Destroying medications

[nurseywifeymommy1]

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.

[noyesno, MSN, APRN, NP]

The pharmacist at my hospital said: since we pee out the byproducts of the drugs, flushing them down the toilet is no biggy.

We're suppose to put coumadin wrappers in the black box thing. Nobody does it. Therefore, our drinking water may have coumadin in it. Blood clot prevention at it's finest.

[tewdles, RN]

Hospice destroys medications in patient homes all of the time. We do not flush them.

We contaminate them with something noxious and place them in the trash.

Common things used are used coffee grounds, kitty litter, soiled briefs. Most of the hospice staff will add the meds to one of the above and may also add other things to make it more "gross", like detergents, etc.

There is a problem with putting many of these chemicals into our ground and waste water, IMHO.

[Tait, MSN, RN]

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.

The only thing in that list that I find unnatural or offensive would be soap from baths and dishwater. Everything else is common in waste water and nature. I am in support of options that allow medications to be wasted but not passed on to the environment, because essentially we are just looking for a way to keep people from abusing them, which to me involves contaminating them as previous posters have mentioned.

It is true, in response to another poster, that many medications are excreted into waste, however I don't feel this is a valid argument for adding even more of the medication into the environment.

Tait

[NutmeggeRN, BSN]

Not everyone lives where there is a waste water treatment system. Many folks in rural area have septic systems and that stuff does leak into the environment.

[chrisrn24]

I agree that flushing them isn't the best thing. Why can't you put them in sharps or contaminate them with something?

[TheCommuter, BSN, RN]

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.

Your thread has been moved to the Geriatric/LTC forum, which is more appropriate for your query.

Keep in mind that once you ask any question on these forums, you might very well find that some (or all) of the answers provided are 'annoying' or too inadequate to answer your inquiry. I am pleased you found the answer to your own question. Good luck to you.

[CrunchRN, ADN, RN]

On a related note in my area it is almost impossible to find any pharmacy that has a program to take expired meds for disposal and if they do (walmart) you have to pay fees for the program. My own husband gave up in frustration when he was trying to properly dispose of expired meds.

[CapeCodMermaid, RN]

I dissolve the meds in hot water then mix in thickit or kitty litter and throw everything away in the trash. After years of living on the Cape where there was a sole source aquifer, we got very careful about what we flushed.

There have been countless studies done on chemicals in our drinking water, waste treatment plants or not.

[wyogypsy, RN]

At the LTC facility where I work now, all unused medications get returned to the pharmacy. They have a program where they donate what they can, and properly waste the remainder. When I worked at Hospice we took a sharps container, put some hot water in the bottom, and added all meds to be wasted. We then added a bottle of this thickit stuff, sealed the lid, and shook it. It didn't take long for it to be like cement. It then went with the biohazard waste to be properly disposed of.

Flushing medications, or putting them down the sink, is no longer a safe method of disposal. I do feel sorry for patients who have personal meds to waste with seemingly nowhere to take them. Luckily our police department offers a program twice yearly where everyone can take any meds that need destroyed.

[Nascar nurse, ASN, RN]

Instant | Effective | Safe ... Drug Disposal System by C2R Global Manufacturing Mukwonago WI

Check this site out....these containers worked great at my last facility. Now to talk my new facility into using them. You can even cut up Fentanyl patches into smaller pieces and dispose of them as well. The stuff smells like ammonia and other chemicals - no one would want to try and pull something out of the jug.

[paRN12]

At the facility I work at, we put the medication in a cup with hot water and then put paper towels in the cup (once the meds are dissolved) to soak everything up and then we throw it out.

[laderalis]

We use the Drug Buster too. It reeks, but is safer and easier. We mostly put used fentanyl patches in them.