CVS Health has secure drug disposal units at some of its locations.
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 medicine that’s expired or that we no longer need.
That’s a problem, according to Elizabeth Skoy, an associate professor at North Dakota State University’s School of Pharmacy. “In recent years, the spotlight has been on eliminating drugs, due to the opioid epidemic,” she said. “It’s important to dispose of any medicine when you’re done with it to prevent it from being misused or falling into the hands of other people.” Also, having old medications in the house increases the risk of accidental poisoning of children or pets.
But while many of us may know not to throw pill bottles in the trash or flush medicine down the toilet, less know about the safe alternatives. And there haven’t been many options beyond the Drug Enforcement Administration’s biannual National Prescription Drug Recovery Day.
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Over the past decade, however, pharmacies, hospitals, and law enforcement agencies have stepped up to help clean medicine cabinets year-round. One of the most accessible solutions is drug collection bins, which are added to convenient locations such as retail stores, health clinics, police stations, and other easily accessible sites.
“We decided in 2016 that 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. Pharmacy chain CVS began putting units into police departments in 2014 and adding them to its more than 9,000 outlets in 2017; so far, it has deployed more than 4,000 bins. States also take the initiative. In North Dakota, the state 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.
Bins work much like library or post office drop boxes, and the process is the same for most locations. “You open the trash can, drop the medicine in, and you’re done,” said Carol Sinopole, CVS District Manager, a licensed pharmacist who operates 17 stores in the Augusta, Georgia, area. A pharmacy manager regularly checks the bin and, when full, the contents are safely shipped to a disposal site where they are incinerated.
If you choose to use a drop box, you should ideally return the medication to the original bottle. Scrape off any personal information on the label. Put all the bottles in resealable bags. Instructions on what can and cannot be accepted are clearly posted on the bins, but in general here are the rules:
- Over-the-counter medications
- Prescription drugs, including opioids and other controlled substances
- Prescription patches
- Prescription fluids
- Creams and ointments
- Syringes or sharp objects
- Illegal drugs like marijuana, cocaine, LSD, and heroin
- Chemotherapy drugs
- Inhalers or spray cans
As an alternative, almost all medications can be safely disposed of in household trash if you do it correctly. Remove the medication from the original container and mix it with an unwanted substance like coffee grounds, dirt, or used kitty litter. This makes the medicine less appealing to children and pets and unrecognizable to someone who might rummage through the trash. Place the mixture in an airtight bag or other container.
Henke suggests putting used needles and/or syringes in empty, opaque plastic detergent bottles. Then throw the bottle in the trash. Typically, inhalers are on the non-disposal list because they can be dangerous if they still contain even a small amount of medicine and are punctured or thrown into an incinerator. It is best to delete all personal information and dispose of it in the trash or contact your local collection and recycling center for advice.
If you can’t get to a collection bin, there’s even a strategy for disposing of opioids at home, Skoy said, using products like DisposeRx or Deterra. A packet may come with your prescription; otherwise, you can ask your pharmacist for one free of charge. Simply mix water, contents of packet and medication and shake. Then throw it in the trash.
It is not recommended to dispose of drugs down the sink or toilet, as traces of drug residues have been found in drinking water supplies. But, if you can’t make it to a drug disposal site, some drugs — such as narcotic painkillers or fentanyl — should be washed down the drain as a last resort, Skoy said. This helps reduce the risk of overdose due to unintended or illegal use. The FDA maintains a list of disposable medications, or you can call your local pharmacist.
As tempting as it may be, it’s not a good idea to hang on to a partially used prescription on a rainy day.
“Antibiotics, eye drops and painkillers are prescribed for a specific condition and treatment. As soon as you’re done with a prescription drug, throw it away immediately,” says Skoy. You also want to check the expiration dates of any medications you are prescribed to “take as needed.” Sinapole said, “Once a medicine has passed its expiry date, we worry about its effectiveness.” Another concern is that patients will not seek treatment when they should, “because they are self-medicating” with expired drugs.
Pharmacists advise each of us to pick a date — New Year’s Day, our birthday, the first day of spring, or anytime — to take inventory of our medications and throw away the ones we don’t have anymore. needed or which are out of date. Help your aging parents, relatives or friends do the same. Henke said, “If everyone does their part, takes the time and takes action, it will help keep our families and communities safe.”