Unused drugs: Take them back or throw away?

In 2008, an investigation by the Associated Press revealed that drinking water supplies in major cities and metropolitan regions across the country are riddled with pharmaceutical compounds. For 41 million Americans, it suggests water with something extra means more than just a slice of lemon, though the quantities of pharmaceutical compounds in the water are too small to constitute a medical dose, according to the report.


One reason why drugs are showing up in drinking water is because often when people take them, some pass through their bodies without being metabolized. But another reason is the habit many people have of flushing unused drugs down the toilet.


The Drug Enforcement Administration, working with local law enforcement agencies, has been arranging national drug take-back days every few months. The main purpose of the events is to keep drugs out of the hands of drug abusers, but sponsors of the events, including city governments and retailers, have touted their environmental benefits as well.


According to a new study by the University of Michigan, however, the best way to get rid of drugs in order to protect the environment may be to throw them in the garbage. The study, published in April in Environmental Science & Technology, measured the total emissions of active pharmaceutical ingredients and other water and air pollutants from three drug-disposal methods: taking them back to the pharmacy, throwing them in the trash and flushing them down the toilet.


The study found that if half of the estimated 200 million lbs. of unused drugs accumulated every year were thrown away and half were taken back, the amount of APIs in the environment would be reduced by 93%, while everybody throwing them in the trash would reduce the APIs by 88%. At the same time, however, the 5% difference would cost the economy possibly more than $1 billion per year and a 300% increase in emissions of greenhouse gases and smog-forming substances. 


“National policy seems to be changing to support take-back programs, and we don’t know if that’s justified,” study author and University of Michigan Department of Civil and Environmental Engineering doctoral student Sherri Cook said.


To keep drug abusers from getting to prescription drugs, the study recommended mixing them in a sealed plastic bag with an unpalatable substance, such as coffee grounds.


Currently, the Food and Drug Administration and the DEA recommend throwing unused drugs away if patients don’t have access to take-back programs, such as those sponsored by pharmacy retailers like CVS and Giant-Carlisle. Supermarket chain Giant-Carlisle announced in May that it had collected nearly 3 tons of unused medications at 43 stores during a national take-back day. Meanwhile, the DEA regards take-backs as the best way to dispose of unused drugs.


“Unused drugs thrown in the trash in their bottles can be retrieved and abused or illegally sold,” a spokesman for the DEA’s Philadelphia division told Drug Store News, saying that the agency only recommends throwing drugs away if no take-back program is available. “Proper disposal of used prescription drugs can save lives.”