American consumers know not to toss old car batteries in the trash or pour motor oil down the drain, but those who want to get rid of unused drugs face a barrage of conflicting guidance: Flush, don’t flush, toss in the trash, don’t toss in the trash. Often, there’s no information at all.
The most likely source of guidance should be the instructions packaged with prescription drugs, or advice dispensed by a pharmacist or doctor.
But an Associated Press examination of hundreds of instructions provided with prescription medications found that Americans are almost never told how to safely dispose of unwanted drugs, despite mounting evidence that medications flushed down the toilet damage the environment and eventually reach drinking water supplies.
The AP reviewed information accompanying the 50 most-dispensed prescription drugs in the U.S. Those drugs, prescribed 1.1 billion times last year, represent 28 percent of the national market, according to the health care information company IMS Health. The AP also contacted working pharmacists around the country to find out what they tell customers.
None of the literature included federal drug disposal guidelines, published more than a year ago, nor any other step-by- step directions about how to get rid of medicines — even though much of the literature is produced or reviewed by the Food and Drug Administration, which helped develop the guidelines.
The most common reason given: Space is very limited on drug instructions and people often don’t read them carefully, so side effects and other risks are more important to detail than disposal.
“Do not flush” represents part of the federal government’s widely ignored and unenforceable guidelines. The guidelines suggest mixing most unwanted medicines with coffee grounds or kitty litter, then tossing the mess into the trash. There are 13 medicines — mostly strong narcotics — that the federal government explicitly says should be flushed so junkies won’t get them.
But federal agencies don’t have a consistent message. For example, the Fish and Wildlife Service says, “DO NOT FLUSH unused medications,” while the White House — backed by the FDA and Environmental Protection Agency — says, “Flush prescription drugs down the toilet,” if they are on the list in the special guidelines. Meanwhile, the Drug Enforcement Administration says there is no “safe, secure and reliable disposal system” for some narcotics.
An EPA spokeswoman said even unused pharmaceuticals considered hazardous waste at hospitals aren’t regulated at home. “Regulation of hazardous waste generated by the millions of households across the country — and usually in very small amounts — was deemed to be impractical by Congress and EPA,” Roxanne Smith said.
Guidelines for proper disposal of Rx drugs
Federal guidelines for proper disposal of prescription drugs:
• Take unused, unneeded or expired prescription drugs out of their original containers. Throw the packaging in the trash.
• Mix prescription drugs with an undesirable substance, such as used coffee grounds or kitty litter, and put them in impermeable, nondescript containers, such as empty cans or sealable bags, before placing them in the trash.
• Flush prescription drugs down the toilet only if the label or accompanying patient information specifically instructs doing so.
• Take advantage of community pharmaceutical takeback programs that allow the public to bring unused drugs to a central location for proper disposal. Some communities have pharmaceutical takeback programs or community solid-waste programs that allow the public to bring unused drugs to a central location for proper disposal. Where these exist, these programs are a good way to dispose of unused pharmaceuticals.
In Colorado, a bill was introduced in the state Senate this year that would have required pharmacists to take back unused medications, but the bill died in committee.
