Medicine cabinets often become archives filled with forgotten prescription bottles holding pills that were never finished, or containers of over-the-counter medications and cold remedies that have long expired.
What’s the best and safest way to get rid of them? Can’t we just flush them down the toilet? (In most cases, no.) How do we choose between toilet, garbage or collection site?
Why proper disposal matters
Properly disposing of medication is important for the safety of your household and the environment.
Improper ingestion of prescription drugs by children alone affects 67,000 a year, according to Safe Kids Worldwide. In the U.S., a child goes to the emergency department every 8 minutes for potential medication poisoning.
To children, capsules and tablets mimic candy, often colorful and just the right size for popping into small mouths. Further, teens, who are the ultimate experimenters, too often gain access to adults' medication for pain, anxiety or attention deficit disorder, with dire consequences.
Disposal is an important matter to get right.
Patrick Chan, manager of the newly opened outpatient pharmacy at UC Irvine Medical Center, recommends you start by checking the label on the container for disposal instructions or a mail-back offer.
If there are no disposal instructions on the container, consider this simple and environmentally conscious approach to disposal:
Pills and liquids
Mixing method: Put expired or unneeded pills in a sealable can or bag with kitty litter, used coffee grounds or dirt. These moist, gritty substances camouflage and degrade the pills. This reduces the risk of children, adults or animals picking pills out of the trash. You can then dispose of the sealed can or bag with your regular garbage.
Pill bottles are generally recyclable. For privacy, remove and shred the label or scratch out the personal information.
The syringes and needles that are so vital to the health of people with diabetes, allergies and other conditions can injure others, if not properly disposed. Injectable medicines like insulin pens and Epi-pens require special care. Some manufacturers or distributors will provide a sharps container.
Or you can make your own, as described in the magazine of the American Diabetes Association. Containers can be stored on a high shelf and then taken to hazardous waste collection sites. Another option is to use a steel can or other sturdy container, and seal it before disposing in the trash.
Medications like inhalers may emit chlorofluorocarbons if they are old, and can be hazardous if punctured or burned. They should be disposed of in the same way as sharps to avoid discharge or explosion.
Fentanyl is a powerful synthetic opioid prescribed for pain relief.
Fentanyl transdermal patches have created a particularly onerous risk to children and pets, who can be harmed if they find them in the trash. The FDA recommends you fold these in half with the sticky sides together, and then flush them down a toilet. Other patches can be handled in the same manner or disposed of through the mixing method.
Can't I just flush pills?
The FDA recommends that you flush only certain medications, narcotics chief among them. If you have children or teens who might be motivated to defeat your mixing system, this may be the safest option.
For other medications, however, consider the mixing method (described above) since antibiotics and other pharmaceuticals end up in our waterways, affecting wildlife and winding up in our drinking water.
DEA 'Take Back' days
Chan, the UC Irvine Medical Center pharmacy manager, also suggests watching for DEA-sponsored "Take back your Meds" days. Many police and fire stations, hospitals and some commercial pharmacies throughout Orange County participate.
Permanent collection sites
There are several centers throughout Orange County that are set up, year round, to collect certain types of pharmaceuticals. Medical waste disposal information is available through the Orange County Health Care Agency.
Making disposal a habit
Along with changing the batteries in your smoke alarms, why not add medication disposal to your "spring forward" and "fall back" to-do list? Establishing a system avoids scrambling to respond to changing situations, like a visit from a young child.
Lock up medicine for safety
Between disposal times, consider getting a medicine cabinet with lock and key. These cost as little as $23-$40, and provide one of the simplest ways to ensure the safety of small children.