The FDA says if you don't utilize a take back program and choose to dispose of meds yourself , mix them with an undesirable substance such as used cat litter , coffee grounds , etc. Seal them in a plastic bag and dispose in the trash .

There are organizations that provide unused medication to those who can't afford it.

https://www.fda.gov/drugs/disp...st-certain-medicines

Drug Disposal: FDA’s Flush List for Certain Medications

If you received specific disposal instructions from your healthcare provider (e.g., doctor, pharmacist) for your unused or expired medicine, you should follow those instructions to dispose of your medicine. The best disposal option is to find a drug take back location, which may be found in retail, hospital, or clinic pharmacies; and/or law enforcement facilities.

If you don’t have a drug take back location near you, check the FDA’s flush list to see if your medicine is on the list. Medicines on the flush list are those (1) sought-after for their misuse and/or abuse potential and (2) that can result in death from one dose if inappropriately taken. If children, adults, or pets in your home accidentally or intentionally ingest, touch, misuse, or abuse a medicine on the flush list, they can suffer serious consequences including death. An example of a medicine on the flush list is fentanyl transdermal system (also known as a fentanyl patch), which contains an opioid. If a drug take-back program is not available, flushing medicines on the flush list helps keep everyone in your home safe by making sure these powerful and potentially dangerous medicines (when used inappropriately) are not accidentally or intentionally ingested, touched, misused, or abused.

Remember, don’t flush your medicine unless it is on the flush list.

Drug Name

Examples of Products on the Flush List1

Drugs That Contain Opioids

Any drug that contains the word “buprenorphine”

BELBUCA, BUAVAIL, BUTRANS, SUBOXONE, SUBUTEX, ZUBSOLV

Any drug that contains the word “fentanyl”

ABSTRAL, ACTIQ, DURAGESIC, FENTORA,ONSOLIS

Any drug that contains the word “hydrocodone” or “benzhydrocodone”

APADAZ, HYSINGLA ER, NORCO, REPREXAIN, VICODIN, VICODIN ES, VICODIN HP, VICOPROFEN, ZOHYDRO ER

Any drug that contains the word “hydromorphone”

EXALGO

Any drug that contains the word “meperidine”

DEMEROL

Any drug that contains the word “methadone”

DOLOPHINE, METHADOSE

Any drug that contains the word “morphine”

ARYMO ER, AVINZA, EMBEDA, KADIAN, MORPHABOND ER, MS CONTIN, ORAMORPH SR

Any drug that contains the word “oxycodone”

CODOXY, COMBUNOX, OXADYDO (formerly OXECTA), OXYCET, OXYCONTIN, PERCOCET, PERCODAN, ROXICET, ROXICODONE, ROXILOX, ROXYBOND, TARGINIQ ER, TROXYCA ER, TYLOX, XARTEMIS XR, XTAMPZA ER

Any drug that contains the word “oxymorphone”

OPANA, OPANA ER

Any drug that contains the word “tapentadol”

NUCYNTA, NUCYNTA ER

Drugs That Do Not Contain Opioids

Any drug that contains the term “sodium oxybate” or “sodium oxybates”

XYREM, XYWAV

Diazepam rectal gel

DIASTAT, DIASTAT ACUDIAL

Methylphenidate transdermal system

DAYTRANA

1 Links in the flush list direct you to specific disposal instructions in each medicine’s labeling (the labeling generally represents the last FDA-approved labeling at the time this webpage was updated). To see the most recently approved labeling see www.fda.gov/drugsatfda or to see the most current labeling see FDALabel at https://nctr-crs.fda.gov/fdalabel/ui/search.

Impact of flushing medicines on the environment

FDA recognizes that the recommendation to flush a few specific medicines when a take back program is not readily available raises questions about the impact of the medicines on the environment and the contamination of surface and drinking water supplies.

In an effort to address this concern, FDA staff published a paper entitled "Risks Associated with the Environmental Release of Pharmaceuticals on the U.S. Food and Drug Administration ‘Flush List’". This paper evaluates the environmental and human health risks associated with the flushing of 15 active ingredients found in these medicines. FDA concluded that these medicines present negligible risk to the environment. However, some additional data would be helpful for confirming this finding for some of the medicines.

FDA believes that the known risk of harm, including toxicity and death, to humans from accidental exposure to medicines on the flush list far outweighs any potential risk to human health and the environment from flushing these unused or expired medicines. Remember only flush medicines on the flush list if a take-back option is not readily available. FDA will continue to conduct risk assessments as a part of our larger activities related to the safe use and disposal of medicines.

Check out the Medication Disposal Q&A for more information about flushing.

Content current as of:
10/01/2020
Regulated Product(s)
Drugs
Topic(s)
Public Awareness
Disposal of Unused Medicines: What You Should Know
Drug Disposal: Drug Take Back Locations
Drug Disposal: FDA’s Flush List for Certain Medicines
Drug Disposal: Dispose "Non-Flush List" Medicine in Trash
Drug Disposal: Questions and Answers

My case was different, I knew not to flush them. I took them to the local CVS, they told me to take them to the fire station. FD said take them to CVS, that was a big help. After much discussion they
begrudgingly accepted them and put them in the 'Red Bucket'. I assume that was hazardous waste from accidents.

It was clear than both CVS and the FD did not know or understand the policy of how to dispose of them.

quote:

Originally posted by sns3guppy:
There are organizations that provide unused medication to those who can't afford it.

Almost all states that accept drugs for charitable pharmacy dispensing require that the medication be in the sealed, original manufacturers container, and must not have been under the control of the patient. This pretty much limits their use to medications dispensed to patients in nursing homes or other assisted living facilities, etc.

It's too bad this topic didn't come up several weeks ago, the DEA just sponsored its national take-back day on October 24th. Almost all law enforcement agencies in the country support this and accept drugs for take back during the event.

