Though some medicines can simply be thrown in the trash, some require special disposal methods

Pills in Shapes of Continents / Cleaning Out Your Medicine Cabinet? Here's How to Dispose of Old and Unused Medications Properly
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January 23, 2017

When it comes time for spring cleaning, many people discover expired and forgotten medications collecting dust in their medicine cabinet. Unless they have pharmaceutical training, most don't know how to dispose of them properly.

Fortunately, we can help with that.

As the Food and Drug Administration (FDA) explains, the best option is often a community-based drug "take-back" program. In the absence of such a program, nearly every medication can be thrown away in the trash, but consumers should take the following precautions first.

A few drugs may be particularly harmful if they are taken by someone other than the patient for whom they were prescribed. Several of these include particular disposal instructions either on their labeling or in a patient information leaflet directing the patient to flush them down the toilet or sink when no longer needed.

Guidelines and Locations for Disposing of Drugs

These guidelines were developed to encourage consumers to dispose of medications safely, reducing potential harm from either accidental exposure or intentional misuse once the drugs are no longer needed.

  • If there are specific disposal instructions included on the labeling or patient information that comes with the medication, follow them. Unless there are such instructions specifically directing you to flush them down the sink or toilet, do not do so.
  • Use any program allowing consumers to bring unused medications to central locations for proper disposal. Call local law enforcement agencies to find out if they sponsor medicine take-back programs in the community. Get in touch with your city or county government's household trash and recycling services to find out what disposal options and guidelines are available in your area.
  • Transfer any unused medicine to a collector registered with the Drug Enforcement Administration. These authorized sites may include retail, hospital, or clinic pharmacies as well as law enforcement agencies. Some offer collection receptacles ("drop-boxes") and/or mail-back programs.

If there are no disposal instructions provided on the labeling, and there is no take-back program available in your area, throw out the medications in the trash by following these steps:

  1. Take the drugs out of their original containers and mix them with some kind of undesirable substance. This will make them less appealing to curious children and pets, and people who intentionally go through trash looking for drugs will not recognize them. Examples of such substances include coffee grounds, dirt, or kitty litter.
  2. Put this mixture into a sealable bag, empty can, or other container that will prevent leaking or breaking out of a trash bag.

Here are a few more tips from the FDA's Ilisa Berstein, Pharm. D., J.D.:

  • Make sure to scratch out any identifying information included on the prescription label to make it unreadable, protecting your identity and keeping your personal health information private.
  • Do not give your medications to friends or family. Doctors prescribe drugs based on your particular symptoms and medical history, and a medicine that works for you could hurt someone else.
  • If you're not sure how to properly dispose of your medication, ask your pharmacist.

According to Berstein, the same methods of disposing of prescription medications may also apply to over-the-counter drugs.

Why Not Just Flush Them All?

If some medications can hurt other people, why should the patient not just flush them when they are no longer needed?

There are some prescription medicines—like narcotic pain relievers and other controlled substances—that specifically must be flushed in order to lessen the danger of being accidentally used or overdosed on and illegally abused.

For instance, the fentanyl patch adheres to the skin and delivers a powerful pain medicine through it. This is one medicine that should be flushed because too much of it can lead to severe breathing problems, possibly resulting in the death of babies, children, pets, and even adults, especially those who were not prescribed the patch.

"Even after a patch is used, a lot of the medicine remains in the patch," says Jim Hunter, R.Ph., M.P.H., an FDA pharmacist. "So you wouldn't want to throw something in the trash that contains a powerful and potentially dangerous narcotic that could harm others."

The Effect on the Environment

It may not seem like a good idea to flush certain drugs due to the potential for trace levels of residues found in both surface water—like rivers and lakes—and in some community drinking water supplies.

"The main way drug residues enter water systems is by people taking medicines and then naturally passing them through their bodies," says Raanan Bloom, Ph.D., an FDA environmental assessment expert. "Many drugs are not completely absorbed or metabolized by the body and can enter the environment after passing through wastewater treatment plants."

"While FDA and the Environmental Protection Agency take the concerns of flushing certain medicines in the environment seriously, there has been no indication of environmental effects due to flushing," he says.

"Nonetheless, FDA does not want to add drug residues into water systems unnecessarily," says Hunter.

What about Inhalers?

Inhalers pose another environmental concern. In the past, many of these products have contained chlorofluorocarbons (CFCs), a propellant that hurts the protective ozone layer. However, these have been phased out of inhaler products and are being replaced with propellants that are more environmentally friendly.

Make sure to read handling instructions included on labels on inhalers and aerosol products. These items can be dangerous if they are punctured or put into a fire or incinerator. Contact your local trash and recycling facility to make sure that you dispose of your products safely and according to local regulations and laws.