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Medication Disposal

TakeAway - Iowa's Medication Disposal Program
Tips for Patients
Drug Specific Disposal Instructions
Needle and Sharps Disposal
Smart Disposal™ - APhA Initiative
Iowa Prescription Drug Donation Repository Program
Regulatory Bodies that Oversee Pharmaceutical Waste Management
Pharmaceutical Waste Management Resources
Reverse Distributors

 

Background

The discovery of pharmaceutical compounds in surface, ground, and drinking waters around the country has raised concerns about the potential adverse environmental consequences of these contaminants.  The consistent increase in the use of pharmaceuticals, driven by both drug development and our aging population, is creating a corresponding increase in the amount of pharmaceutical waste generated.  Unused and expired medication waste that is improperly disposed of can create potential environmental and health impacts.  Pharmacists are in a unique position to educate the public about this growing concern and what they can do to clean up our waters and help prevent fish and people from inadvertent exposure to prescription medication.

In addition to the endangerment to our environment, proper storage and medication disposal can help prevent diversion and abuse, or inadvertent use by children, the elderly, and pets.  Evidence has shown teens most often obtain prescription drugs from their friends’ and relatives’ medication cabinets because access is “free and easy”.  These are additional important reasons to properly dispose of medications that are expired or are no longer being used.

Tips for Patients

Just four simple steps can make a huge difference in safeguarding lives and protecting the environment:

  1. DO NOT FLUSH unused medications.
  1. Check for approved state and local collection programs or with area hazardous waste facilities.  In certain states, you may be able to take your unused medications to these sites or your community pharmacy.  The Iowa Pharmacy Association (IPA) has created a program that allows for non-controlled prescription and over-the-counter medications to be brought back to participating pharmacies. Click here to access the list of TakeAway® participating pharmacies and search by zip code; IPA is excited to have participation in all 99 counties in Iowa.
  1. If no medication collection program is available in your state, follow these steps.  When throwing away unused medications, ensure that you protect children and pets from potentially negative effects by crushing solid medications or dissolving them in water  and mixing them with kitty litter or a solid kitchen substance (such as coffee grounds), then placing them in a sealed plastic bag to reduce the risk of potential poisoning.  (The same applies to liquid medications.)  Also, remove and destroy ALL identifying personal information (prescription label) from medication containers.
  1. Consult your pharmacist with any questions. 

Disposal Procedure in Household Trash-Federal Guidelines

 

Drug Specific Disposal Instructions

Due to their abuse potential, the drugs listed below are the only medications the FDA condones flushing down the toilet.*

1.       Actiq lozenge (fentanyl citrate)

2.       Avinza capsules (morphine sulfate)

3.       Daytrana patch (methylhenidate)

4.       Demerol tablets and solution (meperidine HCL)

5.       Diastat/Diastat AcuDial rectal gel (diazepam)

6.       Dilaudid tablets and oral solution (hydromorphone HCL)

7.       Dolophine HCL tablets (methadone HCL)

8.       Duragesic ER patch (fentanyl)

9.       Embeda ER capsules (morphine sulfate; naltrexone HCL)

10.   Exalgo ER tablets (hydromorphone HCL)

11.   Fentora buccal tablets  (fentanyl citrate)

12.   Kadian ER capsules (morphine sulfate)

13.    Methadone HCL solution

14.   Methadose tablets (methadone HCL)

15.   Morphine sulfate immediate release tablets and oral solution

16.   MS Contin ER tablets (morphine sulfate)

17.   Onsolis buccal soluble film (fentanyl citrate)

18.   Opana immediate release and ER tablets (oxymorphone HCL)

19.   Oramorph sustained release tablets (morphine sulfate)

20.   Oxycontin ER tablets (oxycodone HCL)

21.   Percocet tablets (acetaminophen; oxycodone HCL)

22.   Percodan tablets (aspirin; oxycodone HCL)

23.   Xyrem oral solution (sodium oxybate)

 * Note: Patients should also refer to the printed material accompanying their medication for specific instructions.

