I usually go through all my medications during National Pharmacy Month in September since that’s when I usually remember to do so. It’s also the month I make time to reorganise my drug cupboard. However, this year I have seen many of you start off the new year by decluttering your homes and doing a little bit of “spring cleaning”.
If you are doing this then I definitely recommend going through your medicine box because if you are anything like me, you probably have lots of half used medications that have probably expired.
HOW SAFE ARE MEDICATIONS PAST THEIR EXPIRY DATE?
It seems an absolute waste to throw away medications that are unused or even only half used. Interestingly, a study done by the FDA found that most drugs are actually still safe and effective to use as many as 15 years past their expiry date.
The expiry date is really a guarantee from the manufacturer that the drug will maintain its full potency and effectiveness up until said date. The overall effectiveness of a drug depends on the potency of all its individual ingredients and how the drug is stored in your home. This makes it difficult to determine how long a drug will truly be effective for, outside of a controlled laboratory environment. This is why it’s better to just adhere to the expiry date and discard of your medicines once this date has been reached. You really don’t want to be giving your child a less potent antibiotic, which may result in antibiotic resistance, or a less potent antiepileptic and then your child develops a breakthrough seizure.
SAFE MEDICATION DISPOSAL – WHAT’S RECOMMENDED VS. THE REALITY
Worldwide, the recommended and safest way to dispose of medication is simply to return them to your pharmacy. In South Africa, this is actually the only recommended method of disposal. Pharmacies are by law required to take back your expired or unused medications. I do not know however how well this law is being enforced because as a healthcare professional I did not know about it. In fact on questioning some of my colleagues they confessed to simply just throwing their medications away with their general trash.
I am pretty sure many of us are guilty of this and in some countries it’s not totally wrong, if done properly. This is an alternative used in the US, if you are unable to take back the medication to the pharmacy. What you need to do first is try and disguise them so that they are less appealing to children and even pets if they come across them before you throw them away.
Remove all drugs from their original containers and blister packs and mix them with something like coffee grounds, sand or even kitty litter, this includes liquids. This helps disguise the medication. Put this mixture into a sealable bag and throw into the trash, preferably a bin outside of your house. It is not advisable to crush pills or empty capsules beforehand because of the risk of exposure to the drug through your skin and even by breathing in the dust. Drugs are usually released slowly into the body and by exposure through crushing the immediate dosage may be much higher than normal and can be toxic.
People also like to flush drugs down the drains and toilets, especially liquids. The problem with disposing of drugs in the trash or flushing them down the drain is that at some point they will end up in a landfill or a water system, where they can be harmful to the environment; plants, animals and even humans since they will inevitably find their way back into our food chain. Interestingly though, some medications do actually indirectly end up in our water systems, without us even realizing, since the drugs we take pass through our systems, and the byproducts are eventually excreted in our urine or faeces.
In the US again they actually do allow some drugs to be flushed down the drain if they cannot be taken back to a pharmacy. These are mostly your Opioids and its derivatives, as well as the Benzos such as Valium. The risk of these getting into the wrong hands far outweighs the negative effects on the environment.
There are some special considerations with inhalers. These devices use gases to propel the medication out of the canister. Unfortunately some of these gases are powerful greenhouse gases so these definitely need to be returned to the pharmacy because if not the canisters will end up on some landfill somewhere and continue to release these gases if not completely empty.
You can also check the packaging and drug information leaflets before disposing of the medication. There may be instructions for disposal of that particular drug. Apparently such guidelines are going to be implemented in South Africa in the near future.
IS MEDICATION PACKAGING RECYCLABLE ONCE EMPTY?
Some glass and plastic medicine bottles can be recycled depending on what type of glass and plastic resin they are made up of. The plastic parts of inhalers can usually be recycled. You should be able to confirm this with your local recycling plants. There are also lots of ways to repurpose old medicine bottles and get crafty with your little ones.
Blister packs are a little trickier because they are a combination of foil and plastic and are therefore not readily recycled in this form. You can however try to separate the parts by peeling away the foil carefully from the plastic (I actually tried this the other day and I found it almost impossible). But the plastic recycling may still be a problem because one can never (or rarely) identify the type of plastic resin used. The foil is readily recycled and so are the paper boxes that house the blister packs. Always remember to remove all personal identifiers on prescription labels before throwing packaging away.