National Prescription Drug Take Back Day, April 30, 2011

Patient Expert

What did you do for Earth Day?   I spent the afternoon working with music students preparing for the spring recital and upcoming solo festival.   As a result, there were several people who were visiting my music studio for the first time.   I don't normally look at my studio with the eyes of one who has never been there, but I did today.   What did they see?

There's the ladder which still leans on its side against a long wall since the studio was painted last fall.   The empty paint cans in the corner of the piano room.   I've been meaning to dispose of those properly.   You can't just throw away paint cans with the regular trash.

If you looked very closely, you might see a couple of prescription bottles on the bookcase behind my teaching chair.   Those medication bottles have been on my shelf for years now and I know that the drugs held within are beyond their expiration date.   Another thing which I have been meaning to take care of "one of these days."   But just as it's important to know how to probably dispose of the paint cans, it is equally important to know what you can do with your leftover medications or empty syringes.

According to the Food and Drug Administration (FDA), most drugs can be safely thrown in the household trash under certain conditions (ie. crushing first and/or combining with kitty litter or coffee grounds).   The FDA recommends that a few drugs should be flushed down the toilet or may be disposed of down the sink (a current list can be found here).   Another option is the periodic community-based "take back" programs which are becoming more common.

2nd Annual National Prescription Drug Take Back Day, April 30, 2011

As unwanted and unused prescription drugs can pose a health risk for abuse, the National Drug Enforcement Agency joined forces with approximately 3,000 state and local law enforcement agencies in September 2010 for the first National Prescription Drug Take Back Day.   More than 121 tons of pills were turned in on that day by millions of people and the effort is being repeated next week.

This is a great opportunity to safely dispose of your excess prescription medications which are collecting dust.   Locations throughout the country will be accepting your excess medications from 10:00 am - 2:00 pm on April 30, 2011.   Find a collection site near you.   I discovered that there are more then 20 drop-off locations within 10 miles of my home in the suburban DC area.

Can you donate your excess meds instead?

Some states support programs which will accept prescription medications under very specific and restrictive circumstances.   Very few will take medications directly from patients for safety reasons, some states which will include Arizona, Florida, Georgia, Iowa, Louisiana, Maryland, Minnesota, Missouri, Nebraska, North Dakota, Ohio, and Wyoming.   In any event, I recommend that you talk to your doctor about any excess meds you would like to donate in case your doctor's office offers a way to ensure that   the medication goes to someone who may need it.   This would be especially helpful when dealing with the expensive biological medications we use for diseases such rheumatoid arthritis or multiple sclerosis.

The National Conference of State Legislatures offer these general guidelines for consumers hoping to donate drugs:

-      Only specific entities can make a donation, such as licensed health care facilities, hospitals, pharmacies, pharmaceutical manufacturers or distributors.   As mentioned above, some states do allow patients to donate directly.

-      Pills in opened or partly used bottles are never accepted.   Generally the  drug must be in its original, unopened, sealed, and tamper-evident unit dose packaging.

-      Old drugs are never accepted.   Expiration dates must be visible, and usually at least six months  later  than  the date of donation. (Many prescription products carry an expiration date approximately one year after the original date of the purchase)

-      Commonly, donated drugs must be delivered to a specific type of medical or pharmacy facility.   Some may require  the donor  to sign a form or waiver.

-      Usually financial compensation is prohibited.   Donations may be tax-deductible if paid for by the individual patient and taxpayer.   Beyond donation programs, patients and other individuals may not sell any prescription drugs - such transactions are strictly regulated by State Boards of Pharmacy and other state and federal laws.

-      If your goal as a consumer  is simply to protect your local water supply or clean out your medicine cabinet, these programs will not meet your needs.

-      If you wish to participate, check with a local pharmacy or prescriber for practical advice on what  may work in your situation, in your state.

Disposing of Used Sharps or Syringes

Several of the self-injectable biologic medications prescribed for RA are supplied in a pre-filled syringe or pre-filled auto-injector device.   After injecting the medication, it is important to know what to do with those used syringes and single-use devices.

DO NOT place the used syringe or auto-injector device directly in your household trash.   DO NOT place them in recycling either.   When you are done with your injection, place the used syringe in a closable puncture-resistant container such as a red biohazard sharps container (obtainable from the pharmacy which provides your medication) or a hard plastic container such as a large laundry detergent bottle.   The detergent bottle was my preferred collection device when I used daily shots of Copaxone (a medication for MS).   I could fit almost 300 used syringes in one large bottle before I needed to dispose of the container.   DO NOT use a glass or clear plastic container.

When your "sharps container" is full, securely fasten the lid so that it will not come off.   Some counties will allow you do dispose of the secured container with your household trash (mine does); other counties do not.   Ask your doctor for instructions on how to dispose of sharps in your area.   There may be special state and local laws regarding the disposal of used needles and syringes, including auto-injectors.   Contact your local waste management company for more information.