Do you have a bottle of cough syrup that didn’t get used up or some expired prescription pills? Maybe you ended up with a bag of medicine after a family member died. Or your veterinarian switched your pet to a different medication, leaving you with some of the old one leftover. What should you do with medicine that has expired or that you don’t need?
The old advice was to flush unneeded medicine down the toilet—to get them out of the house and out of the reach of children and pets. It seems so easy just to toss medicines in the trash or to flush them down the toilet. But these “easy” methods of disposal have unintended, negative consequences for public health and safety and for the environment. When they are flushed down the toilet or sink, most of these chemicals pass through treatment plants or septic systems and can end up in nearby rivers or lakes.
As researchers learn more, the advice changes. However, many people still don’t know why medicine should not be flushed down the toilet or thrown in the trash. Even those that do know not to flush meds may not know what their options are for getting rid of their unused medicine. Instead of flushing, we should take our unused medicines to a medicine collection program if there is one available nearby.
So why shouldn’t we just flush or trash our unused meds?
There are three main reasons why the toilet, sink or trashcan should not be the first places you turn when getting rid of your unused medicines.
A wide range of pharmaceutical chemicals have been found in rivers, streams, lakes, groundwater, and drinking water nationwide. These include antibiotics, anti-depressants, steroids, seizure medications, cancer treatments, painkillers, tranquilizers and others. Even though the chemicals occur at very low levels (parts per billion or trillion), they are causing changes in behavior, reproduction, and growth in frogs, fish, mussels, and other aquatic animals. Scientists are concerned about aquatic species because they are constantly exposed to the chemicals. But exposure to pharmaceuticals is not limited to only to aquatic species.
Pharmaceuticals have also been found in plants and earthworms exposed to sewage sludge. And in just a decade, millions of vultures in India, Nepal, and Pakistan died of renal failure after consuming carcasses of cattle and water buffalo that had been treated with an anti-inflammatory drug. Researchers are documenting the short-term effects on wildlife, but the long-term impacts of having pharmaceuticals in the environment are not yet known.
Since we get our drinking water from groundwater, rivers, and lakes, people could be impacted too. A 2008 Associated Press investigation found pharmaceuticals in the drinking water supplies of at least 41 million Americans in 24 major metropolitan areas. So far, the thinking is that the concentrations of these chemicals in our drinking water are safe for human consumption. Still, it is worth taking a proactive approach to decrease the amount of unused medicines reaching our water supply.
Medicines that are stored insecurely in the home, or placed in the trash without taking precautions, are easy for children and pets to get into. Tragically, this can result in unintentional poisonings. Between 2001-2008, over 430,000 children five years or younger were brought to emergency rooms after self-ingesting medicines. And in recent years, human medications have topped the list of pet toxins. Pain-relievers, antidepressants, heart medications, and ADHD medicines all made the list of top 10 medications that poisoned pets.
Drug Abuse and Diversion
Prescription drug abuse is on the rise, particularly among teenagers, many of who mistakenly believe that prescription pills are safer than street drugs. According to the Centers for Disease Control and Prevention, prescription medications, including opioids and antidepressants, are responsible for more overdose deaths than street drugs such as cocaine, heroin, and amphetamines. The Drug Abuse Warning Network reports that emergency department visits involving misuse or abuse of pharmaceuticals increased 98.4 percent between 2004 and 2009, from over 627,000 visits to over 1.2 million. In some cases the drugs being abused were prescribed to the patient, but in many cases they were shared, illegally purchased, or stolen, sometimes from the trash.
How Does Medicine Get Into the Water?
The medicine in water gets there from many sources—livestock farms, hospitals and nursing homes, and households, just to name a few. This U.S. Environmental Protection Agency graphic shows the complex pathways that medicines take to reach the environment.
Many medicines enter the water system when they are excreted or when they are rinsed off of the skin. However, some end up in the water when people dispose of human or animal medicines via the toilet, sink, or trash. This is a source we can all do something about if we properly dispose of our unused medicines.
Septic systems and most municipal wastewater treatment facilities are not designed to remove pharmaceutical chemicals from the water. Different treatment techniques are successful at removing some of the chemicals, but current technology does not completely remove all pharmaceutical chemicals from treated water. The presence of pharmaceutical chemicals in sewage sludge is also of concern, as it is often used on agricultural land as a fertilizer.
Medicines that are thrown in the trashcan end up in a landfill where they either leach out or are pumped to wastewater treatment plants. In either case, they can end up in local streams and rivers. Medicine should never be burned in a burn barrel.
How do I properly dispose of my unwanted medicines?
- Don't flush medications down the toilet.
- Take unwanted medicine to a collection program. The medicine is destroyed at regulated incinerators.
- If a collection program is not available in your area, either use a medicine mail-back envelope (available at many pharmacies) or dispose of the medicine in the trash after following these tips:
- Keep medication in its original container. Do not crush pills.
- Remove or blacken out all personal information, but leave the name and dose of the medication visible.
- Add a safe and unpalatable substance such as kitty litter or used coffee grounds to the medication and then replace the lid.
- Seal the medicine bottle in a leak-proof container such as a coffee can. Dispose of in the trash as close to pick-up day as possible.