How to Safely Dispose of Unused Medications

Why is a veterinarian discussing disposal of unused medications? Well, companion pets also take supplements, over-the-counter (OTC) and/or prescribed medications. Think about your pet’s medicine cabinet: does it have a heartworm or other preventative? If unused or expired, these medications should not be forgotten when you are spring cleaning your personal medications. 

Spring cleaning medications should not be a convenient trip to the toilet or the trash can because they can end up back in the environment. In fact, they already do. How? 

Well, the U.S. Geological Survey (USGS) has an excellent infographic that details how OTC and prescription medications eventually make their way into the environment, and will harm the health and behavior of wildlife. 

You might be looking at your medicine cabinet and see a few OTC, prescriptions, and supplements. Now multiply by that 100 or 1,000. The USGS states that many of the more than 4,000 prescription medications for human and animal health will enter the ecosystem and possibly our drinking water. 

Humans contribute through excrement and flushing unused medications down the toilet. Many wastewater treatment plants do not routinely remove medications. 

In fact, recycled wastewater that goes through a wastewater treatment plant, is disinfected and purified to become usable water, can increase the amount of nitrochloroform, a tear gas. A 2020 study from the University of Southern California found that N-methylamine drugs like Prozac and methamphetamine are precursors to nitrochloroform. When they come into contact with ozone during the treatment process, they react to form nitromethane, which converts into nitrochloroform during chlorination.

Antibiotics from farm animal excrement are absorbed by crops or runoff into streams, which can end up in drinking water and contribute to antibiotic resistance. 

One route many of us never consider is striking. The USGS notes that vultures that eat livestock carcasses contaminated with the painkiller, diclofenac, suffer acute kidney failure.

So, how should you dispose of your companion pet’s and your personal medications? 

The U.S. Food and Drug Administration (FDA) and Drug Enforcement Agency (DEA) have many webpages on the subject and it can become confusing. We’ll break them down for you.

The Best Way to Dispose of Medications 

The best thing is to find a drug disposal site for your supplements, OTC and prescribed medications. These drop boxes are plentiful and can be found at many pharmacies. The DEA actually has a search page that allows you to find a close disposal site. There are other search tools such as Safe Pharmacy available that may provide more information. Bear in mind, you can toss a lot of medications into these drop boxes, but double-check the labels affixed to the boxes before you toss in items. 

Let’s say you are at your local pharmacy and it does not have a drop box. Depending on state law, pharmacy staff can take back medications. In some places, they cannot take back opioids and certain other drugs. They will let you know which ones. 

Another scenario could be you just refilled a prescription, went to the doctor and they changed the dosage. So, you are left with an entire bottle and you do not want it to go to waste. The FDA does not really like this option, but many states have donation programs.

Mail-back programs are also available. 

The Flush List

The FDA has a flush medication list, but only if you can truly not get to a drug drop box. Bear in mind, the flush list contains only a handful of all available medications out there and is mostly comprised of opioids. The FDA recognizes the harm flushing can cause on the environment. However, the agency believes the risks to human and companion animal health outweigh the risks to the environment due to the high levels of abuse and possible death from ingestion. 

Tossing in the Trash (Not preferred!)

We really do not like this advice from the FDA if you live remotely and cannot get to a drop box. They advise:

1). Remove the drugs from their original containers and mix them with something undesirable, such as used coffee grounds, dirt, or cat litter. This makes the medicine less appealing to children and pets and unrecognizable to someone who might intentionally go through the trash looking for drugs.

2). Put the mixture in something you can close (a re-sealable zipper storage bag, empty can, or other container) to prevent the drug from leaking or spilling out.

3). Throw the container in the garbage.

4). Scratch out all your personal information on the empty medicine packaging to protect your identity and privacy. Throw the packaging away.

Some companion dogs (many, in fact), like to eat cat feces or dirt. We assume and hope you keep medications out of reach of your companion dogs and children. Dispose of the medications per the instructions above in the garbage can – not the trash can in your house. 

Additional Resources

10 Poison Pills for Pets – American Veterinary Medical Association; Retrieved: October 20, 2021

Drug Disposal: Questions and Answers – FDA; Published: October 1, 2020; Retrieved: October 20, 2021

Where and How to Dispose of Unused Medicines – FDA; Published: April 21, 2021; Retrieved: October 20, 2021 

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