Disposal of Household Pharmaceutical Waste
In the past, the recommended way to dispose of expired or unwanted medications, whether prescription drugs or over-the-counter medications, was to flush the drugs down the toilet or a drain. While this method prevents anyone else from accidentally taking the medication, research has shown these chemicals can pose a problem to the environment, and end up in our drinking water, as recently reported by the Associated Press. The long-term health effect of such continuous, low-level exposure is not known. As a result, we need to find better ways to dispose of these materials.
What's the Problem?
Drugs can enter the environment both as a result of improper disposal and because they are excreted by the person taking the medication if the patient's body does not react with the entire dose. Recent research has shown that wastewater treatment plants and septic systems only partially remove pharmaceuticals, so these chemicals end up in rivers and streams. They can then affect both wildlife and disease-causing organisms in nature, harming the former and increasing drug-resistance in the latter. The long-term risks to the environment are not fully known, but birth defects affecting the ability of fish to reproduce have been observed, as well as changes in the numbers of fish and the ratio of male to female fish. Over time, accumulations of these chemicals might result in fishing advisories, as has happened with pesticides after their widespread use. Also, any potential source of disease-causing organisms developing drug resistance should be avoided if possible due to the potential threat to public health.
Disposal of pharmaceuticals down the drain has been shown to affect drinking water supplies. EPA notes that the long-term health risk of consuming of minute quantities of pharmaceuticals over a lifetime though drinking water is not known.
The Knox County Health Department recommends taking waste pharmaceuticals to a community collection event or dropping the medications at a collection drop box. The first Knoxville pharmaceutical waste drop box will be opening in Mid-November, 2008, in the lobby of the City of Knoxville Police Department (KPD) Headquarters, 800 Howard Baker Jr. Ave., Knoxville, TN 37915. Additional locations are planned to open in 2009 across Knox County. For more information about the medication collection and safe drug disposal event, contact either John Homa, the city’s Solid Waste Public Manager, at 215-2872 or Officer Craig McNew with the KPD at 215-7031.
If you cannot take your pharmaceuticals to a collection event or a waste drop off site, you may be able to arrange for pick-up through the KPD (call for information). As a last resort, you can dispose of the wastes to a landfill, following the instructions below.
Pharmaceuticals sent to a municipal landfill will decompose over time. Even if they leak out of their containers, the chemicals will be captured by the leachate collection system of the landfill, and will be properly treated before they escape into nature.
What to do?
DO contact your pharmacy and see if there is a program available where unwanted drugs can be returned for safe disposal.
DO dispose of waste pharmaceuticals, including over-the-counter medications, by sending them to a landfill or solid waste incinerator with your other household trash, as described below.
DO NOT dispose of these materials by flushing them down the toilet, whether you have a septic system or are on a sewer line, except for specific drugs where the FDA recommends doing so (see list) or where the product information indicates it is safe to do so.
The FDA advises that the following drugs be flushed down the toilet instead of thrown in the trash:
- Actiq (fentanyl citrate)
- Daytrana Transdermal Patch (methylphenidate)
- Duragesic Transdermal System (fentanyl)
- OxyContin Tablets (oxycodone)
- Avinza Capsules (morphine sulfate)
- Baraclude Tablets (entecavir)
- Reyataz Capsules (atazanavir sulfate)
- Tequin Tablets (gatifloxacin)
- Zerit for Oral Solution (stavudine)
- Meperidine HCl Tablets
- Percocet (Oxycodone and Acetaminophen)
- Xyrem (Sodium Oxybate)
- Fentora (fentanyl buccal tablet)
Note: Patients should always refer to printed material accompanying their medication for specific instructions.
DO NOT burn in your backyard household waste containing pharmaceuticals. This may not completely destroy the drugs and may scatter them in your immediate environment.
How to do it?
There is a small chance that the trash bag containing your drugs may break, so certain precautions should be taken so children, pets, or drug abusers cannot make use of your pharmaceuticals. These include:
- Remove the medication from its original container
if you are comfortable doing so. If the drug is kept in the original container, scratch out or cover with permanent
marker the name of the patient, but leave the name of the drug visible.
Modify the medication to discourage consumption
Add a small amount of water to pills or add a non-toxic material to a liquid drug to
make a foul-smelling mess. You might add coffee grounds, kitty litter, salt, flour, charcoal, or a non-toxic spice like turmeric or mustard. For plastic blister packs of pills, wrap the entire pack in duct tape or other opaque tape.
Seal and conceal
Tape the lid of the medication shut, and hide the drug (or the drug container, if not transferred) in a non-transparent bag or a non-transparent plastic container like a yogurt or cream cheese container or a margarine tub so the contents cannot be seen.
Some types of pharmaceutical wastes require special disposal. Unused ampoules,
vials, and IV bags should not be opened; just mark out the patient's name and place
in a non-transparent plastic container, sealed with duct tape or other heavy tape.
Sharp items, like insulin needles, if a sharps container is not available, should be
placed in a sturdy container like a Clorox or milk jug with screw-top lid, or a margarine tub and sealed with duct tape, The container can then be put in a bag, and disposed in the trash compactor or dumpster at any of the Knox County Convenience Centers.
Your manufacturer or health care provider may have additional options for disposal of such items. Chemotherapy drugs may require special disposal as they are sometimes more toxic than other medications. Check with your pharmacist or hospital for disposal guidance.
The above recommendations have been revised to reflect the 2007 recommendations of the National Office of Drug Control Policy (click here) .
The US Geological Survey (USGS) and US Environmental Protection Agency (US EPA) websites have additional information on the environmental presence and effects of pharmaceuticals:
You may also call the Knox County Health Department with questions, at 865-215-5242.