You can use the questions and answers below when teaching patients about proper medication disposal.

Question: Why should I clean out my medicine cabinet?

Answer: It’s good to do a spring-cleaning. Look closely in your medicine cabinets at home and take inventory. What medications are you storing? How long have you been storing them? Why do you continue to store them? Many of us keep medications long past their expiration dates, such as those prescribed when we had strep throat 2 years ago or an ear infection a year ago. (Remember? The doctor told you to take one tablet three times a day for 10 days; but by day 5, you felt much better and thought you’d save the remaining tablets for another illness.) Or how about the unused pain medication you’re keeping “just in case”? (After all, medications are expensive.) At some point, we’ve all done these things or know someone who has.

Millions of people overdose or are accidently poisoned each year because of unused medications in their own medicine cabinets. And many people suffer adverse effects from sharing medications found in a friend’s medicine cabinet. You can’t assume that if a drug worked so well for your friend’s sore throat, it should work for you. This just isn’t true.

Question: Why can’t I just flush my old tablets and capsules down the toilet or pour my old liquid medications down the drain?

Answer: Our water waste-treatment facilities aren’t designed to remove pharmaceutical compounds, so these compounds may find their way back into our local waterways and even the water we drink. Our water supply is at risk as discarded medication waste has been found in groundwater and soils. These could create future health risks, especially if they emerge as environmental contaminants in drinking water.

Question: Why can’t I just toss my old medications in with my trash?

Answer: Children and pets may accidently find and ingest or swallow unused medications in the trash. Also, someone who intentionally looks through trash may find them. Many accidental poisonings result from unused medications that have been tossed into the trash. Medications are small; some are brightly colored like candy, making them attractive to young children. What’s more, if you leave your old and unused medications in their original containers when you toss them into the trash, you run the risk of identity theft.

Question: Should I dispose of old and unused over-the-counter (OTC) medications the same way I dispose of prescription medications?

Answer: Yes. Medication disposal guidelines apply to both prescription and OTC medications. OTC products can be as poisonous to children and pets as prescription drugs, and they pose an equal danger to the environment if not disposed of properly. All medications must be disposed of as the manufacturer recommends.

Question: So how should I dispose of my old medications? Whom can I call for information? Where can I find information?

Answer: You can get information from various sources. Try your local pharmacy, hospital, or trash and recycling service. Visit the Food and Drug Administration (FDA) website at www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm186187.htm.

According to the FDA, if the label on your medication container doesn’t include instructions and your community lacks a drug take-back program, you can put the medication in the trash—but be sure to follow these guidelines:

• Take the medication out of its original container and mix it with an undesirable substance, such as coffee grounds or kitty litter. Place this mixture in a sealable plastic bag, an empty can with a lid, or any container that would prevent the medication from leaking into the trash.
• Scratch out all identifying information on the prescription label to protect your identity and personal health information.

The American Medicine Chest also offers information on safe medication disposal at www.americanmedicinechest.com (1-877-919-2622). The American Medicine Chest Challenge provides a unified national, statewide, and local focus on the issue of medicine abuse by children and teens. On the second Saturday of November every year, the organization holds a nationwide day of disposal of unused, unwanted, and expired medicine at a collection site or in the home. It also generates media attention on the issue of prescription and OTC medication abuse, and it challenges all Americans to take the five-step American Medicine Chest Challenge to help prevent abuse:

1. Take an inventory of your prescription and over-the-counter medicine.
2. Secure your medicine chest.
3. Dispose of your unused, unwanted, and expired medicine in your home or at an American Medicine Chest Challenge Disposal site.
4. Take your medicines exactly as prescribed.
5. Talk to your children about the dangers of prescription drug abuse.

Mary E. Fortier is an assistant professor in the College of Nursing at Seton Hall University in South Orange, New Jersey.

Selected references

Barra Caracciolo A, Grenni P, Falconi F, Caputo MC, Ancona V, Uricchio VF. Pharmaceutical waste disposal: assessment of its effects on bacterial communities in soil and groundwater. Chem Ecol 2011;27:43-51.

U.S. Food and Drug Administration. How to dispose of unused medicines. April 2011. www.fda.gov/downloads/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/understandingover-the-countermedicines/ucm107163.pdf. Accessed December 29, 2012.

The American Medicine Chest. http://www.americanmedicinechest.com. Accessed January 9, 2013.