ICHP Position Statement - Disposal of Unused and Expired Patient Home Medications and Supplies

The Illinois Council of Health-System Pharmacists (ICHP) supports the recommendations of the United States Food and Drug Administration (FDA) regarding the handling of unused and/or expired patient home medications.

  1. Unused and expired medications generally should not be flushed down the toilet or poured down sink drains into local sanitary waste treatment systems, in order to reduce introduction of pharmaceuticals into the water supply and the environment.1
    1. Check for approved state and local collection programs, nearby hazardous waste facilities, or commercial drug takeback options (See Resources below). Consider available mail back program options, when available and feasible. 
    2. Remove and destroy all identifying personal information from the medication container before dropping them off.
  2. If a take back program or approved disposal container is not available, unused medications should be disposed of in a manner that protects children and pets from potential harm (e.g., drug overdose, poisoning).2 ICHP recommends that consumers (i.e., ultimate users) should consider the following:
    1. Consult with the pharmacist.  As the medication expert on the healthcare team, the pharmacist is available to provide guidance on how to properly dispose of unused medications.
    2. Remove and destroy all identifying personal information from the medication container before disposal.
    3. Follow the Food and Drug Administration (FDA) recommendations for safe medication disposal instructions (See Resources below).
    4. Check for FDA's Flush List of medications that can be flushed  down the toilet if a take back program is not available (See Resources below).

ICHP also supports:

1. Development and expansion of programs for safe medication disposal to increase access to patients.
2. Government entities assuming the responsibility for implementation and associated costs of safe medication disposal programs.
3. Development of educational programs for health professionals and consumers on the proper handling and disposal of pharmaceuticals, unique dosage forms (i.e., inhaler products or aerosols, adhesive skin patches, oral suspensions), and associated supplies and materials (e.g., contaminated hypodermic needles and syringes).

Resources:

- National Prescription Takeback Day information:
https://www.deadiversion.usdoj.gov/drug_disposal/takeback/index.html
- Look up Local Drug Disposal locations:
https://www.fda.gov/drugs/disposal-unused-medicines-what-you-should-know/drug-disposal-drug-take-back-locations
- Look up Public Controlled Substance Disposal locations: https://apps2.deadiversion.usdoj.gov/pubdispsearch/spring/main;jsessionid=O_W09rUm6eTYKc_fXhFhymBJ7ONzzaBhg3V8xGUQ.web2?execution=e1s1
- FDA: https://www.fda.gov/drugs/safe-disposal-medicines/disposal-unused-medicines-what-you-should-know
- Medication Flush List: https://www.fda.gov/drugs/disposal-unused-medicines-what-you-should-know/drug-disposal-fdas-flush-list-certain-medicines#FlushList

Revised 4/27/21

References:

1. Kolpin DW, Furlong ET, Meyer MT, et al. Pharmaceuticals, Hormones, and Other Organic Wastewater Contaminants in U.S. Streams, 1999−2000: A National Reconnaissance. Environ Sci Technol. 2002;36(6):1202-1211. doi:10.1021/es011055j

2. Lawrence AE, Carsel AJ, Leonhart KL, et al. Effect of Drug Disposal Bag Provision on Proper Disposal of Unused Opioids by Families of Pediatric Surgical Patients: A Randomized Clinical Trial. JAMA Pediatr. 2019;173(8):e191695-e191695. doi:10.1001/jamapediatrics.2019.1695