”. They’ve learned enough to understand that illegal drugs like cocaine and heroin are dangerous. But they feel that prescription medicines are safe. If mom and dad keep these agents in the home, they must be safe, right? And, they were prescribed by a physician. Teens do not understand the danger of harm and even death that can occur from the inappropriate use of medicines. Although prescription medicines present a greater risk of harm, even over the counter medications can be harmful when used inappropriately.
And, according to the Centers for Disease Control and Prevention, the abuse of prescription medications is the fastest growing drug problem in the U.S. Additionally, every 14 minutes, someone loses their life as the result of an unintentional drug overdose. We, as a society, cannot continue to leave medicines around our homes to serve as a potential source for poisonings and abuse.
What Can I do About it?
As someone who has worked in poison control for many years, the number one recommendation that I give is to get any medicines that are no longer needed out of the house. I feel that the best method for med disposal at this time is to take any unused medicines to a community medicine take back program. If a program is not available, another option is mail-back. Many pharmacies sell envelopes in which medicines can be placed and then mailed for disposal. There are some medicines that should not be mailed, so instructions in the envelopes should be reviewed carefully. If neither of those are an option, my next best recommendation is to use the kitty litter/coffee grounds method. Pour the meds into a sealable zipper bag, add kitty litter or coffee grounds and a some water, seal the bag, place it in a disposable container (like a butter tub), and then place it in the trash (preferably directly into an alley or curbside disposal bin). Although this method still may result in environmental impact, it is preferable over the harm that could occur to family members, friends, acquaintances, or even pets.
Our poison center started a medicine disposal program in 2009 and has conducted 29 events to date. As a result, we have collected over 15,000 pounds of unused medicines for proper disposal. These are meds that are no longer available to serve as a source for poisoning or abuse.
What Do Take-Back Programs Do With the Medicine?
Medication take back programs are likely to vary across the U.S. as each state has different environmental and pharmaceutical regulations. With our program, medicines that are classified as “controlled”, like many pain medicines, are turned over to law enforcement as required by law. This amounts to about 10% of our collected meds. All other medicines are sent for incineration at a pharmaceutical-approved facility by a waste management company. These facilities must meet strict environmental requirements that minimize environmental impact.
How Can People Find Take Back Programs in Their Area?
The U.S. Drug Enforcement Administration (DEA), in coordination with local law enforcement agencies, has been holding National Medicine Take Back days twice a year. While it is unclear at this time how long the DEA will continue these, they do have a date set for this spring (April 26, 2014.) Individuals can visit the DEA website at: http://www.deadiversion.usdoj.gov/drug_disposal/takeback/ to determine if an event will be held in their communities.
Many take back programs exist across the country and are supported by various organizations. In fact, there are too many to list here and I am unaware of a single site for referencing all of these. I would recommend a general internet search for “medication take back program” as a good starting point. Also, many local police and/or sheriffs’ departments now have drop boxes available, so a call to an individual’s local police or sheriff department is an option.