[Pharmwaste] Article: Getting rid of unused prescriptions isn't nearly as easy as you might imagine

DeBiasi,Deborah dldebiasi at deq.virginia.gov
Fri Aug 25 11:33:56 EDT 2006


Rx for disposal

Getting rid of unused prescriptions isn't nearly as easy as you might
imagine

BY BETTY BOOKER

 

TIMES-DISPATCH STAFF WRITER

 

Monday, August 21, 2006




What do you do with old pills in your medicine cabinet -- the ones you,
your kids and granny didn't use?

Most people flush them. It's not against the law for private citizens to
do that.

Environmentalists don't like it much because medicines contaminate
drinking water.

Some people throw them in the garbage.

Law and drug enforcers don't like that.

Scavengers paw through trash for painkillers to use or resell. Children
and pets might inadvertently poison themselves. If the medicines make it
to the dump, they decompose and leech into the groundwater.

Don't give them to friends and relatives, either.

They might have adverse effects. Plus, it's against the law for pills to
be used by anyone other than the person for whom they're prescribed.

Don't leave leftovers where teens might sample them. Pharmaceutical
abuse is a growing problem.

It's even hard to give them to the poor. Many free clinics aren't taking
medications anymore.

"We don't accept medicines that have been prescribed for anyone else,"
says Susan Carr, director of clinical services for the Fan Free Clinic.

"Until recently, we were able to accept donated medicines," adds Mary
Moore, spokeswoman for Crossover Ministry, a nonprofit organization that
provides health care for metro Richmond's uninsured poor.

"But we now have a licensed pharmacy, and that's why we can't take
anything that doesn't come from a licensed source.

"At least once a week, we have someone calling because their parent or
spouse has died and they have perfectly good medicines left over -- and
we just cannot take them. It really is a terrible waste."

Instead, Crossover buys in bulk for the uninsured from drug
manufacturers.

"The problem is that once medicine has been taken out of the stock
bottle in the pharmacy and put in another bottle, there's no way to
account for the condition of the medicines," says pharmacist Carol Pugh,
quality officer at the Virginia Association of Free Clinics.

The medicines can't legally be dispensed a second time because they
might be contaminated, adulterated or degraded.

"There are probably a lot of good medicines that end up getting trashed
because of erring on the side of safety," she continues. "People who
used to take them in the past are realizing that's not a practice we
should be doing.

"It's very frustrating, because a lot of people need medicines they
can't afford," says Pugh, who is researching free clinics' drug disposal
options.

Charity clinics have to work with approved drug-disposal companies
licensed by the Drug Enforcement Administration. Biohazard containers
aren't secure enough for drug disposal.

"The private citizen [is] in a quandary," Pugh says. "I don't think
anybody's come up with a way for John Q. Public to dispose of
medicines."

Ask your local pharmacy if it is willing to put your unwanted pills
through its biohazard disposal service, suggests Dr. Rodney Stiltner,
assistant director and acting director of VCU Health System's pharmacy
services.

However, pharmacies generally are unwilling to do that nowadays, says
Elizabeth Scott Russell, executive director of the Virginia Board of
Pharmacy.

"Pharmacies have to pay to have drugs destroyed, and it's an expensive
process" in a retail business with a low profit margin, she says. Also,
federal law prevents returning controlled substances to a drugstore.

"This is a huge mess. In a nutshell, I do not believe, in this point in
time, there are any laws that prohibit private citizens from flushing
drugs. Whether it's a good idea or not, the jury's still out."

Hospitals' out-of-date medications are returned for credit from
manufacturers or are disposed of through a licensed disposal service,
Stiltner says.

That's what well-run hospitals do, says Tom Griffin, director of
Hospitals for a Healthy Environment in the state Department of
Environmental Quality's pollution prevention office.

Nursing homes that can prove unused medications have been handled
properly can donate them to free clinics, but that hasn't been widely
done, Russell says. The medicine has to go through a pharmacy that has
to ensure the integrity of the drug.

It's against the law for nursing homes or hospices to give a deceased
resident's unused medications to a poor patient in the facility, Russell
says.

VCU's Stiltner sends people wanting to help overseas to MAP
International, a nonprofit group that gets and distributes donations of
medical products from corporations.

But the global group doesn't take people's used meds, says spokeswoman
Nancy Butler.

Neither does the American Red Cross, says the Richmond chapter's
spokesman, Bill Harrison.

"I realize most people are honest, but we would never give out donated
medication because we don't know the origin of it," he says.

Nor does the Richmond-based International Mission Board of the Southern
Baptist Convention take supplies or medications anymore, says Dr. Van
Williams, a physician and medical director.

States are just beginning to grapple with drug disposal and recycling
options, Russell says.

Some states, such as California, let counties collect unused drugs from
nursing homes, wholesalers and manufacturers for distribution to the
uninsured poor. Virginia has no similar program, Russell says.

Minnesota has developed criteria for disposing of medicines because they
were getting in the water supply, Stiltner says.

Virginia's pharmacy board and the Department of Environmental Quality
"are trying to come up with a good way to deal with this problem,"
Russell says.

So what do you do with unused prescription meds?

"It's recommended not to dispose of medications in their original
container because there is a potential for re-use. You don't know who
will go through the trash," says VCU pharmacist Punam Patel.

"I don't have a good answer for that," the pharmacy board's Russell
says. "There's no law I know of that says a private citizen can't
dispose of them in their private residence."

So what's the answer?

"I'd probably flush them," Pugh says.

"The best thing to say is that people are aware that flushing is not the
best thing to do for the environment," says Smith, of the state
pollution-prevention office. "However, flushing is probably one of the
best options."

But not the best in his environmentalist's view because wastewater
treatment plants treat bacteria, not drugs and chemicals.

"I'd rather see people throw drugs in the landfill where they'll have
much less impact than going directly down the sink. But that's just from
the environmental side."

Take care that pills and medicines are hidden and syringes are in a
hard-sided container so they don't stick the trash collectors.

Don't put these hazardous things out in the trash can until the garbage
truck is coming down the alley. That way you can watch them go straight
into the truck's compactor.


Contact staff writer Betty Booker at bbooker at timesdispatch.com or (804)
649-6805.

This story can be found at:
http://www.timesdispatch.com/servlet/Satellite?pagename=RTD/MGArticle/RT
D_BasicArticle&c=MGArticle&cid=1149190064713

 

 

Deborah L. DeBiasi

Email:   dldebiasi at deq.virginia.gov

WEB site address:  www.deq.virginia.gov

Virginia Department of Environmental Quality

Office of Water Permit Programs

Industrial Pretreatment/Toxics Management Program

Mail:          P.O. Box 10009, Richmond, VA  23240-0009 

Location:  629 E. Main Street, Richmond, VA  23219

PH:          804-698-4028

FAX:      804-698-4032

 

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