How do you waste medications?

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We are all aware of the controversy about medications in our water supply, especially after the AP's report earlier this year. What I (and other nurses I work with) want to know is this: How do YOU waste medications? What kind of meds are they? What kind of a facility do you work in? Where are you located? Are there state laws in your area that mandate a certain practice? And, what would you, if you could, do to improve the wasting of meds in your facility?

I know, this is a broad-ranged question, but it would be SO GOOD to know what we are all doing, and to see what Nurses can do to make a difference! :loveya:

Specializes in Cardiac.

I dump all liquid meds (versed, fentanyl) down the sink. I don't waste many controlled pills. If I had to, I'd toss them into the needle box.

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When I worked in LTC, we sent meds back to the pharm. They wouldn't accept narcs back, so we wasted them by flushing down the toilet or in a sink. Never have run into the need to get involved with this in home health. The family usually just keeps the meds that have been discontinued.

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Specializes in Ortho, Neuro, Detox, Tele.

regular pills go in the trash..I personally put them in the sharps container.....

Narcotics go in the sink....or sharps...

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Specializes in Staff nurse.

It all goes down the sink in our med room, to the "sewer rats". I used to put wasted pills in the sharps until we were told some employees were wading thru the sharps for the pills.

There has to be a better, safer way, but until there's evidence based practice, I'll make the sewer rats happy.

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Turtle, I am just curious. No study---yet. But, I do think one is warranted. Perhaps there should be legislation mandating appropriate disposal. All facilities I have worked with---hospitals, nursing homes, home health--all are wasting down the drain, in the trash, or in a sharps container. I have inquired at several facilities and from different states, and have found it to be the same. I hear--second hand---that it is the same in Canada. (I'm in the US.)

Thanks for sharing your experience and thoughts!

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I want to thank all of you for contributing your thoughts and experiences. As I told Turtle in Scrubs, we aren't conducting a study, although it sounds like it would be a good idea. I AM unofficially collecting data to support my passion for the environmental concerns that are raised from our expeience with wasting meds, coupled with the recent media attention there is to this issue. If you could tell me where you live and what kind of facility you work in, I could get a better idea of what is going on where. I think all of us as nurses have, collectively, a HUGE voice and the ability to protect the public from massive amounts of waste going into the water supply. I know a couple of you have responded that you heard that the drugs in the water are coming from excetions---that is what was reported in the AP report earlier, in March of this year. However, when talking with John Q Public, I am finding that nobody understands that hospitals and other facilities routinely waste into the water supply. Hospice nurse organizations often have to flush down the toilet with the deceased's family and in home health, meds are wasted down the sink/toilet. Excretions may account for a percentage of the pharmaceuticals in the water supply, but I think a whole lot is also coming from our health care systems. So, Ladies and Gents, if you could help me undersand more of this issue, we can begin to make a difference!! Thank you to all who are responding!!:yeah:

And, if you are reading this PLEASE RESPOND!!! The number of responses is useful data, and is as important as the response itself. I.e, we can see the number of people/places/facilities doing the same practice---or not---so your response really matters, even if it's already been said!!!!

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I'm not really consistent about this - depends on where I'm standing, I might waste into the sink, trash or sharps. Big volume PCA's always get wasted into the sink. This is a large urban hospital. When I go in I will see what the actual policy is, because I don't really know.

Is there a best way to waste? Doesn't trash end up in landfill and eventually seep into ground water?

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Specializes in ER.
My understanding is that the meds in the water supplies primarily come from urine. The water prusification proceses can't filter the meds out so it ends up back in the drinking supply.

:barf02:YUCK!!!!

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I'm not really consistent about this - depends on where I'm standing, I might waste into the sink, trash or sharps. Big volume PCA's always get wasted into the sink. This is a large urban hospital. When I go in I will see what the actual policy is, because I don't really know.

Is there a best way to waste? Doesn't trash end up in landfill and eventually seep into ground water?

Don't most hospitals have incinerators? That would solve the problem of addict digging through trash or sharps, too.

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does your hospital have a policy on the proper disposal of medications?

several government agencies (epa, etc.), state epa, and professional organizations (american pharmacist association) have developed guidelines for medication disposal.

most of these guidelines address disposal in the home. perhaps these guidelines are not binding on healthcare organizations (??) one would need to refer to their STATE epa for that information.

a search of "disposal of medications" yields a number of states that have weighed in on this issue.

it's interesting that Canada already has a NATIONAL program in place.

http://www.whitehousedrugpolicy.gov/publications/pdf/prescrip_disposal.pdf

http://www.smarxtdisposal.net/index.html

the guidelines are consistent across the board. hope these links are helpful.

imho, we should be taking steps to prevent further contamination of our waters by unused meds.

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Specializes in LTC, Med-Surg.

I'm currently an LPN in a LTC facility. Right now, anything that is not a narcotic is sent back to the pharmacy if it needs to be wasted (resident deceased, discharge or med discontinued or changed, etc) and we flush the narcotics. Two nurses have to sign off on a form that the narcotic is being wasted and both have to present when it's flushed, etc. However, our county passed legislation this year on narcotic and prescription drug wasting and started a new program to discourage this practice of flushing meds. Soon, we will be storing wasted narcs in a special container that is locked in a cabinet in the DON's office, to which only the DON has a key. Once a month, the container will be taken to the county waste management facility, where the pills, liquids, creams, etc, are dissolved into 55 gallon barrels of solvent. Then these barrels will be taken to a special hazardous incinerator in St. Louis to be disposed of properly. This program is available to the public as well as health care facilities; so people who do not want to flush or throw away old or expired meds can bring them on specific days to the waste management facility. The staff that will be overseeing this process are specially trained and are actually deputized by the county for this purpose. I think it's going to be a great boon for this issue, especially considering how close my community is to the Mississippi and other rivers. I'm really proud we've taken this step.

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You know, I guess if ya **** (pee) and moan long enough, things finally get changed! I kept telling our supervisor that flushing wasted meds was NOT an environmentally sound option! Never has been! I initiated the use of an empty pop bottle, fill it with the pills, top of with water, make sure they dissolve and into the trash. Still not a perfect solution. This brings me to a serious medication dilema I have regarding storage of meds not being used......I will start a new thread.....please join me there. I need support and feedback!

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