Flowers & Power: What to do with old medications? A new study says put ‘em in the trash

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What should I do with that old bottle of seasickness medication rattling around in a drawer in my bathroom? The expiration date passed long ago, and it’s been at the bottom of the drawer for so long that the label is illegible.


By some estimates, more than 200 million pounds of pharmaceuticals go unused in the U.S. each year, including everything from Tylenol to arthritis medications. Keeping these pills around the house isn’t a good idea, and not only because you’re sick of moving the bottle to find your nail clippers, like I am. Getting leftover drugs out of the medicine cabinet can reduce the risks of abuse and accidental poisoning.


Should I toss the pills in the trash? Flush them down the toilet? Drive to a local pharmacy with a take-back program to have them incinerated with other medical waste? A new study in Environmental Science & Technology says dropping them in the waste bin might be best.


Steven J. Skerlos and his colleagues write in ES&T that the hard part of getting rid of unwanted drugs is finding a good balance between release of APIs (“active pharmaceutical ingredients,” the compounds that make medicines work), which could harm people and animals out in the environment, and non-API releases like air pollution produced by transportation and incineration.


On one end of the spectrum, they found that flushing leftover pills is the best way to reduce non-API releases, because it doesn’t even require a garbage truck to carry the drugs to the landfill. It does, however, produce the most drug-related releases, because many of the compounds in the medicines go through wastewater treatment plants into rivers and lakes.


On the other end of the spectrum, the group says the best way to keep active ingredients out of the environment is incineration, at the cost of more air pollution. However, they cite studies showing participation rates in take-back programs, which incinerate the drugs, are usually less than 50 percent. The group says a national participation rate of 50 percent in a take-back program, considered to be a high level, would reduce releases of drugs by 93 percent. Besides a low participation rate and more air pollution, another downside of take-back programs is the expense of putting these programs into place at a national scale (about $2 billion each year).


An all-trash disposal program on its own would reduce API releases by 88 percent because most of the compounds are absorbed and retained in landfills. It produces more air pollution than flushing, from the garbage trucks that haul our trash, but much less than take-back programs.


The group says since 60 percent of Americans already put their pills in the trash, that’s probably the best option for reducing the numbers of drug compounds that make into the environment while keeping other pollution and costs low.


What do you do with your unwanted medications? Have you ever used a take-back program? Are you comfortable with trashing your meds, even though they might make it into the environment?


“Life Cycle Comparison of Environmental Emissions from Unused Pharmaceutical Disposal Options” Envir...

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