UC HEALTH LINE: Spring Cleaning and the Medicine Cabinet

CINCINNATI—People are known to hang on to unused or leftover prescription pills, syrups, creams and ointments for a variety of reasons. Some people shove them to the back of the cabinet because they think they might need them again someday, or there’s the case of cleaning out your deceased Aunt Millie’s household items.

While it’s a given that expired prescriptions should be disposed of—time can degrade the compounds,  making medicines lose their potency or become totally ineffective—proper disposal of prescription drugs is gaining attention as reports by the U.S. Fish and Wildlife Service indicate that pharmaceuticals have crept into water sources that support fish and wildlife.

Though the impact is contained to fish and wildlife at this point, and indications are that the trace amounts come from the drugs passing through humans and into sewage systems, there are guidelines in place to help consumers make the best decisions when disposing of drugs.

According to the U.S. Food and Drug Administration (FDA), common prescriptions like antibiotics or antihistamines can be disposed of in the household trash but should be rendered irretrievable by doing such things as crushing the pills and mixing the remains with cat litter or coffee grounds and placing the remains in a sealed container. This not only disguises the drugs but makes them unattractive for consumption by children and household pets.

A select group of drugs that are recommended to flush including narcotics and other potent drugs can be viewed at the FDA Web site.  

These drugs, says Bethanne Brown, PharmD, assistant professor of pharmacy practice at the University of Cincinnati (UC) James L. Winkle College of Pharmacy, are considered to be more hazardous because of the risk of harm to others if taken inadvertently.

While there has been some effort to keep drugs out of the environment, such as with the take back programs sponsored by local government and private industry, "there are no laws governing individual disposal and no solid programs in place to help consumers,” says  Marianne Ivey, PharmD, vice president of UC Health University Hospital pharmacy services.

"The Environmental Protection Agency (EPA) doesn't want us to put any pharmaceuticals in the water supply; the Board of Pharmacy rules are that medication disposal should be done in such a way as to assure that they are not available to unauthorized persons.  In the meantime to keep them out of the water we are recommending that unused medications be put in cat litter, coffee grounds or other undesirable material. Research scientists familiar with the disposal of medications recommend finding chemical methods of neutralizing the chemicals in the medications, but this currently doesn't exist,” says Ivey.

That’s why she and other members of Leadership Cincinnati—a nonprofit civic organization that focuses on community improvements—have plans to implement a consumer drug disposal system.

The team meets in May for a roundtable discussion "to try and find ways to help people who have unused medications in the home,” says Ivey, adding that University Hospital does its part to reduce the impact on the environment by manually separating unusable drugs into different waste categories for proper disposal.