What happens to expired medications? A survey of community medication disposal

Improperly disposed-of expired medications pose a significant risk to children. To determine how expired medications are disposed of, 500 callers to our poison information center, 100 community and hospital pharmacies, the state Boards of Pharmacy, and the FDA and EPA were surveyed about medication disposal habits. Of the 500 people polled, 1.4% returned medications to a pharmacy, 54% disposed of medications in the garbage, 35.4% flushed medications down the toilet or sink, 7.2% did not dispose of medications, and 2% related they used all medications before expiration. Of the 100 pharmacies surveyed, all but 3% had specific policies on the disposal of undispensed expired medications, which were usually returned to the producer. Alternative disposal means used for nonreturnable medications were incineration (15%), hazardous waste disposal contracts (17%), and conventional solid waste disposal or down the toilet (68%). Only 5% of the 100 pharmacies had consistent recommendations for their customers on drug disposal; 25% of the pharmacies indicated questions on drug disposal were handled by individual pharmacists only upon consumer request. A variety of drug disposal techniques were encountered in our survey. Pharmacies had specific policies for expired undispensed pharmaceuticals, but lacked uniform guidelines. Little information on the safe disposal of medications was routinely passed on to the public. Uniform guidelines need to be created for the safe disposal of expired medications and should be included in routine consumer education provided by poison information centers and pharmacies.