Green Lantern: Should you flush drugs down the toilet?

By Nina Shen Rastogi
Tuesday, December 8, 2009

I've been hearing a lot about how prescription medications and the other drugs we take end up in the water supply. It got me wondering: What's the most environmentally responsible way to dispose of old pills and cough syrups?

It's true: A wide range of pharmaceuticals have been found in our lakes, streams and drinking water. Scientists are trying to puzzle out what effects these drugs might have on people and wildlife, but there's still a lot we don't know. Even without hard evidence on the impacts of long-term exposure to trace contamination from our water, most government organizations recommend that you dispose of old medications in the trash, rather than the toilet. (Of course, that doesn't address the fact that, according to most estimates, the vast majority of pharmaceutical pollution comes through our bodily excretions.)

Sometimes, however, broad environmental risks have to be balanced against more-immediate hazards, such as the danger that a child or a pet might accidentally consume a toxic drug that's lying in a trash can or that someone might steal medication and use it illicitly. In that case, flushing may be preferable, since the drug is immediately removed from the home and rendered unusable.

In 2007, the Office of National Drug Control Policy, the Environmental Protection Agency and the Department of Health and Human Services issued the first set of federal guidelines for proper disposal of prescription drugs. For the vast majority of medications, the government suggests taking them out of their original containers, mixing them with an "undesirable substance" (such as kitty litter or used coffee grounds), putting the mixture in a zip-lock bag or a container with a lid, then throwing the whole package in the trash.

The guidelines do recommend flushing in a few select cases -- such as Demerol, OxyContin and Percocet -- where the risk from accidental ingestion or the potential for abuse is very high. The Food and Drug Administration maintains an ever-evolving list of drugs that should be sent down the toilet.

These federal guidelines aren't binding, and your state or local authority may have somewhat different advice. For example, several states caution people never to flush any medications, dangerous or otherwise. (Connecticut suggests taking extra steps to keep your meds out of unwanted paws or hands, such as dissolving pills and capsules in water, wrapping blister packs in duct tape, and adding flour, salt or mustard powder to liquid medications to make "a pungent, unsightly mixture.")

Take-back programs -- in which unused drugs are collected for disposal by pharmacies, community organizations or government groups -- are starting to pop up throughout the United States, though they're often expensive to operate. A law enforcement officer must supervise the collection sites if "controlled substances" (such as Ambien, Vicodin and codeine) are involved. To see if there's a facility in your area, search the database at http://www.earth911.comhttp://for "unwanted or expired medications." Sharps Compliance, a Houston-based medical waste company, also operates a mail-in program for unused medications. Drugs collected through take-back programs are generally incinerated.

Finally, there are limited opportunities to donate your unused medications to charity. According to a recent report from the National Conference of State Legislatures, 15 states have enacted laws allowing individuals to donate various kinds of prescription drugs, typically provided that they're not expired, that the packaging is unopened and that the person donating can provide proper documentation. These programs are a source of concern for some physicians and pharmacists, who worry about the pedigrees of donated drugs.

When you finish all your pills, what should you do with your empties? Pharmaceutical packaging (bottles, caps, blister packs) uses a fair amount of plastic: 1.2 billion pounds in the United States in 2007, according to the Freedonia Group, an industry research firm. And this plastic is often difficult to recycle.

Most over-the-counter bottles are made of high-density polyethylene (that's No. 2 plastic), though some may be made of polyethylene terephalate (No. 1). Both types are widely recyclable, but many curbside programs won't take such bottles because they're small and can jam up equipment. Amber prescription bottles are usually polypropylene (No. 5), which is rarely accepted by recyclers. The design company Preserve collects No. 5 plastics at many Whole Foods, though, and you can also mail your polypropylene empties directly to the company. Some shelters, clinics and veterinarians' offices also collect prescription vials and reuse them, so if you've got a whole bunch of them on your hands, it might be worth looking for such a facility in your area. The Lantern likes to use hers as coin containers or carrying cases for earrings and safety pins when she travels.

Meanwhile, if you want to reduce the footprint of your personal pharmaceutical habit, you should also spare a thought at the beginning of the process. Buying in bulk usually makes a lot of environmental sense, but those benefits are undercut if you have to throw away an unused product because it has gone bad. If you know you're not going to consume 500 Advil capsules before the expiration date, get the smaller bottle.

Is there an environmental quandary that's been keeping you up at night? Send it to, and check this space every Tuesday. Read previous Green Lantern columns at here.

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