As we mentioned in a previous blog post about medication safety, unused medications, whether expired or simply no longer needed, should be disposed of to prevent them from getting into the wrong hands (or paws).

But how do you safely get rid of those medications? If you wash them down the drain or flush them away, they get into the water system. Too much medication disposed of this way can be harmful to the environment. If you throw them in the trash, they can possibly get into the wrong hands or be found by animals.

Drug Take Back Locations and Programs

The best way to dispose of most medications is to drop off the medicine at a drug take back location or program. Police stations or certain pharmacies near you may offer a permanent collection site for unused or expired medications. To find a permanent collection site near you in Massachusetts, click here, or permanent nationwide collection sites can be found here. The U.S. Drug Enforcement Administration (DEA) also periodically hosts National Prescription Drug Take Back events. During these Drug Take Back Days, temporary drug collection sites are set up in communities nationwide to dispose of prescription drugs safely.

Safe Disposal at Home

If a drug take-back option is not readily available, there are safe ways to dispose of your medicine at home, and the method will depend on the specific medication.

• If the medicine is on the U.S. Food and Drug Administration (FDA) flush list, you should immediately flush it down the toilet. This generally includes strong narcotics (e.g., oxycodone, fentanyl pain patches). The harm that can be done by these types of medications being discovered in the home or taken from the trash outweighs the trace amounts that would be added to the water supplies. For example, the patches that contain narcotic medication meant to be released over time can cause dangerously decreased breathing or heart rates, leading to a potentially fatal incident if a child or pet comes in contact with them. There are still small amounts of medication in the patch – even after it has been used for its full course – that can be toxic to someone for whom the medication wasn’t intended.
• Don’t flush your medicine unless it is on the flush list. Since the FDA limits the number and types of medication that can be disposed of this way, only trace amounts of these types of flush-list drugs appear in the water system. Although this may run counter to your good environmental sense, in actuality, these types of drugs are already found in the water supply in safe, trace amounts, arriving there via natural human waste from the people who used the medication as prescribed.
• If the medicine is NOT on the flush list, mix it (do not crush tablets or capsules) with something unpalatable like dirt, coffee grounds, or kitty litter and place the mixture into a sealed plastic bag. Then, the bag can be placed in the household trash.
• When disposing of medications, it is wise to remove or obscure any personal information on the prescription bottle. This keeps your medical information confidential.

Medication Donation Programs

Some states have donation programs for certain non-controlled medications that are sealed and still in date. As of September 2023, the National Conference of State Legislatures indicates 44 states, Washington D.C., and Guam, have operational drug repository programs (programs that collect and donate unused medications), although Massachusetts is not included on this list yet.

Here are some medication donation resources:

• SIRUM has information and options for donating unused, non-controlled, and non-refrigerated medications.
• Aids for AIDS has information and lists options for donating unused HIV medications.
• Insulin for Life USA has information and options for donating unopened and refrigerator-maintained insulin and other diabetes supplies.

Additional Resources

The FDA website has a good overview of safe medication disposal and a detailed list of medications that should be flushed.