Dispose of outdated medications safely
Dear Dr. Gott: You recently responded to a reader who wanted to know how to dispose of outdated medication. I feel your answer directing the population to further contaminate our water supplies by flushing them down the toilet is completely inappropriate. This is totally against all and any safety regulations. Why are you so driven to destroy our environment? If perchance you correct your column, you will have already done insurmountable damage by the time your response appears in print.
Dear Reader: Since my column appeared in late May, I have received several letters on the subject. While some were not as strong as yours, I have chosen to address the subject again with the hope I can redeem myself.
Unused over-the-counter and prescription medications can be found in almost every household, nursing home and hospital in the country. In the past, discarded pharmaceuticals were commonly flushed away. Out of sight, out of mind. Since those days, studies have revealed that over-the-counter and prescription drugs may have a harmful effect on water supplies and soil. The trace levels are extremely low, but they do exist. The major concern is the possibility of drugs ending up in drinking-water sources.
To confuse the issue, the Office of National Drug Control Policy (www.whitehousedrugpolicy.gov) advises that more than a dozen drugs, including OxyContin and morphine, be flushed, and gives other approved disposal methods.
There are several organizations that recycle drugs. Such organizations generally give leftover drugs prescribed to American HIV patients to HIV sufferers in other countries. The expensive retroviral medications are collected after patients in the United States switch prescriptions, stop the medication or die. They are then passed on to people throughout foreign countries. The organizations enlist the help of a physician, clinic or hospital that collects and ships the medicine to the programs. Laws in the United States don’t allow redistribution of any medications in this country, but there is no prohibition when exporting to other countries.
Data from the Food and Drug Administration’s Shelf Life Extension Program reveals that almost 100 different drugs stored in their unopened, original containers can remain stable for almost five years following their expiration dates. One very expensive antibiotic was tested and found to be safe and effective nine and a half years after the expiration date listed. Two other medications were found to be effective after 25 years and retained antiviral activity after boiling and being held at 149 degrees to 185 degrees for several days. Medical Letter journal consultants believe most drugs – even those opened and stored under reasonable conditions – retain up to 80 percent of their potency for up to two years after the expiration date. Despite this evidence, most manufacturers urge disposal of “expired” medications. However, they can be a great benefit to recycling programs.
Many states have a hazardous-waste collection program that can dispose of medications properly. Check with your local pharmacy or hospital, or your state offices to determine whether they have programs in place to aid in the disposal of unwanted medications.