As we discussed in the previous article, “Ecopharmacology: drug contamination”, the accumulation of drug residues in the environment can cause undue exposure to active ingredients that modify the habitat causing undesirable effects on the health of both humans and other living beings.

That is why it is important to know the correct ways to dispose of disused medications.

Here are some options for disposing of expired, unwanted, or unused medications:

• Drug collection program
• What is the best way to dispose of medications at home?
• Donation of unused drugs

Drug collection programs

Various countries have established procedures and rules to receive drug discards. For example, the FDA recommends discarding disused drugs for being leftover from a treatment or for having passed their expiration date to authorized collection sites, pharmacies, etc. Similar disposal policies are followed by Canada and various countries in Europe. MedsDisposal is a website that provides information on recommendations from different European countries. With the exception of Germany, which incinerates household waste and therefore accepts pharmaceutical waste therein, the rest of the countries of the European Union request their disposal through the community pharmacy or special institutions.

Medicines that can be flushed down the toilet

Because some medicines could be particularly harmful to other people, they come with specific instructions to immediately flush them down the sink or toilet when they are no longer needed. To find out which drugs are suitable for flushing, you can consult the Food and Drug Administration’s drug list (FDA flush list).

Medicines that can be thrown away in household garbage

If the medications you have are not on the “flush list” and there are no collection programs for them, they can be disposed of in the household trash. Including prescription and over-the-counter medications, in the form of pills, liquids, drops, patches, creams, and inhalers.

To dispose of them correctly, follow these steps:

1. Remove medications from their original container and mix them with an undesirable substance, such as used coffee grounds, dirt, or kitty litter. This makes the medicine less attractive to children and pets, and unrecognizable to someone who might purposely scavenge for drugs.
2. Put the mixture in a sealable plastic bag, empty can, or another container to prevent the medicine from leaking or spilling.
3. Throw the container in the trash.

Drug donation

Drug donation services like SafeNetRX and SIRUM represent an option for individuals and organizations who want to help reduce prescription drug waste. They are part of a growing network of drug donation programs that work with manufacturers, pharmacies, long-term health centres, and individuals to connect ill-gotten patients with treatment.

Steps to donate unused medications.

Offering disused drugs to institutions or individuals helps to improve certain situations. However, the donor must avoid causing harm by donating expired or poorly preserved products.

The FDA instructions for a correct donation procedure are reproduced. These indications adapted to the uses of each country or region are easily fulfilled

-Step 1: Determine if the drug is eligible for donation.

All donated medications must meet the following criteria:

• Has not expired.
• Unopened and in tamper-proof packaging. “Tamper-proof” means that the packaging leaves visual evidence once opened (such as a plastic seal).
• Does not require refrigeration.
• It is not a controlled substance. Controlled substances are drugs that are regulated by law and can cause physical and mental dependence.

-Step 2: Check your region’s regulations on drug donation

-Step 3: fill out the required forms

You will need to include general information such as your name and contact information, the date of the donation, your signature, etc. You may also need to add details about each drug you are donating.

-Step 4: Remove any personal information from the package

Cover any personal information on the prescription label, such as the patient’s name or prescription number, with a permanent marker.

Be careful not to cover any information about the drug itself. Pharmacists reviewing and sorting these donations will need to see the name of the drug, the expiration date, and the dosage.

-Step 5: Coordinate the shipment or delivery of the medicine

Follow the instructions for specific programs to mail your donation or drop it off at a designated drop off location. For example, depending on the region, all donations must be taken to a certified pharmacy or have donors from the state use a drop-off site and donors from out of state send the medications.

It is important to be aware that an expired medicine becomes a toxic waste and must be treated with care and responsibility. Proper management of these takes care not only of people’s health but also of the environment we live in.