Tuesday, July 17, 2007

Pill bottles and other medicine containers saved with the intention of later use can be forgotten, and their contents can expire before their users realize they are still there.

But having expired medicine around the house can lead to a series of problems, including the potential for drug abuse, health issues and environmental problems, unless it’s properly disposed of.

To help avoid problems like these, the White House Office of National Drug Control Policy (ONDCP) was created in 1988 by the Anti-Drug Act to establish policies, priorities and objectives for the nation’s drug control problem.

In February, the ONDCP teamed up with the Environmental Protection Agency (EPA) and the Department of Health and Human Services (HHS) to create the country’s first interagency guidelines for proper disposal of prescription and over-the-counter drugs.

“This is the first time we’ve developed any interagency guidelines for getting rid of prescription drugs,” says Jennifer de Vallance, a spokeswoman for the ONDCP. “There have always been guidelines for commercial entities and industries, but not for individual users.”

These guidelines are the result of the growing rate of prescription drug abuse, Ms. de Vallance says. Prescription drug abuse is now the second highest form of illegal drug use, and the problem is increasing because of easy access to these types of medicines at home, she says.

“People don’t have to go to the shady world of drug dealers to get access to them,” Ms. de Vallance says. “All they have to do is go to mom and dad’s medicine cabinet.”

Matthew Fricker, a pharmacist and program director with the Institute for Safe Medication Practices, says the first step to avoiding any problems with expired medicines at home is to get rid of them. The nonprofit institute devotes itself to medication error prevention and safe medication use.

“Most drugs do not work as effectively after they expire,” Mr. Fricker says. “It’s best just not to take it after the date because some [medicines] can even cause harm to the person taking it.”

Most people save prescription drugs and other medications because of the high cost, or the idea that they’ll save it for later use, Mr. Fricker says. Some people save them to share with family members because “people don’t like to throw money away and want to save a trip to the doctor,” he says.

“Sharing prescriptions is never a good idea,” Mr. Fricker says.

The FDA recommends cleaning out medicine cabinets at least once a year, checking for expiration dates and throwing away all expired medications.

To properly dispose of these excess and expired medicines, the federal government recommends that consumers first take the medicine out of its original container.

The container can be thrown away with regular household trash or recycled.

Taking the medicine out of the bottles is a crucial step to thwarting drug abusers, Mr. Fricker says. “The goal is to make sure that the pills are not identifiable while they’re in the trash.”

Once the medicine and container have been separated, there are several options for getting rid of the medicine itself.

“The easiest thing to do is put the pills into a Ziploc or other sealable bag and smash them with a hammer,” Mr. Fricker says. “The main thing is to make sure that addicts can’t tell what they are.”

The ONDCP’s guidelines then recommend mixing the medicine with undesirable substances like coffee grinds and cat box litter. Liquid medicines can also be mixed with these items.

After mixing the medicine, it should be sealed in an impermeable, nondescript container like a Ziploc bag or empty can before being thrown away with the household trash. This will help keep the medicine from seeping into the environment, Ms. de Vallance says.

Flushing medicine down the toilet was once a popular way for getting of unneeded medicine, but Mr. Fricker explains that some medicines can release chemicals into the sewer, which then get into drinking water and eventually back to humans.

“People using medicine patches should be really careful to fold them over on themselves so that the adhesive sticks to itself,” he says. “The chemicals can get into the water and impact fish.”

Instead of flushing medicine down the toilet, Ms. de Vallance says they should be thrown away with the regular trash because landfills are now required to be lined, so there’s no worry about the drugs seeping into the environment.

Some medicines specifically ask users to flush them if there are any excess pills. Drugs like Percocet and Oxycontin have these restrictions because of their high abuse rate.

Jessica Emond, deputy press secretary for the EPA, says pharmaceuticals enter the nation’s rivers from sewage treatment plants or septic systems. They are being found in minute traces in the water supply, however it is much less than what a doctor would prescribe. It is not known what effects such small quantities may have on people, she says.

“The agency is aggressively pursuing research on occurrence and fate and transport of pharmaceuticals in various water sources, possible health effects in humans and aquatic life, and the effectiveness of water treatment technologies,” Ms. Emond says.

The final recommendation from the federal government asks users to take advantage of community take-back programs that allow the public to bring unused drugs to a central location for proper disposal.

While most counties in the Washington area have take-back programs for household hazardous wastes, most do not accept old or expired medicines. The Department of Public Works in the District lists old medicine as one of the items it will take during its fall and spring take-back days.

Public works departments in Virginia and Maryland also have household hazardous waste take-back days, but they do not take back old medicines.

For more information about the new federal guidelines, visit www.whitehouse drugpolicy.gov.

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