How to safely dispose of old medications

Unneeded prescriptions and over-the-counter drugs can be dangerous to humans, pets and the environment — but getting rid of them responsibly isn’t as simple as tossing them in the trash

Illustration of a garbage can, recycle bin and toilet with round and oval shaped pills surrounding them.
(Emily Wright/The Washington Post illustration)
6 min

If you have expired painkillers accumulating in your medicine cabinet, you’re not alone.

According to the Drug Enforcement Administration, studies have found that between one- and three-quarters of patients store unused opioids for future use, or simply misplace them. While the dangers of those drugs are especially well known, keeping any kind of old prescription around can be risky. Accidental medication ingestion is a leading cause of child poisoning and the most common reason people call the ASPCA Animal Poison Control Center for their pets.

Getting rid of medications, though, is more complicated than just tossing them in the trash. Federal agencies including the DEA, Food and Drug Administration, and Environmental Protection Agency work together to educate the public on how proper disposal can keep children and pets safe, deter misuse and prevent pharmaceuticals from entering streams and rivers when they’re poured down a drain or flushed down the toilet.

Here are the ways those agencies and other experts recommend disposing of unneeded drugs.

Find a DEA-registered collection site

The DEA has more than 15,000 permanent consumer drug take-back receptacles across the country. You can search for one near you within an online database. (Some locations — including your neighborhood pharmacy — might be listed by a different name, so you may need to cross-check the address.)

The receptacles are large, mailbox-like containers in which you can deposit old pills in their original bottles, no questions asked. There are rules around what you can and can’t deposit: Yes to unused or expired prescription or over-the-counter medication, including pet medication, in tablet, capsule, liquid, patch or ointment form. No to illegal drugs (including marijuana even where it’s legal), needles, syringes, thermometers and inhalers. Inmar Intelligence, a company that partners with the DEA to provide one-third of these drug-collection kiosks, has collected more than 1 million pounds of drugs through the program since 2017.

Participate in a DEA national collection day

Twice a year for more than a decade, the DEA has held National Prescription Drug Take Back Day events at more than 4,000 locations nationwide, often in parking lots of hospitals, fire departments and law enforcement agencies. The drop-offs are anonymous, and the same collection rules apply here as at the kiosks, but the take-back events also accept vaping devices.

After the drugs are collected at both the permanent and pop-up spots, the bags — which are never opened — are sent to incinerators across the country. The take-back events are typically held the last Saturdays of April and October from 10 a.m. to 2 p.m. A couple of weeks before, visit DEATakeBack.com to find your nearest location.

Mail in your meds

If you can’t get to a drop-off kiosk, the EPA recommends mail-back envelopes, which come postage-paid and pre-addressed to an incineration facility. They are available online (through ARXG and CVS, for example) or for purchase at some pharmacies.

Trash can be an option — with precautions

While the take-back locations or events are preferable, you can also follow these steps to dispose of most medicines in your home trash, according to the EPA:

  • Empty medicines into an unappealing substance such as dirt, cat litter or used coffee grounds.
  • Place the mixture in a container such as a sealed plastic bag or jar.
  • Throw away the container in your trash at home.
  • Scratch out personal information on the prescription label to protect your identity, then trash or recycle the empty packaging or bottle.

Donate sealed and unexpired meds

One in 4 Americans don’t refill prescriptions they need because of cost, according to Sirum (Supporting Initiatives to Redistribute Unused Medicine), an organization that collects and distributes donated medications.

In a statement to The Washington Post, the FDA cautioned that donated medications “do not have the same assurances of safety and effectiveness as those drugs that FDA routinely oversees.” Even so, most states have established good Samaritan laws allowing donated prescriptions to be matched with uninsured people who need them.

Plus, Sirum’s guidelines are strict: The organization does not accept controlled substances, including opioids, and all prescription and over-the-counter donations from individuals must be unexpired, non-refrigerated, and sealed and unopened (which means those amber-colored pharmacy bottles are ineligible). Commonly donated medicines are diabetes or heart disease pills in blister packs, chemotherapy drugs, EpiPens and inhalers.

While Sirum donations come mostly from nursing homes and pharmacies, hundreds of thousands of dollars of medicines have been donated by individuals, says co-founder Kiah Williams. She explains that after Sirum donates the medications to community partners, the partners verify their safety by confirming the packages haven’t been opened or tampered with. Good Pill, a Sirum partner and nonprofit pharmacy in Georgia, has filled more than 600,000 prescriptions for those in need since 2017.

In limited cases, flushing is okay

As recently as the 1990s, the EPA advised flushing old medications down the toilet. But as science became clearer about the presence of pharmaceuticals in groundwater and surface water, the agency updated its recommendations. The experts I talked to confirmed that sending old meds down the toilet is for the most part a no-no today. “We have to rely on public education to remind people that the toilet is not a trash can,” says D.C. Water spokesman John Lisle, who emphasizes that chemicals from pharmaceuticals can affect aquatic life.

Even so, there are still some exceptional cases in which flushing is okay. The FDA maintains a flush list, which includes a dozen opioids and two other medications that have been deemed so risky to keep in your home — because accidental or intentional ingestion could be deadly — that the government advises flushing them if you can’t get to a take-back location right away. The medication label will alert you if your drug is in this category; examples include fentanyl patches and Vicodin. (A 2017 FDA study on the impact of drugs on this list concluded that flushing them has negligible effects on the environment.)

Think before you buy and refill

The best way to reduce the volume of unused medications in your home is to not acquire them in the first place. Rather than refilling a prescription that you may never take or buying over-the-counter drugs just in case, consider waiting until you need that medication. Think about all the extra room you’ll have in your medicine cabinet!

Melanie D.G. Kaplan is a writer in D.C. Her website is melaniedgkaplan.com.

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