Whether it’s a bottle of baby aspirin in a cabinet above your kitchen sink or a shelf of prescriptions on the bathroom shelf, medication is a common household item that often goes unrecycled. According to a study by the Consumer Healthcare Products Association, 81 percent of adults use OTC medicines as a first response to minor ailments. The Centers for Disease Control reported that 48.9 percent take at least one prescription medication every month. That’s a lot of medicine that can expire, go to waste, or end up in a landfill or the water supply.
What happens when you get rid of the nasty cold and no longer need that cough medicine? Should you throw it in the trash? Or can you flush it? Disposing of medication (and its containers) can be tricky. So, what do you do with medication that’s expired or that you no longer need?
Where Do I Start?
First, let’s define what “pharmaceutical waste” actually involves. Dubbed “pharmaceuticals and personal care products as pollutants” (PPCPs) by the EPA, these products include:
- Prescription and over-the counter therapeutic drugs
- Veterinary drugs
- Sun-screen products
- Diagnostic agents
- Nutraceuticals (dietary supplements, like vitamins)
Sources of PPCPs range from pharmaceutical manufacturing and residues in hospitals to your very own medicine cabinet.
The EPA reports that some PPCPs don’t pose a significant threat, however this isn’t the case for all medications. Because PPCPs don’t dissolve easily and don’t evaporate at normal temperatures, they often make their way to domestic sewers or waterways and can excrete toxic materials.
Flushing medication down the toilet is considered an option, but it results in water pollution because water treatment plants cannot filter out molecules of all sizes. Medication labels should state if the drug can be safely flushed. If you don’t find that information on the packaging, check the FDA’s website for a list of flushable medications and the substances that can contaminate waterways.
It’s a good idea to handle all medical waste as potentially toxic and dispose of it responsibly, no matter how convenient the toilet seems.
What Can I Do With My Leftover Meds?
How do we properly dispose of harmful medications that cannot be flushed? First, contact your city or county government’s household trash and recycling service to check if your community offers drug take-back programs or other household hazardous waste programs that may accept the substance.
If that isn’t an option, there is a proper way to dispose of the drugs at home. In February 2007, the White House Office of National Drug Control Policy issued the first consumer guide for proper disposal of prescription drugs. Here’s a quick rundown of disposing of your medications from the Food & Drug Administration:
- Take prescription drugs out of original containers.
- Mix drugs with a substance such as cat litter or used coffee grounds.
- Place this mixture in a disposable container with a lid. The guide suggests an empty margarine tub or a sealable bag.
- Throw the sealed container with the drug mixture in the trash.
- Conceal or remove any personal information and prescription number from the empty packaging by covering it with permanent black marker or simply scratching it off. Throw the packaging in the trash.
Is There Another Option?
Donating your excess medication is a great way to avoid medication pollution while scoring some philanthropic points. UNICEF estimates that around 9.7 million children under the age of five die due to preventable causes and lack of basic services to treat illnesses such as pneumonia, diarrhea, malaria, and HIV/AIDS. These deaths could be preventable with some medications that you might have in your bathroom. Specific data for preventable causes are hard to come by, but the overall rate of death for children under five is dropping over time, as UNICEF reports.
Each state has different laws about the disposal of medicines. Thirty-eight states have donation and reuse laws on their books. For example, Iowa collected $17.7 million work of medications in 2016 for free redistribution to people in need. Thirteen states have also instituted redistribution programs for cancer drugs, one of the most costly medical categories.
If you’d like to donate your medications, consider these options:
- World Medical Relief
- Volunteers In Medicine (accepts only sealed unused drug packaging)
- Memorial Sloan Kettering Cancer Center (accepts donated cancer drugs)
Why Is Proper Disposal Important?
There’s a lot of controversy surrounding the flushing any drug. A 2008 investigation by The Associated Press found that 250 million pounds of pharmaceuticals are flushed each year by hospitals and long-term care facilities. PBS found in 2014 that water treatment facilities can remove only 95 to 98 percent of the drugs flushed in the U.S. before returning the water to the environment or for drinking.
There’s a notable presence of pharmaceutical substances in our drinking water. In 2008, a CBS report found that, “A vast array of pharmaceuticals — including antibiotics, anti-convulsants, mood stabilizers and sex hormones — have been found in the drinking water supplies of at least 41 million Americans.” The World Health Organization’s study on risks for pharmaceuticals in drinking water and a WebMD article point out that while the potency of disposed drugs in water is “low,” it’s not without risks. Estrogen in the water supply can affect development; consequently, children are more affected by contaminants overall than adults
What does that mean for us? According to the EPA, studies have shown that pharmaceuticals are present in our nation’s bodies of water, some causing ecological harm. However, to date, scientists have found no evidence of detrimental effects on human health.
According to Dr. Raanan Bloom, an environmental assessment expert for the FDA, the main way medications enter water systems is by people ingesting them and then naturally passing the substance through their systems.
“For those drugs for which environmental assessments have been required, there has been no indication of environmental effects due to flushing,” Bloom said.
Editor’s note: Originally published on September 7, 2009, this article was updated in December 2018.