I heard somewhere that flushing pills

begalli · Mar 12, 2005

What would be a good, safe, legal alternative?

Put them in a sharps container.

In Janurary we began disposing of ALL medications in fluid form in a sharps container - bag and all. We usually waste or return drugs in solid form or in bottles or vials to pixis.

One day I came into work and found these giant 3 foot tall and 2 foot wide sharps containers on wheels in every room. I was informed that we can no longer dispose any IV fluid other than normal saline down the sink. So now when we d/c a drip or a fluid the entire contents of the bag goes into this giant sharps container....even maintanence fluid like D5.2NS.

Environmental studies have shown traces of drugs (heparin, amio, epi, morphine, etc) showing up in the waters of the San Francisco Bay.

Home Health Columnist / Guide · Mar 12, 2005

But what about my homecare patinets? No sharps in the home to dispose of expired or discontinued drugs.

pickledpepperRN · Mar 12, 2005

I took a CE class yesterday. A nurse from another county said they were told at a staff meeting the EPA does not allow hospitals to put medication down the drain. Neither flushing pills nor draining IV bags in the sink.

We still empty unused IVs in the sink - Dopamine, NTG, Heparin, TPN, and all.

Does anyone know about this?

begalli · Mar 12, 2005

Does anyone know about this?

Yep. See my post above.

Let me see if I can find something about this online.

stevierae · Mar 12, 2005

You know, I am concerned about wasting perfectly good pills when patients die in hospice, homecare, or nursing homes. (I know, this is a separate issue than flushing expired or refused pills.)

I would like to encourage folks who work in such situations where terminal or elderly people die to call their local AIDS organizations. Not all will accept someone else's prescritions, but many, many will---and particularly the ones for p.o. narcotics or the many antiretrovirals that AIDS patients take that are very, very expensive---particularly for those that are disabled and have no health insurance.

lsyorke, RN · Mar 12, 2005

Interesting topic!

This came out a few months ago.

Report: Prozac Found in Britain's Drinking Water

LONDON (Reuters) - Traces of the anti-depressant Prozac have been found in Britain's drinking water supply, setting off alarm bells with environmentalists concerned about potentially toxic effects.

The Observer newspaper said Sunday that a report by the government's environment watchdog found Prozac was building up in river systems and groundwater used for drinking supplies.

The exact quantity of Prozac in the drinking water was unknown, but the Environment Agency's report concluded Prozac could be potentially toxic in the water table.

Experts say that Prozac finds its way into rivers and water systems from treated sewage water, and some believe the drugs could affect reproductive ability.

A spokesman for Britain's Drinking Water Inspectorate said Prozac was likely to be found in a considerably watered down form that was unlikely to pose a health risk.

"It is extremely unlikely that there is a risk, as such drugs are excreted in very low concentrations," the spokesman said. "Advanced treatment processes installed for pesticide removal are effective in removing drug residues."

But environmentalists called for an urgent investigation into the findings.

Norman Baker, environment spokesman for the Liberal Democrats, said it looked "like a case of hidden mass medication upon the unsuspecting public."

"It is alarming that there is no monitoring of levels of Prozac and other pharmacy residues in our drinking water," he told the Observer.

The Environment Agency has held a series of meetings with the pharmaceutical industry to discuss any repercussions for human health or the ecosystem, the Observer said.

Prescription of anti-depressants has surged in Britain. In the decade up to 2001, overall prescriptions of antidepressants rose from 9 million to 24 million a year, the paper said.

begalli · Mar 13, 2005

I can't find anything specific as to why my hospital has started disposing of IV fluids in sharps containers as oppossed to draining the bag down the sink like we used to do.

I did find many, many articles such as the one that lsyorke posted. And many environmental studies that show drugs in drinking water. ewww.

I work tonite. If I can remember, I will find out why the hospital has begun doing this and if there are new regulations surrounding this procedure.

Home Health Columnist / Guide · Mar 13, 2005

googled: epa + medication disposal and found:

origins and fate of ppcps in the environment

drug take-back event in south portland, maine encourages proper ...

... an effort to encourage proper disposal of household prescription drugs, ...

and the epa by hosting the nation's first-ever drug take-back program in a ...

www.epa.gov/boston/pr/2005/feb/sr050201.html

what happens to expired medications? a survey of community ...

... 100 community and hospital pharmacies, the state boards of pharmacy, and the fda and epa were surveyed about medication disposal habits. ...

msnbc - got old medicine? don't flush it

hospitals:

disposal of hazardous pharmaceutical waste

home:

a remedy for prescription drug disposal . . .

Fiona59 · Mar 13, 2005

When my Dad died and we had loads of morphine in the house, we were told that only two pharmacies would accept it for return. One was way to far to go, and the other was just plain difficult to get to.

We turned his meds over to the dr. who handled his care and had a lot of palliative patients who couldn't afford meds. Since most of Dads meds were in individual doses and two prescriptions weren't even open no problem, they were accepted and re-routed to other cancer and HIV/Aids patients.

Better somebody can use them than they are disposed off.

boggle, ASN, RN · Mar 13, 2005

Just thinking here......

I've always wondered about the trace or small amounts of meds ingested that don't get metabolized and pass through the GI or GU tracts and right down the drain. Does that small amount multiplied by the gazillions of folks on meds add up to anything significant in the water systems of the world?

(I sure donate a lot of my multivitamin !!) :)

GLORIAmunchkin72 · Mar 13, 2005

I like to crush mine and wash it down the sink.
Why is putting it down the toilet no longer acceptable?
Are they finding pills at the sewer plant??
Somebody been taking them??? OMG
What a way to get drugs.

Down the sink or down the toilet they somehow find their way to the water supply.

DutchgirlRN, ASN, RN · Mar 13, 2005

Down the sink or down the toilet they somehow find their way to the water supply.

Where I work we dispose of any medications/IV bags other than maintenence fluids in a sharps container. I realize that home patients generally have to flush or pour down the sink but the amounts of their combined meds is probably less than .0001% of what is wasted in a hospital. Hospital med waste could really muck up the public water quality! At home I have been known to crush and dispose of the powder in the trash.