Medicine disposal

[JNF RN]

When we have a death we dispose of the liquid meds (morphine, lorazepam etc.) down the sink and the po meds down the toilet. What are some other methods that are used in your agency? Disposing into cat litter or coffee grounds are two other methods I have heard of. Right now our policy is to put them down the drain/toilet. I am not thrilled with this method. Thanks for your input.

[rnboysmom]

My only concern with returning meds to pharmacies are your local and state laws regarding transportation of medications. In some states, the only time a nurse or other entity can transport medications is when they come directly from pharmacy and are in a stapled or sealed bag with labels attached. If you are in the posession of an opened drug and are stopped on a traffic stop--what is the liability for your license? In our state, if you are stopped and your car is searched (and they can do this even on a speeding violation and especially if a drug dog sniffs the drug) and you are in posession of a drug that you personally do not have a script for, you can be jailed and charged with a felony---no questions asked and no time to offer explanation.

I like the idea of the dish detergent. I know one nurse at a company who carries a small container of "sac-crete" (sp?)(quick set concrete) and pours a small amount into a baggie with the medications and adds water. Our company still disposed into the septic system, but I wish we were more environmentally friendly. We supply all of our patients with disposal information.

[shrinky]

We used to flush but there have been traces of meds found in the water supply because the filtering methods don't necessarily filter drugs. We no longer flush and teach our families to use cat litter, coffee grounds or cayenne pepper added to liquid meds in a container and toss in the trash or burn if that's what they do with their trash. We give them an entire teaching sheet on how to dispose of meds in the home and go over ot with them on admission. Pills have to be melted in a liquid before adding to an above substance. It sure is time consuming, but I would rather have a clean water supply.:Crash:

[Higgs]

Er...throwing narcotics in the trash? Take it home? Nobody would want it? - I've had addicts route through sharps bins, take old fentanyl patches and lick them hairs and all. What about accounting for it?

Do you *really* trust your colleagues to be getting rid of them?

Dr Shipman was a British GP who killed many of his patients (http://en.wikipedia.org/wiki/Harold_shipman) by narcotic injection. He obtained his supply because at that time, when a patient died, the health care professional attending the body at home was trusted to dispose of the narcotics and then signed to say that it had been done. However, he signed to say they had been disposed of, but kept them and used them to kill other patients.

Because of this, the system was changed. The health care professional has to send it all back to a pharmacy and it's all counted in and signed for.

BTW, I met him the day before his arrest and he seemed like the kindest Doc ever.

[debblynn13]

We have been instructed that the medications are the patients meds and the family is to destroy them. We instruct the family to make a solution out of the pills and then mix it with kitty litter and throw in mess in the garbage. We still have them flush the fentanyl patches.

[redheadedvixen]

Since my agency purchases the narcotics we are responsible for the disposal and the kitty litter method is working well for us. We bring the bottles back to the office to dispose of them though.

[grbrico]

In our agency, we use quickcrete concrete, not sure of the resource... but from what I understand we are no longer to flush meds down the toliet or rinse down the drain due to chemical residue that cannot be filtered out during water treatment processes.

We discard of all narcs this way add to a baggie half filled with quickcrete, put in meds.. if the liquid meds are not enough moisture to activate the concrete then we add a wee bit of water.. squishy squishy and then throw in the trash.... We do the disposal infront of a family member witness that then signs the discard sheet stating that we destroyed the medications in front of them. It has both the nurses signature and that of a family member.