bottles and blister packs of prescription and OTC medications

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% of adults use over-the-counter medicines as a first response to minor ailments. The Centers for Disease Control reported that 48.9% 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 medications that are 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” (PPCPs) by the EPA, these products include:

  • Prescription and over-the-counter therapeutic drugs
  • Veterinary drugs
  • Fragrances
  • Cosmetics
  • Sunscreen 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 acknowledges that PPCPs are contaminants of emerging concern; they are “increasingly being detected at low levels in surface water” and may harm aquatic life. Because PPCPs dissolve easily and don’t evaporate at normal temperatures, they often make their way to aquatic environments via treated sewage or landfill leaching.

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 treat all medical waste as potentially toxic and dispose of it responsibly, no matter how convenient the toilet seems.

flushing prescription drugs down toilet
Before flushing any medications down the toilet, check the FDA’s website for a list of flushable medications. Or better yet, take them to an authorized drug collection site.

What Can I Do With My Leftover Meds?

How do we properly dispose of harmful medications? A great option is Prescription Drug Take Back Day, sponsored by the U.S. Drug Enforcement Agency in communities nationwide. You can also find an authorized drug collection site near you or call the DEA Diversion Control Division Registration Call Center at 1-800-882-9539 for more information about these collection sites.

Some police and fire stations have prescription medication take-back days or accept medications year-round. You can also contact your city or county government’s trash and recycling service to ask if there is a local household hazardous waste program that may accept the substance.

If none of the above is an option, there is a proper way to dispose of medications at home. Here’s a quick rundown of disposing of your medications from the Food & Drug Administration:

  1. Take prescription drugs out of original containers.
  2. Mix drugs with a substance such as cat litter or used coffee grounds.
  3. Place this mixture in a disposable container you can seal, such as an empty margarine tub or a zip-close bag.
  4. Throw the sealed container with the drug mixture in the trash.
  5. Conceal or remove any personal information and prescription number from the empty packaging by covering it with a permanent black marker or simply scratching it off. Throw the packaging in the trash.
Source: U.S. Food & Drug Administration

Why Is Proper Disposal Important?

There’s a lot of controversy surrounding 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% of the drugs flushed in the U.S. before returning the water to the environment or for people to drink.

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 drugs disposed of 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? Studies have shown that pharmaceuticals are present in our nation’s bodies of water and harming aquatic life. 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.