Destroying medications

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At the facility where I work, the DON and policy states we are to crush all discarded or expired medication, 2 nurses sign off and flush down the toilet. All patches are to be wrapped in TP and flushed. Isn't this illegal ? I work in IL. I feel like I'm contaminating our water. What should I do if anything? I'm not an organic freak- but this bothers me.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

This method of discarding unused medications is common in the long-term care setting.

Wastewater gets treated so that contaminants are removed. There are worse things in wastewater than unused medications. I'm thinking of urine, fecal matter, menstrual blood, poopy toilet paper, skin cells, suds from our showers and baths, old dishwater, rotting food particles, and many more amazing things.

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Specializes in Med-Surg, Emergency, CEN.

We had that changed a bit here. Now we pour it out into the garbage or crush and waste it into the sharps container.

0.5ml into the garbage doesn't make it easy for anyone to get even if they lick the garbage.

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Yes I know there are worse things. Your reply is annoying and u didnt answer the question. Think back to phosphates used in detergent and what it did to lakes and ponds with the overgrowth of seaweed & algae. There are consciences to this flushing medication that treatment plants can't remove or the chemicals used to remove agents flushed.

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Specializes in Nurse Leader specializing in Labor & Delivery.

Annoying. Huh.

We waste IV push meds in the sink, unless they're a "black" med (I don't know what constitutes a "black med" but they have a list), and then we dispose of them in a black box that looks like a sharps container that's mounted on the wall of our med room. I've never had to throw away pills, but I would feel more comfortable crushing and flushing than just tossing in the trash.

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Yes annoying. Warfarin is a black box med and its crushed and flushed. To each his own. Water is the source of life that we can't live w/o.

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Medication Disposal Disposal of Unwanted or Unused Pharmaceuticals Fact Sheet Disposal of unused or unwanted pharmaceuticals is an emerging and complex environmental issue. http://www.epa.state.il.us/land/hazardous-waste/household-haz-waste/pharmaceuticals-disposal.html

The Illinois Environmental Protection Agency is working with various stakeholders to find convenient and environmentally responsible ways for residents to manage waste pharmaceuticals. Waste pharmaceuticals include a wide variety of items, including over-the-counter and prescription medications.

These wastes come in the form of solid pills and capsules, creams, liquids and aerosols. Many pharmaceuticals intended for pets are similar or identical to those prescribed to humans and should be treated exactly the same. Recent United States Geological Survey studies have found traces of painkillers, estrogen, antidepressants, blood-pressure medicines, etc. in water samples from 30 states. Studies have linked hormone exposure to reproductive defects in fish, and environmental exposure to antibiotics to the development of drug-resistant germs.

Don't Flush! The age-old advice of flushing pharmaceuticals down the toilet is now considered to be the least desirable of all alternatives. For many years many households and businesses have gotten into the habit of flushing waste pharmaceuticals down the toilet or pouring them down the drain because it is low cost and appears to be the simplest way to prevent unintended use or other diversion. However, wastewater treatment plants and septic systems are generally not designed to treat pharmaceutical waste. So don't flush your waste drugs! Residents are advised to save all old or unwanted medications for an Illinois EPA-sponsored household hazardous waste collection.

In addition, the Illinois EPA is partnering with many counties to sponsor dedicated collections for old/unwanted pharmaceuticals. Illinois EPA Recommended Handling/Disposal Options for Households Reduce pharmaceutical waste whenever possible: Use all antibiotics as prescribed by your doctor. Not using all doses of an antibiotic could lead to development of antibiotic resistant strains of bacteria. Buy only as much as can reasonably be used before the expiration date.

For example, don't buy 500 aspirin just because it's cheaper, unless you will use them all. When your doctor prescribes a new medication, ask the doctor to prescribe only enough to see if the medication will work for you and in the lowest dose advisable. That way, if the medication doesn't suit you, there is less to waste. Do the same for your pet's medications. Dispose of the remainder properly.

Whenever possible, take your unused pharmaceuticals to a pharmaceutical collection program or household hazardous waste collection event. If a collection program does not exist in your area, encourage your health care provider, local governments and local law enforcement to develop one.

Note: If you choose to store your waste while you wait for a pharmaceutical collection event to occur, please minimize the risk of accidental poisoning, overdose or diversion (illegal use by someone other than the intended person) by storing medications out of reach of children or in a locked cabinet.

Dispose of your unused pharmaceuticals in the trash. Especially when there is a risk of accidental poisoning, overdose or diversion, it is better to dispose of household pharmaceuticals than to hang onto them.

When placing unused pharmaceuticals in the trash, be sure to do the following: remove or mark over all labels that identify the materials as pharmaceuticals or that could provide personal information about you, including prescription information that someone could try to refill; render them unattractive to children and thieves by dissolving them in a small amount of water or alcohol, or by grinding them up and mixing them with coffee grounds or kitty litter; and put them in a second container or small plastic bag and and hide them in your trash. Never burn pharmaceuticals or personal care products in a burn barrel. Uncontrolled burning can create dioxins and other air pollutants.

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Found my own answer. :)

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Specializes in Emergency, Telemetry, Transplant.

We recently got an email at work that included the line "remember, all wastes are to be down down the sink." I usually put my unused portions of narcs into the sharps bin.

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Specializes in Emergency, Telemetry, Transplant.
Yes annoying. Warfarin is a black box med and its crushed and flushed. To each his own. Water is the source of life that we can't live w/o.

I think the person who brought up "black" meds was not referring to black box meds, but rather meds which require a special waste procedure.

Could be wrong, but I don't think they meant black box med.

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Specializes in Nurse Leader specializing in Labor & Delivery.

I don't know what a "black box med" is. All I know is that in our department, certain meds have to be disposed of into the black box, rather than the trash or sink. If that makes them "black box meds" then I guess they are. When I go in to work this afternoon, I'll look at the box and the instructions next to it and see what they say. I work in OB, so there aren't too many meds that we use, and I've never had to dispose of a med in the black box.

Just looked at the definition online - no, I didn't mean "black box meds" I just meant meds that have to be disposed of in a special way. I'm guessing it would be chemo drugs, that type of thing.

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