Waste Medicine - The Problem
Most of us have leftover or expired medicines in our homes. About 1/3 of medicines sold go unused for many reasons.
Medicines save lives and treat illnesses. But expired or left-over drugs need to be handled safely and disposed of properly to prevent harm to people and our environment. Washington needs a secure take back program for unwanted medicines. Drug companies already provide these programs in some other countries, and should do the same here in Washington.
Medicine Abuse & Addiction: Our communities are struggling with an epidemic of prescription drug abuse, that is linked to the heroin crisis. Leftover and expired medicines that accumulate in our homes increase risks of medicine abuse and addiction. Many kinds of medicines are abused, including stimulants and over-the-counter cough syrups and antihistamines. Secure medicine take-back is part of a comprehensive approach to preventing medicine abuse endorsed in the National Drug Control Strategy.
- About 70% of people who abuse medicines get them from family or friends, usually for free. SAMHSA/NSDUH National Surveys on Drug Use and Health: 2011 and 2013
- 73% of teens say it’s easy to get drugs from parents’ medicine cabinets. Many teens think prescription medicines are safer to abuse than street drugs. Partnership for Drug-Free Kids. 2012 PARTNERSHIP ATTITUDE TRACKING STUDY
- Over-the-counter cough medicines, antihistamines, decongestants, and diet pills are often abused, especially by teenagers. National Institute on Drug Abuse - Cough and Cold Medicine Abuse and abovetheinfluence - Over-the-Counter
- Stimulants and ADHD drugs are often misused. Nonmedical use of Adderall, rose 67% among young adults between 2006 and 2011. The number of ER visits involving misuse of Adderall among 18- to 25-year-olds also rose from 862 visits in 2006 to 1,489 in 2011. During this period the number of Adderall prescriptions remained unchanged among young adults. Lian-Yu Chen et al. “Prescriptions, Nonmedical Use, and Emergency Department Visits Involving Prescription Stimulants” J Clin Psychiatry. Feb. 2016.
- 45% of heroin users are also addicted to prescription opioid painkillers. Centers for Disease Control. “Today’s Heroin Epidemic. More people at risk, multiple drugs abused” https://www.cdc.gov/vitalsigns/heroin/
Medicine Poisonings & Overdoses: To prevent poisonings and misuse, medicines need to be securely stored at home and securely disposed of at a take-back program when no longer needed. Poisoning by prescription and over-the-counter medicines is one of the most common means of suicide and suicide attempts. Medicines are a common cause of home poisonings and ER visits. Drug overdoses exceed car crashes as the leading cause of accidental deaths in Washington.
- 415 Washington residents died from prescription opioid overdoses in 2015, including unintentional and intentional deaths. WA Department of Health. “Opioid-related Deaths in Washington State, 2006-2015”
- From 2004-2013, there were over 28,000 non-fatal self-inflicted poisoning-related hospitalizations among Washington residents. Washington State Department of Health, Nonfatal Injury Hospitalizations. Cause by Year 2004-2013.
- 26% of child poisoning deaths were caused by someone else’s over-the-counter medicines and 32% by prescription medicines. Sabel, J. (2004). Washington State Childhood Injury Report – Poisoning Chapter. WA DOH
- In 2009 national data, 71,224 emergency department visits made annually for medication overdoses by children under age 18. 82% of ER visits involved children under age 5. 34% of these ER visits involved commonly available over-the-counter medication, such as acetaminophen, cold medicines, NSAIDs, and antihistamines were the most frequently reported. Schillie, S.F., et al. 2009. Medication overdoses leading to emergency department visits among children. Am J Prev Med 2009
Medicines in the Environment: Prescription and over-the-counter medicines are found in many streams and waterways. It’s a wide range of medicines – antibiotics, painkillers, antidepressants, and antihistamines – in the water and sediments.
For example, a U.S.G.S. study of studies in the Columbia River from Wenatchee to Longview found pharmaceuticals and other pollutants. Researchers are finding that even the low levels of powerful drugs found in our environment have the potential to impact fish and other aquatic species. A mixture of medicines have been found in Puget Sound salmon. Medicines are also found, at very low levels, in municipal drinking water supplies when the water source is not protected from wastewater effluents and other sources.
- Pharmaceuticals are an emerging contaminant of concern in freshwater and marine water ecosystems, and in drinking water supplies. WA Ecology “Pharmaceuticals in the Environment”
Improper disposal of unwanted household medications – estimated at 1/3 of all medicines sold - through flushing or trash disposal adds to pharmaceutical pollution in our waterways and drinking water supplies.
Medicines enter our waterways when they are flushed down toilets or when humans and animals pass medicines through their bodies. Flushing medicines is bad for the environment because septic systems and wastewater treatment plants can’t remove all drugs, and some medicines pass through into waterways. While some drugs may be captured during wastewater treatment, they could make their way back into the environment through land application of biosolids.
- A 2010 report by the U.S. EPA and WA Department of Ecology concluded that a “2008 screening study detected pharmaceuticals and personal care products in every influent, effluent, and biosolids sample analyzed from five Pacific Northwest wastewater treatment plants.” Control of Toxic Chemicals in Puget Sound Phase 3: Pharmaceuticals and Personal Care Products in Municipal Wastewater and Their Removal by Nutrient Treatment Technologies, USEPA 2010 Pub. Number 10-03-004
Throwing leftover medicines in the trash isn’t a good solution. Trash cans at the curb are not secure. Narcotics that are put in the trash might be picked up for illegal use. And putting medicines in the trash doesn’t guarantee they won’t get into the environment from garbage cans or landfills. The liquid “leachate” that is captured from some landfills is typically sent to wastewater treatment plants, which cannot remove all medicines before discharging the water back into the environment.
- Pharmaceuticals are commonly found in landfill leachate. U.S.G.S. studies.
The FDA, the DEA, and the EPA all support the use of medicine take-back programs as the best way to dispose of leftover drugs. Drug take-back is secure, and it’s the most environmentally sound because the drugs are completely destroyed by high temperature incineration. In areas where there are no drug take-back programs, federal and local agencies are having to advise people to throw medicines in the trash as an interim, or last resort measure. Some local governments prohibit flushing or trash disposal of waste household medicines.
FAQs – Learn more about secure medicine disposal and producer responsibility for secure drug take-back.
Last Updated (Monday, 20 February 2017 14:09)