If you want to find a location that accepts drugs for destruction throughout the year the DEA website has a list that can direct you

https://apps2.deadiversion.usd.../main?execution=e1s1

I would propose (being in the environmental field as a consultant first and then regulator for the last 16 years - inspecting water and wastewater treatment plants):

It's better to just put them in the trash than flush them down the toilet IF you can't find someone to accept them for destruction.

The landfills are lined and any water coming thru from rain is collected and treated in some fashion. I would think the pills in the bottle will likely degrade quite a bit while compacted amongst all the other garbage, before it gets released to the environment.

If you flush it - it goes into the septic field or the sewage plant and then the river, without much degradation happening. If it CAN be quickly degraded by bacteria, it will happen somewhat while in the sewage plant...but we do have a lot of evidence of many chemicals leaving these treatment plants unaffected. Sewage plants are designed to break down and treat poop and related ingredients - not complex chemicals.

quote:

Originally posted by Marc1911:

In my opinion, drug takeback programs will not become mainstream until the pharmaceutical manufacturers agree to pay for them.

Short sighted to say the least. Burden the one making the big bucks. Ever read about asprin costing $25 a pill? As dispensed by the hospital? Its the big profit takers who don't want any of the costs associated with them. If they want to "earn" the big bucks, then burden them with the other costs as well. But they don't want that, they want the gross profits to pay their salaries.

No, I don't pour my old drugs down the toilet. But on my dresser I have a pill bottle with the remaining pain pill from the 1970s! Who knows if its still good or not. But if I get another kidney stone, I'll take it instead of suffering. It was prescribed for me, I paid for the doctors visit, and by God its mine. My wife is a nurse. She always fills her prescriptions, but only takes pain pills as needed. Which means usually not. I'm not paying to dispose of them, or dropping them at the PD so one of their clerks can trip out on them.

My personal care physician changes my meds constantly. This new guy tells me to take what's left before starting the new one. OK, maybe if I feel like it, or maybe not. I'm my own dispensing drug store. Stuff that gives me the shits almost never gets finished. I'd give that to the local druggie, just for fun. I don't take drugs that have side effects I don't like.

To summarize, our entire health care system is out of whack. Can't get the stuff you need without extreme effort and expense. If I pay it, I'm keeping it.

I'm not sure I understand your comment below. Are you saying that Hospitals and pharmacies are the ones making the big bucks and should pay for these programs as opposed to the drug companies (PhRma)??

quote:

Originally posted by rburg:

quote:

Originally posted by Marc1911:

In my opinion, drug takeback programs will not become mainstream until the pharmaceutical manufacturers agree to pay for them.

Short sighted to say the least. Burden the one making the big bucks. Ever read about asprin costing $25 a pill? As dispensed by the hospital? Its the big profit takers who don't want any of the costs associated with them. If they want to "earn" the big bucks, then burden them with the other costs as well. But they don't want that, they want the gross profits to pay their salaries.

No, I don't pour my old drugs down the toilet. But on my dresser I have a pill bottle with the remaining pain pill from the 1970s! Who knows if its still good or not. But if I get another kidney stone, I'll take it instead of suffering. It was prescribed for me, I paid for the doctors visit, and by God its mine. My wife is a nurse. She always fills her prescriptions, but only takes pain pills as needed. Which means usually not. I'm not paying to dispose of them, or dropping them at the PD so one of their clerks can trip out on them.

My personal care physician changes my meds constantly. This new guy tells me to take what's left before starting the new one. OK, maybe if I feel like it, or maybe not. I'm my own dispensing drug store. Stuff that gives me the shits almost never gets finished. I'd give that to the local druggie, just for fun. I don't take drugs that have side effects I don't like.

To summarize, our entire health care system is out of whack. Can't get the stuff you need without extreme effort and expense. If I pay it, I'm keeping it.

Call before you go, regarding epi pens and glass vials.

Seems that some places will not accept them

Instead of complicating things , just make a bonfire in the back yard and burn them .

When my Veterinarian Dad died, there were some narcotic medicines still around. I had to send them to a State agency for that kind of medicine. I forget what the official agency was.

You mean you don t feed them to the pigeons in the park?

quote:

Originally posted by RichardC:
You mean you don t feed them to the pigeons in the park?

Thanks for the memory of that.

Or give them to your pharmacy so they can flush them down Their toilet.

quote:

Originally posted by greco:
Or give them to your pharmacy so they can flush them down Their toilet.

They have to pay $$$ to send them to a .gov approved reverse disposal distributor. With documentation.

Where'd you get that " they can flush " idea?

^^^ I think he means we go to the effort of dropping them off at a correct spot, but don’t know for certain they truly get disposed of properly. I believe locally that some of the stuff we include in recycle bins, now ends up in landfills because recycling it has become too expensive. Meds are but one item on the list of things that can be hard to dispose of properly. Marine flares are a problem for me locally.

I don’t dump anything down the toilet, except that for which the toilet was designed. However, my policy is due to my concern over the proper operation of my toilet and the aging piping leading to the county sewer system.

No pun intended, but of all the shit to fret over in life!? The proper disposal of a relatively-small quantity of expired meds is not high on my list.

quote:

The proper disposal of a relatively-small quantity of expired meds is not high on my list.

yes in tiny town it is a "relatively - small " amount.

but add that to 756 tiny towns, and ten major cities throughout the Mississippi river catchment .
(Including the ohio and missouri rivers)

and you have got major problems, no not in tiny towns all over but in all the tributaries involved,

what happens in Des Moines does not stay in
Des Moines

How about goldfish? Can I still flush those?

quote:

Originally posted by darthfuster:
How about goldfish? Can I still flush those?

Only those on crystal meth