Pharmaceutical waste and disposal in the United States: Nurses' perspective

Nurses are concerned about waste pharmaceuticals and associated disposal practices of the general public. Waste pharmaceuticals are medications that are unused for reasons including past expiration date, no longer required, allergic reaction, ineffective, patient's death and others. Nurses are frequently asked how to dispose of pharmaceuticals by their patients, family members and acquaintances. Historically, the easy answer was to spill these pharmaceuticals down the sink or flush down the commode. These are no longer viable options. Waste pharmaceuticals, when flushed down the drain, threaten the nation's drinking water, impact fresh water aquatic life and human health. Trace amounts of antibiotics, hormones and anti-depressants have been found in bodies of water and in wild life in the United States. Another common practice is to keep the unneeded pharmaceuticals in a medicine cabinet or other unsecured storage place. This practice is extremely dangerous. Children, persons with altered mental status, the developmentally disabled, drug addicts, adolescents seeking an easy, inexpensive high, and pets often find these pharmaceuticals and ingest them. In the absence of an available drug take-back program, the Federal government currently recommends bagging waste pharmaceuticals in kitty litter or coffee grounds into a plastic bag and throwing the plastic bag out with the household garbage, unless the pharmaceutical label specifically recommends flushing. Disposing of medications utilizing plastic bags is not a sustainable or ultimately secure solution. Nurses want improved, more secure sustainable options for pharmaceutical waste and are taking action to develop policy and programs. Solutions addressing more efficient pharmaceutical prescribing, recyclable pharmaceutical packaging and convenient secure drug take-back programs are being discussed. Nurses are asking that drug take-back programs be financed and provided by pharmaceutical manufacturers. Nurses are spearheading successful drug take-back events. These events occur through consortiums of interested agencies and organizations and involve intense coordination and advertising to ensure success. Nurse legislators are bringing these issues to their state and federal colleagues' attention. Nurses and the entire public health community need to become educated in this conversation by working with the appropriate government agencies, then devising and practicing safe, reliable, sustainable pharmaceutical waste disposal options.