Disposing of medications at time of death

[RubyRN,CHPN]

I was approached this week by a former colleague with a question. I thought I'd throw it to the experts:

Is it becoming common at time of death for hospice nurse to release unused narcotics to funeral home/director to give to coroner's office for disposal? Have you seen this done at your hospice or know of a hospice where this is being done? What is your policy?

[TazziRN, RN]

In the hospital we had containers similar to sharps containers in racks on the wall, that all meds were wasted into. Meds only, nothing else. Nothing was to be poured down the sink or flushed.

The fish are mutating.

Here's something that we teach our home health pts to do: put hot water into the pill containers, tape the lids on securely, and shake, then toss in the trash.

[herring_RN, ASN, BSN]

When my Dad died almost ten years ago the hospice nurse took the unopened medications with her, fentanyl patches and such.

The opened ones she put down the garbage disposal.

Nor our hospital has one was containers for medication.

And a big one outside. It could be accessed from the passenger side of a car - just dump it in and can't get it out.

I don't want medication in the water.

[marachne]

I think it's a message we really need to get out to patients, anyone we know really, that we all need to be conscious of how we dispose of medications.

[leslie :-D]

But it still gets to the same question: how does the housekeeper then dispose of it? Is it still going down a drain somewhere?

absolutely not.

he either ships it, maintenance drops it off to an approved medical-wastes site.

we do have a contract w/one where we can mail all sharps contents.

leslie

[rockchalk_jayhawk]

our preferred method of disposing of medication, after counting such medication with a family member or nurse, is using cat litter. if its a liquid medication, just pour it into the cat litter. mix it up and dispose in the trash. if it is tablet form you can still do the same but mix a little water in it. coffee grounds work well also, but not much of a deterrent as they are edible. cat litter is not. and no worries about them going into our water supply. (but if you think about it going to your local landfill, it could leach into the ground water supply.) if you think about this too long, there is no "perfect" solution. good luck.

[aimeee, BSN, RN]

our preferred method of disposing of medication, after counting such medication with a family member or nurse, is using cat litter. if its a liquid medication, just pour it into the cat litter. mix it up and dispose in the trash. if it is tablet form you can still do the same but mix a little water in it. coffee grounds work well also, but not much of a deterrent as they are edible. cat litter is not. and no worries about them going into our water supply. (but if you think about it going to your local landfill, it could leach into the ground water supply.) if you think about this too long, there is no "perfect" solution. good luck.

this is our method now as well. we follow the federal guidelines:

http://www.whitehousedrugpolicy.gov/drugfact/factsht/proper_disposal.html

[czyja, MSN, RN]

I wonder, though, if opioids persist in the environment. They are "natural" substances or analogs of natural substances so it seems that they would degrade with relative ease.

As for the cat litter - if it will get one high rest assured an addict somewhere will try it! The problem for the addict is finding the "good" kitty litter amidst the bad LOL.

[Mimi2RN, ASN, RN]

All our wasted meds and IV fluids/tubing at the hospital go into big pharmacy waste containers. When full, they are sealed on the unit and eventually will be incinerated.

I wish that all these prescription meds could somehow be redistributed to people who really need and can't afford them.

I like the kitty litter idea! That's a wonderful extra use.

[BlueRidgeHomeRN]

although our p&p doesn't cite the method in which we are to dispose, it only states that 2 rn's are required.

over the yrs, we were wasting down the sink/toilet.

but now, contamination is a concern.

now, we're disposing everything in our sharps containers.

we discard solutions in there (not the vials/bottles, only solution);

crush pills then discard into sharps;

and cut up patches into little pieces then discard.

most everyone seems to be satisfied with this method.

leslie

leslie...

no way!!!

this just came up at a conference...do we want junkies to root thru sharps containers for oxcontin??? hep b and hiv, here we come!!

her in va, we crush, mix with kitty litter, and double bag.

[leslie :-D]

blue, there's nothing detectable in the sharps.

last yr i had asked about using kitty litter....

the dir gave some unintelligible excuse about a homeless person eating it...

not sure of specifics, but it deterred the facility from using this method.

leslie

[BlueRidgeHomeRN]

blue, there's nothing detectable in the sharps.

last yr i had asked about using kitty litter....

the dir gave some unintelligible excuse about a homeless person eating it...

not sure of specifics, but it deterred the facility from using this method.

leslie

yea, i guess it's different in facilities that have waste removal companies.

this came up in reference to home settings....where sharps in coffee cans and laundry det. bottles go with the general trash. if word got out, there'd be drug seekers in the trash looking for a fix...not healthy.

the cheap kitty litter is pretty inedible.

guess there is no good answer---so terrible we can't donate to third world missions who could do so much good with them...

[aimeee, BSN, RN]

so terrible we can't donate to third world missions who could do so much good with them...

that is what bugs the heck out of me. the hospices in africa have to charge their patients (most of whom have next to nothing) for morphine (if they can even get what they need) and here we are dumping it out right and left. it is so wrong.