Educating Your Patients on Disposing of Unwanted Medications

Most physicians would likely not be surprised that many American homes have an accumulation of unused, unwanted, or expired medications. But did you ever consider the potential safety hazards these surplus medications present?

It’s not uncommon for patients to take their unwanted medication and, with good intentions, give it to a family member or friend complaining of similar symptoms who has not yet seen a physician and failed to be evaluated. Controlled substances pose additional safety hazards. While young exploring children may take them accidentally, teens and adults may take them to experiment - creating potential or continued drug abuse behavior. In fact, many instances of misused opioids in the United States are the result of leftover medications obtained by family and friends.

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Occasionally, believing they are being diligent, physicians with patients complaining that an opioid has an intolerable side-effect or is not working, will have the patient bring the unused medication back into the office before a new prescription is provided.  As the physician, you might believe it safer for the patient and your license if you were to ensure the safe disposal of any unused controlled substances. However, according to the DEA, physician offices do not qualify as those authorized to collect medications and it is NOT advisable for physicians or office staff to accept, take back, or dispose of any unused, unwanted, or expired medications. 

The reality is that patients and physicians alike often do not know how to properly dispose of unwanted medications.

To avoid diversion and decrease the potential abuse of prescription medications, the DEA began take-back programs. These consists of designated drop boxes where patients can anonymously turn in unwanted prescription medications – no questions asked. However, since these national and local events are typically held only a couple of times a year, it is also recommended to check with local pharmacies and Sheriff’s Departments for regular positioned prescription drop box locations in your area.

Since only DEA-designated officials can receive and dispose of controlled substances, the best way you can assist your patients is to learn local take-back information and educate your patients on the importance of proper disposal of unwanted medications. Some risk strategies you may wish to employ:

  1. View the information provided in A Patient Guide to Disposing of Unused, Unwanted, or Expired Medications for tips on properly disposing of medications including take-back programs, pharmacies, Sheriff’s Departments, and, as a last resort, how to properly dispose of medications at home.
  2. Provide a copy of A Patient Guide to Disposing of Unused, Unwanted, or Expired Medications to those patients that would benefit from the education.
  3. Prescribe small amounts (few pills) of opioids until it is determined the patient can tolerate the medication. This prevents the patient from having extra pain medications at home and from potential misuse by the patient and/or family members.
  4. Do not dispose of controlled substances that your patients bring into the office.  Instead, provide patients the proper local disposal sites information and instructions.
  5. If there are no local take-back programs in your local area and you work in an area with multiple physician offices, consider coordinating with physician offices/buildings and local law enforcement to organize a local take-back day.
  6. Continue strict compliance of narcotic contract enforcement, obtaining regular urine toxicology screening, and checks with prescriptions monitoring programs (CURES).