Opioid Disposal

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By Robert G. Smith

The opioid epidemic is a national public health emergency that requires a comprehensive approach. Proper and timely disposal of unused prescription opioids is one method to deter improper use of these medications and prevent overdose. The U.S. Food and Drug Administration (FDA) has identified safe storage and proper disposal of prescription opioid products as essential steps to address opioid misuse and abuse.

Health care providers play a prominent role in minimizing opioid misuse. Cautious prescribing habits with limits enforced on the quantity of opioids prescribed, close follow-up and consistent and frequent provision of opioid education are musts. Evidence points to the powerful positive impact of patient education in promoting safety around opioid use. Most people who misuse prescription opioids obtain them from family or friends. Storing opioids in the open or not disposing of unused opioids increases the availability of these opioids for misuse by others.

If a patient receives specific disposal instructions from your healthcare provider (e.g., doctor, pharmacist) for their unused or expired medicine, they should follow those instructions to dispose their medicine. The best disposal option is to find a drug take back location, which may be found in retail, hospital, or clinic pharmacies; and/or law enforcement facilities. Medication take-back programs allow the public to bring unused drugs to a central location for proper disposal. Patients should be instructed to call their local government’s trash and recycling service to see if a program is available.

  If a drug take-back program is not available, flushing medicines on the flush list helps keep everyone in your home safe by making sure these powerful and potentially dangerous medicines (when used inappropriately) are not accidentally or intentionally ingested, touched, misused, or abused. If you don’t have a drug take back location near the patient, they may check the FDA’s flush list:

Drug Disposal: FDA’s Flush List for Certain Medicines | FDA to see if their medicine is on the list. Medicines on the flush list are those that are sought-after for their misuse and/or abuse potential and those drugs that can result in death from one dose if inappropriately taken. If children, adults, or pets in their home accidentally or intentionally ingest, touch, misuse, or abuse a medicine on the flush list, they can suffer grave consequences including death. 

Flushing or dumping opioids down a drain or toilet is not the best way to dispose of this type of medication. Sewage treatment systems cannot remove all the medications from the water released into lakes, rivers, or oceans.Pharmaceuticals have been detected in the environment and there is genuine concern that this could be causing impacts to human health or to aquatic organisms. A vast array of pharmaceuticals including antibiotics, anticonvulsants, mood stabilizers and sex hormones have been found in the drinking water supplies of at least 41 million Americans.

The following are resources/websites that the prescribing providers or staff may give patients who receive opioid prescriptions:

  • Environmental Protection Agency: How to Dispose of Medicines Properly. go.usa.gov/xNwXc
  • Disposal of Unused Medicines: What You Should Know. go.usa.gov/xNw9z
  • Where and How to Dispose of Unused Medicines. go.usa.gov/xNw9S

Finally, patients should be empowered by prescribing providers with information centered on the preferred options to dispose of  unwanted or unused opioid pills, medicated liquids, or other medications by utilizing a local take-back or mail-back program, or medication drop box at a police station, DEA-authorized collection site or pharmacy if the pharmacy has a secure drop-box program.

Robert G. Smith DPM., MSc., RPh., FNAP, is President and founder of Studying Opioid Harm-Non-Profit 501.3(c). 

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