Needle and Sharps Disposal

The FDA has outlined how to safely dispose of needles and sharps outside of the healthcare system.  Their website provides information for patients and providers on the disposal of sharps at home, work, and when traveling.  Click here to access the FDA website.  You can also try contacting your local waste authority to find out how to dispose of them locally.

Smart Disposal™

The American Pharmacists Association (APhA) and the U.S. Fish and Wildlife Service teamed up for an initiative in March of 2007 to protect the environment from improperly disposed of medications.  The Smart Disposal™ campaign is designed to raise public awareness of this issue and provide the American medication consumers alternative medication disposal routes instead of ‘flushing’ unused mediation.

APhA Press Release

US Fish and Wildlife Service

 

Iowa Prescription Drug Donation Repository Program

In 2005 the Iowa State Legislature passed House File 724 which allowed for the implementation of a Prescription Drug Donation Repository Program (PDDRP). The purpose of the program is to improve the health of low-income Iowans through a prescription drug donation repository that authorizes medical facilities and pharmacies to re-dispense prescription drugs and supplies that would otherwise be destroyed.

Any medication, except for controlled substances, may be donated if it is (1) “in its original sealed and tamper-evident packaging. However, a prescription drug in a single-unit dose or blister pack with the outside packaging opened may be accepted if the single-unit dose packaging remains intact. (2) The prescription drug bears an expiration date that is more than six months after the date the prescription drug was donated.”  Medications that are dispensed in traditional label and vial format cannot be donated.

Frequently Asked Questions    

Iowa Department of Public Health Rules on Prescription Drug Donation Repository Program

To Learn More contact Iowa Prescription Drug Corporation at 515-327-5405 or 1-866-282-5817.

 

Regulatory Bodies that Oversee Pharmaceutical Waste Management:

                   - Iowa Department of Natural Resources (IowaDNR)

                   - State Pharmacy Boards

§         Iowa Board of Pharmacy

State regulations, as compared to the federal regulations, may be more stern.  California, Washington, and Minnesota have more stringent hazardous waste regulations that impact pharmaceutical waste management. 

 

Pharmaceutical Waste Management Resources:

Premier, Inc.: This website will give you access to a webcast presentation on how to implement a pharmacy waste management system, a 10-step blueprint on managing this issue, and links to various useful tools and agencies who oversee this subject matter.

Iowa Department of Natural Resources (Iowa DNR)

 

Reverse Distributors

What are reverse distributors?

According to Iowa Code, reverse distributors are defined as, ‘the receipt of prescription drugs including controlled substances, whether received from Iowa locations or shipped to Iowa locations, for the purposes of destroying the drugs or returning the drugs to their original manufacturers or distributors.’  In other words, reverse distributors provide a method for pharmacies, hospitals, and wholesalers to return drug products for destruction and a potential credit from the manufacturer. It is important to note, some distributors destroy medications and other hazardous supplies only and do not provide credit.  Different Reverse Distributors may have different permits and accommodate the needs of different entities.

The regulatory bodies who oversee the reverse distribution process are the same regulatory bodies that govern pharmaceutical waste management (EPA, DEA, DOT, OSHA, etc). 

Reverse Distributor Companies

The major companies that dominate 85% of the reverse distributor market are:

However, there are a multitude of other smaller reverse distributors located throughout the U.S.  There is one reverse distributor located in the Des Moines area and the contact information for them is provided below:

Iowa:

National Pharmaceutical Returns, Inc.
4164 NW Urbandale Drive
Urbandale, IA 50322
1-800-470-7725 or 515-252-7722

Schedules: 1,2,3,3N,4,5

Guide – Choosing a Reverse Distributor

DEA Definition and Registration of Reverse Distributors

Federal Register Final Rule on Reverse Distributors

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