Why is it important to dispose of unused or expired medicine?
The longer an unnecessary medication is kept in the household, the more likely it is that there will be some sort of misuse, whether it be purposefully or accidentally. Medications often don’t appear different when the naked eye is looking at an expired prescription or an un-expired one. A patient can easily mistake one for the other, this can lead to inefficiency of the drug therapy. It is also very important to keep this medication from getting into the hands of anyone but who it was prescribed to. By getting it out of the house, it is then out of reach from any other family members or guests. By disposing it correctly, it is better kept out of the hands of strangers, dumpster-divers, and hungry little animals.

How can I utilize medicine take-back options?
Obeying the drug-specific disposal directions on the medicine packaging is always the first go-option for medication disposal. The next option is for the patient to utilize drug take-back options, and only if those aren’t available, that is when a patient can proceed to throwing out the medication in the trash or flushing it down the toilet depending on the guidelines. Take-back options can be in the form of periodic events (ex: National Prescription Drug Take-Back events) or permanent collection sites.

How do I find out more about National Prescription Drug Take-Back? Visit this website:
https://www.deadiversion.usdoj.gov/drug_disposal/takeback/index.html

How do I find DEA-registered collection sites near me? Visit this website: https://apps.deadiversion.usdoj.gov/pubdispsearch/spring/main?execution=e1s1

For any other questions, patients can also call the DEA Office of Diversion Control’s Registration Call Center at 1-800-882-9539.

What medicines can I flush down the toilet?
Benzhydrocodone/Acetaminophen
Buprenorphine
Fentanyl
Diazepam
Hydrocodone
Hydromorphone
Meperidine
Methadone
Methylphenidate
Morphine
Oxycodone
Oxymorphone
Tapentadol
Sodium Oxybate

A printable version of this list can also be found on the following website: https://www.fda.gov/downloads/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/UCM588196.pdf

The medications on this list are recommended for flushing because of their high potential for abuse. One dose can be fatal to a patient not prescribed this medication by a licensed medical professional. So if the take-back option is not readily available, these drugs should not be kept laying and thus should be flushed.

What are the steps for disposing medicines in the trash?
Disperse the medicines among unpalatable substances including dirt, coffee grounds, and cat litter (NOTE: do not crush tablets or capsules)
Use a plastic bag or any other airtight vessel to conceal that mixture
Toss it in the trash
Scratch or Cross off any personal information still displayed on the medicine bottle with a sharpie

If there are no directions for disposal on the packaging of a drug, there are no readily available drug take-back options, and the medication is not on the flush list, then the medication can be thrown into the trash using the steps above. This would be the last resort.

This article was written by student pharmacist Karen Namubiru.