Have you ever wondered what to do with your prescription bottle/container that has some medication left? The U.S. Drug Enforcement Administration (DEA) periodically hosts National Prescription Drug Take-Back events where collection sites are set up in communities nationwide for safe disposal of prescription drugs. The Food and Drug Administration (FDA) has developed guidelines to dispose medication responsibly through the Take Back program. If people do not have access to that program, he or she can just throw out unused medications, but there is also a list known as the “flush list” where excess medicines from this list should be flushed for public safety. Product formulations listed on the most current version of the flush list contain the following 13 active pharmaceutical ingredients (APIs): buprenorphine, diazepam, fentanyl, hydrocodone, hydromorphone, meperidine, methadone, methylphenidate, morphine, oxycodone, oxymorphone, sodium oxybate, and tapentadol. Characterizing by their effects, the thirteen APIs can be broken down into one benzodiazepine (diazepam), one respiratory and central nervous system stimulant (methylphenidate), one central nervous system agent (sodium oxybate), and the remainder being opioids. Out of all items on the flush list, opioids are dominating the list. Perhaps it has been done so reduce the accidental ingestion by children. We are in the midst of opioid epidemic so quickly disposing excess opioids is highly recommended to avoid non-medical use of opioids by adolescents or accidental ingestion of sodium oxybate by children, which can result in rapid sedation. Pets are also at an elevated risk to these potentially hazardous medicines.
These APIs are listed in the flush list due to their severe toxicity and documented poison cases. But a large problem remains: even when flushed as it can remain in and poison our water system and soil. The effect of the existence of these APIs in the environment on human health is not yet fully understood, but researchers are assuming that this has a negative impact on health and are demanding an alternative to flushing these pharmaceutical ingredients.
Recently endocrine disrupting compounds are also found in the drinking water. And Drinking water which serves or about 28 million people were tested for fifty-one different kinds of drugs by Mark J. Benotti, Rebecca A. Trenholm, Brett J. Vanderford, Janie C. Holady, Benjamin D. Stanford and Shane A. Snyder. Water was contaminated with not only different kinds of drugs but also other organic compound which is definitely pose risk for plant or animal plankton, fish and human as well. Pharmaceutical compond such as atenolol, atrazine, carbamazepine, estrone, gemfibrozil, meprobamate, naproxen, phenytoin, sulfamethoxazole, TCEP, and trimethoprim were found. Researchers also stated :
“The typical compound concentrations were less than 10 ng/L for these top eleven with an exception for sulfamethoxazole at 12 ng/L, However, TCEP levels at one drinking water treatment plant was detected to be at an absurdly high level of 120 ng/L, showing wide variance in these concentrations. Atenolol, atrazine, DEET, estrone, meprobamate, and trimethoprim can also serve as indicator compounds to represent potential contamination from other pharmaceuticals and EDCs and can gauge the efficacy of treatment processes.”
As mentioned earlier, FDA suggested guidelines about disposing drugs in household trash. It says to mix the capsule/tablet with cat litter or used ground coffee and put the mixture in a sealed plastic bag. Any personal information on the medication must be scratched off before disposing the original medicine packaging container.
If anyone is interested to know how to dispose drugs, he or she may visit the following link.
A hot line is available for the consumer to provide information about disposal of drugs .Consumers may directly call 18008829539 to get DEA Office of Diversion Control’s Registration Call Center to reach the drug collector in the surrounding area. Although there is no evidence that the presence of in nature in significant amount and contributing to ecotoxicology, we hope that all our unused medication can be disposed and stored safely in certain areas so that they will not pose any threat to the environment or to the public.
Source:
https://www.ncbi.nlm.nih.gov/pubmed/28787777
https://www.sciencedirect.com/science/article/pii/S0048969717313773?via%3Dihub
https://pubs.acs.org/doi/abs/10.1021/es801845a