Unused Prescription Drugs Should be Disposed of Carefully

A lonely tree. (Dr. Noorali Bharwani)
A lonely tree. (Dr. Noorali Bharwani)

It is a common dilemma in every household – what to do with expired and unused medications.

An article in the Canadian Medical Association Journal (CMAJ August 5, 2014) says unused prescription drugs should not be treated like leftovers and kept sitting in a closet for years to come.

On May 11, 2013, Public Safety Canada and the Canadian Association of Chiefs of Police coordinated the first National Prescription Drug Drop-Off Day, which resulted in the return of more than two tones of unused medications, says the CMAJ article. This initiative was repeated on May 10, 2014.

The whole idea of this exercise was to reduce the amount of unused prescription drugs in Canadian households and, ultimately, drug-related harm. Unused prescription drugs are common in most households.

Some individuals are reluctant to throwaway unused medications because they may be useful in the future. A good example is painkillers. A second example is antibiotics.

A review found that more than a third of patients did not complete their antibiotic course as prescribed, and unused antibiotics were taken by more than a quarter of the patients for new infections.

If you keep unused prescription drugs in the house then another member of the family may think that the same pills may be useful for his or her ailment.

Unused opioids, benzodiazepines and stimulants are major sources of misuse and diversion, says the article. Fifteen per cent of students in grades seven to 12 in Ontario reported using prescription medications (most often opioids and stimulants) for recreation in the preceding year. Most of these pills were prescribed to one of the parents or sibling.

Unused prescription drugs are sometimes brought to “pill parties” (also called “pharm” or “Skittles” parties), where adolescents experiment with pills they select from the pool of medications brought by partygoers, says the article. Some of the drugs can kill if mixed with other drugs or alcohol.

Self-medication with antibiotics, without proper professional diagnosis, is a common practice, most often for a sore throat and common cold.

What about our toddlers?

Between 2001 and 2008, more than 450 000 cases of poisoning in children less than six years of age were reported to US poison control centers. Of these, 95 per cent involved the ingestion of a prescription medication, which resulted in substantial morbidity and resource use (i.e., non-fatal injury, visit to the emergency department and admission to hospital), as well as 66 deaths, says the article.

To minimize these kinds of harm, there should be responsible disposal of unneeded or expired medications.

Health Canada recommends that unused medications be returned to local pharmacies or municipal waste disposal centers and should not be disposed off in the garbage or by flushing them down the toilet.

Flushing the pills down the toilet is not a bad idea although Health Canada does not like it. The US Food and Drug Administration recommends disposal in the garbage after the unused medications have been mixed with coffee grinds or cat litter to mask the drug or render it unpalatable. Not an easy disposable system.

The most important thing to remember is all medications should be stored in a secure place.

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