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Who, Why, Where and How – Unused Medicine

Unused Expired Medications

Brett Snodgrass, FNP-C, CPE, ACHPN, FAANP

If you’re reading this, your first thought is probably ‘why would I EVER throw away medications! I or someone in my family might need them again. It is tempting to “hoard” unused medications, but there are reasons to get rid of them. Today, I want to convince you to part with expired or unused meds, as it can mean life or death, and how to safely discard those medications when you take the leap to discard them. Unfortunately, we, as healthcare professionals, are the worst about this. 

Why Discard Expired or Unused Meds?

Most medications do have a shelf-life or an expiration date. Would you drink milk that was a year old? Of course not. It would be NASTY, right? Medications lose their potency after about one year of being on your shelf. Those need to be discarded. Research supports that taking old antibiotics can lead to the explosion of “super bugs”. After a certain amount of time (not more than a year), the tablet no longer contains the milligram dosage appropriate to kill the bacteria it is meant to kill. Therefore, you are undertreating these bugs, so rather than killing them – they can mount a resistance against that antibiotic. Basically, under-treatment of these bacterias, simply make them mad, and they fight back through resistance. This is one reason.

Another HUGE reason to discard expired or unused medications is due to safety and the risk of overdose and possibly death! These include controlled substances like pain medications (hydrocodone, oxycodone, morphine, Percocet, Lortab, etc.), anxiety medications (Ativan, Xanax, valium, etc.), ADHD medications (Adderall, Ritalin, Concerta, etc.), or cough medications containing hydrocodone; as well as any other medications deemed controlled substances by the FDA. 

Check the Medicine Cabinet

Most people store these medications in their medicine closet. Everyone knows this! The medication closet is a prime location for theft in suburbia. How?

– Those seeking these medications will go to open houses posing as a potential home buyer take prescriptions from the medicine closets located in bathrooms and kitchens.

– Consider your teenagers – well, of course, we know our children – “and they would never….”  What about their friends or teenage relatives? Unfortunately, “fish bowl” parties are quite popular currently. This is where every participant brings a prescription bottle – usually obtained unknowingly from their parents, grandparents, or other family members. These medications are then poured into a community bowl, mixed around, and everyone takes a handful of pills. Multiple reports of overdose and even death have occurred. Read more here 

– Do you know who sprays your house for bugs, cleans your house, or may have access to your house when you are or are not there? There has been known theft by individuals in homes performing other services.

How to Discard Your Unused and Expired Medications

FDA Disposal of expired medicine

1) National Prescription Take-Back Day through the FDA is Saturday, April 30, 2022 –  All you have to do is take any unused medication to this location and the DEA will safely discard those medications, with no questions asked. These occur about twice a year. You can google your nearest drug take-back location

2) Per FDA Guidelines, another way and what is proper with most medications (any medications including pain medication, anxiety medications, and ADHD medications – except for Methadone and Fentanyl) is:

    a) Removed the label from the prescription bottle and shred.

    b) Mix them with an undesirable substance, such as used coffee grounds or kitty litter (this makes the drug less appealing to children and pets and unrecognizable to people who may intentionally go through the trash-seeking drugs). 

    c) Place the mixture in a sealable bag, empty can, or other containers to prevent the drug from leaking or breaking out of a garbage bag.

3) Finally, to dispose of unused or expired methadone or fentanyl – per Product Information for each product AND the DEA it is recommended that these medications be flushed. The reason for flushing these products is due to their potential lethal dose in very small amounts. A used fentanyl patch or even 1 methadone pill that a child or pet could come into contact with could be very likely lethal in even a small amount.

I recognize there is great controversy regarding the flushing of any medications. This quote was taken directly from the FDA website – “The main way drug residues enter water systems is by people taking medicines and then naturally passing them through their bodies,” says Raanan Bloom, Ph.D.

I hope I have convinced you to take a look at your medicine closet or even the medicine closet of your parents, and get rid of unused and expired medications. It could truly save a life!

See Brett Snodgrass, FNP-C, CPE, ACHPN, FAANP speak at a 2022 Skin, Bones, Hearts & Private Parts CME Conference. Click here to find out where you can see her live and in-person!