by S.Todd Stolp MD
©May 2008
Keeping waste separate from sources of drinking water has been a practice of civilizations throughout recorded history. Before we bashfully attribute this behavior to our scientific brilliance and responsible environmental stewardship, we must recognize that cautious sewage management is not unique to humans. The ease with which cats and dogs can be house trained suggests that cautious handling of waste has somehow been hard wired into our lesser companions. Even raccoons are known to maintain “latrines” in a location separate from food and water sources. However, commercial medications pose a new challenge to safe disposal of sewage. Our septic system technology has not been designed to remove many pharmaceuticals from our sewage stream. We are told not to dispose of unused medications down the toilet or drain, but at the same time we find medicine cabinets engorged with unused and potentially dangerous medicines. How do we safely dispose of old drugs and unused narcotics?
This problem is more than just a nuisance. Prescription drug misuse is now the fourth most common form of substance abuse, following tobacco, alcohol and marijuana. Prescription narcotics create the illusion of safety because of their legitimate use in health care. While the benefits of pain relief to patients suffering from illnesses can not be overstated, pharmaceutical products come in a wide variety of doses and drug delivery systems which can be as dangerous as a firearm in the hands of an untrained person. Deaths occur every year in our communities as a result of unexpected effects of prescription medications when they are not used in accordance with their intended purpose.
It should also be pointed out that the greatest contribution of drug contamination to our sewage stream is not from inappropriate disposal of medications down the drain, but rather from the medications that pass through our own kidneys. It is more than a little exasperating to consider that a good portion of your pharmaceutical co-payment ends up going right into the plumbing fixtures after a quick trip through your personal subway system.
Back to the point. Now is a good time to go through your medicine cabinet to locate unused or old medications in order to avoid the potential dangers they pose. Check expiration dates and remove those which have expired. Remove those which have been discontinued, or which were prescribed when you were pregnant with your college-aged son or daughter. Remove those with the name of relatives who are memorialized on the trunk of your family tree.
Medications, except for controlled substances like narcotics and tranquilizers, can be discarded during community Hazardous Waste Collection campaigns. Information is usually available from local Environmental Health offices or from your local sheriff or law enforcement agency.
There are currently insufficient provisions in the United States for the disposal of unused prescription narcotics, tranquilizers and stimulants. Law enforcement agencies are currently the only legal entities that can receive controlled prescription medications for disposal, but such drug disposal programs are not currently funded. Nevertheless, efforts are now underway to provide residents with other options.
Until then, it is important that unused prescription medications either be discarded during local hazardous waste collection campaigns, or, for controlled medications like narcotics, stored safely in a secure location where they cannot be diverted for misuse and abuse. If you have a specific challenge relating to the disposal of controlled substances, you may call your local health department or law enforcement agency for advice.