If you’re like most of us, you have some old pills lurking in your medicine cabinet.
Maybe you had a procedure ages ago and your doctor gave you something to help with post-op pain. You took it for a couple of days, felt better, and now the leftover pills are still sitting in your medicine cabinet, likely expired. So how do you get rid of them: Flush them down the drain? Stuff them in the trash? Crush them?
Turns out, there’s no one right answer.
The short answer is that you can put most drugs in the garbage. For safety reasons, there are a few you can’t, including prescription pain pills.
It’s worth taking the trouble to get rid of pain medicines properly, especially the type called opioids like fentanyl, morphine, hydrocodone, methadone, and oxycodone.
There are two reasons: These drugs are among those most likely to be abused (crushed, chewed, snorted, injected, or otherwise ingested for the high). They also have a high risk for addiction and overdose, even from a single dose.
So you want to be sure that no one — including a child or pet — could get these drugs once you’ve gotten rid of them. Opioid poisonings in children are on the rise, especially in kids 5 and under, but any medicine can be dangerous.
Best option: Find a “take-back” site or mail-back program
The safest option, and the best for the environment, is to let the professionals dispose of drugs.
In particular, any controlled substance — and there are hundreds — needs to kept out of the wrong hands. For the average person, painkillers are the most likely controlled substance in the house. Here’s a full list from the Drug Enforcement Administration (DEA).
Depending on where you live, some states and cities have permanent prescription drug take-back sites, usually at hospitals, pharmacies, and police stations. Check this database at AwareRx (by the National Association of Boards of Pharmacy) for an approved location; note that not all take controlled substances.
The DEA also organizes local drug “take-back” events twice a year, usually in September and April. In the fall of 2015, the DEA’s annual National Prescription Drug Take-Back Day collected more than 700,000 pounds of unused, expired, or unwanted drugs from thousands of collection sites around the country. Check the DEA website or your local news for information on the next event.
If you can’t get to a collection site, there are also mail-back programs. Many pharmacies will sell envelopes you can fill and mail to a facility where they incinerate (burn) the drugs. They cost about $5 at CVS and other pharmacies.
(Any unused chemotherapy drugs should generally go back to the clinic you got them from.)
Next best option: Flush it
If you don’t have an authorized collector near you and there’s no take-back event coming up, you can get rid of high-risk drugs by flushing them (pain pills and other high-risk drugs). As soon as you know you don’t need the drugs anymore, get rid of them this way, ASAP. (See this list from the FDA for flushable drugs.)
This doesn’t just apply to pills and capsules; fentanyl, for example, comes in a patch and these should also be flushed immediately after use (even used patches contain a lot of the drug).
Next best option: Trash it
Environmentally, it’s not ideal but you can throw some medicines in the trash. (Anything not on this list.)
For medications that can go into the garbage, the FDA recommends that you:
- Do not crush capsules or tablets.
- Mix the drug with something unsavory, like dirt, food remnants, kitty litter, or coffee grounds, then place the mixture in a sealed bag.
- Dispose of the bottle or other container, too, but first remove all identifying information on containers, including the drug name and your personal information.
Could Flushing Drugs Down the Toilet Hurt the Environment or Other People?
It may seem as if you’re putting some pretty powerful chemicals into the water supply when you put a drug down your plumbing. The levels of pharmaceuticals in drinking water are generally low and not known to harm public health, though future research could change that view. (It’s worth remembering that that after we take drugs, much of them eventually go down the toilet.)
Similarly, the agency says the effects on the environment are not thought to be of concern right now, but it recommends giving any unused medication to an authorized collector or at a take-back event as the most ecologically sound way to get rid of leftover drugs.
If someone ever takes any medicine by mistake, immediately call 911. For more information on safe medicine disposal, contact the free national Poison Help at 1-800-222-1222 (operated by the American Association of Poison Control Centers).
Editor: Deepi Brar
Lorie Parch is a health journalist based in Long Beach, California.
US Food and Drug Administration (FDA). Disposal of Unused Medicines: What You Should Know. FDA.gov
US Environmental Protection Agency (EPA). Collecting and Disposing of Unwanted Medicines. EPA.gov.
Nova Next. The Complicated Question of Drugs in the Water. PBS.org.
Harvard Health Letter. Drugs In the Water. Harvard Health Publications.