Expired
Medications
January 15, 2004
Dear HouseCalls Doc. I just read that expired medicine should
not be dumped into the toilet anymore? What do you think I should
do if I have prescription drugs that are expired?
John, Coulterville, CA
Dear John,
That’s a very good question. We did a little research to
get more information on the topic.
No one knows just how many unused drugs Americans dump each year,
or how many are hoarded because patients don't realize the drugs
have expired or simply don't know what to do with them. It's an
issue that has prompted pharmacy groups to launch an annual "Clean
Out Your Medicine Cabinet" campaign.
Individual patients aside, one study estimated the nation's nursing
homes discard anywhere from $73 million to $378 million worth
of drugs a year. Some are incinerated, but many are flushed. The
Environmental Protection Agency is studying whether to develop
formal recommendations for what to do with old drugs.
In fact, a new women’s contraceptive actually comes with
do-not-flush instructions, because it still contains estrogen
after it's been used. Women are instructed to wrap the NuvaRing
in an accompanying foil patch and put it in a trash can out of
reach of children and pets — the idea being that landfill
disposal slows drug seepage.
The issue is the "pharmaceutical and personal care pollutants"
that defy traditional wastewater treatment. This has long been
a concern abroad and only recently made headlines here when the
U.S. Geological Survey found traces of dozens of drugs —
painkillers, estrogen, antidepressants, blood-pressure medicines
— in water samples from 30 states.
The long-term effects aren't known at this point, but scientists
worry that exposure to even tiny amounts might cause some harm,
at least ecologically. Studies have linked hormone exposure to
reproductive side effects in fish, for example, and environmental
exposure to antibiotics may encourage development of drug-resistant
germs.
Fortunately the disposal issue is starting to get more attention.
The Food and Drug Administration is reevaluating its policies
to determine which drugs need the environmental assessments that
may spark disposal instructions. Separately, some states are working
to allow nursing homes to donate leftover drugs to indigent patients,
as long as they weren't opened and were guarded. For individual
patients, officials offer some disposal advice: 1. Take all of
a prescribed medicine so there aren't leftovers, unless there's
a specific reason to quit, like a bad side effect or allergic
reaction. 2. Trash disposal is better than sewer disposal. 3.
If you must toss it in the trash then break up the capsules and
crush tablets, put the remains back in the original container
with its child-resistant cap. Tape it up and double-bag before
tossing.
Alternatively, check if local household hazardous-waste collection
programs — where you're supposed to take motor oil and batteries
— accept expired medicines.
If you have any health questions you would like answered please
send them to us at docs@twainhartetimes.com. Until then stay healthy
and happy!
Dr. Matt and Dr. Bob
Bob Uslander, MD and Matthew Personius, MD founded Sierra HouseCalls
Medical Group, a local company providing at-home physician visits
to the Tuolumne County area. Ph: 532-4287.
Return
to Ask the Doctors
