Dispose of Unused Pills Responsibly: Step-by-Step Guide

How Should You Dispose Of Your Unused and Expired Medicine and Why?

Unused, unneeded, and expired medications should be disposed of properly to avoid harm to people, pets, and the environment.

Safe disposal of old medication (pills, liquids, needles, etc.) is necessary to lower the risk of people consuming or touching a medication by accident, particularly children given they are at a higher risk of toxicity. 

It is worth noting that non-medical use of prescription drugs, specifically controlled substances taken without a doctor’s prescription and supervision, can be just as dangerous as taking illegal drugs.

Medications also need to be properly disposed of to prevent their inappropriate or illegal use. 

Last but not least, proper disposal prevents medications from contaminating the water supply and harming the environment and aquatic life.

Risks of Improper Disposal of Unneeded or Expired Medication

• Accidental poisoning: Ingestion of a medicine by someone who hasn’t been prescribed the drug can lead to poisoning, which can be fatal, especially in children and pets.

• Drug abuse: Improper disposal of medicines, which are controlled substances with a potential for abuse and addiction, can give access to someone seeking prescription drugs for misuse.

• Diversion: Unneeded medications can be sold illegally on the market for misuse.

• Contamination: Improper disposal of medicines can contaminate waterways and harm human and animal life.

• Injury or Harm: Not only can medication within unused needles or injections cause toxicity, but the needles alone can lead to injury when handled improperly

Safe Disposal Methods: Where Is The Best Place To Dispose Of Old Pills?

DEA Take Back Days

The United States Drug Enforcement Administration (DEA) organizes Take Back Days twice a year in April and October. These events encourage the public to remove unneeded prescription drugs and over-the-counter medications from their homes. You can find information on the next Take Back Day and the nearest collection site on the DEA website.

Drug Take-Back Programs  

Many community groups sponsor pharmaceutical take-back days or short-term drug collection events. DEA regulations require law enforcement to be present during these events. 

How Do I Dispose Of Old Medications In My State?

Some state-sponsored drug drop-off locations can be found on the following web pages:

• Florida

• Pennsylvania

• Michigan

• Washington State

• Ohio

• New York State

Nationwide Programs: 

• Pharma Logistics

• Inmar Intelligence

• MED-Project

In-Store Medication Disposal Kiosks

The DEA has authorized certain pharmacies, retail stores, and hospitals to install year-round drug collection kiosks. You can find the nearest drug disposal site in your community with the DEA’s Authorized Collection Site Locator. Permanent drug disposal boxes can be found in 42 states. The DEA says at least 70% of the U.S. population lives within 5 miles of a drug drop-off box.

Kiosks at Law Enforcement Agencies

You can contact your local law enforcement agency to find out if they offer a permanent drug drop-off kiosk.

Mail-Back Envelopes

Many retail pharmacies, community organizations, and state agencies provide postage-paid pre-addressed mail-back envelopes that you can use to send in your unused medicine for proper disposal.

How Do You Dispose Of Unused Prescription Tablets?

Disposing in Household Trash  

The U.S. Food and Drug Administration (FDA) and Environmental Protection Agency (EPA) recommend you dispose of expired, unneeded, or unused medication at home as follows (if there are no drug take-back options available):

1. Remove the prescription drug from its original container.

2. Mix the drug with an undesirable substance like cat litter or used coffee grounds.

3. Put the mixture in a sealable, leak-proof container or bag.

4. Remove any personal information including your name and Rx number from the prescription label by scratching it off, covering it with duct tape, or concealing it with a permanent marker.

5. Safely dispose of the sealed container and the now-empty original container in the trash.

FDA Flush List 

Some medications are especially harmful and come with directions to be flushed down the sink or toilet immediately when they are no longer needed and a drug take-back option is not readily available. The prescription label or patient information leaflet will mention if you need to flush a medicine to safely dispose of it.

Flushing is required for properly disposing of the following medications: 

• Medicines that have a potential for misuse or abuse.

• Medicines that can result in fatal poisoning with just one dose.

• Medicines that can result in serious health consequences if they are accidentally touched, ingested, misused, or abused.

Examples of medications on the FDA Flush List that are not suitable for household disposal in the trash include:

• Fentanyl transdermal system (fentanyl patch)

• Hydrocodone (Hysingla ER, Lortab, Norco, others)

• Hydromorphone (Dilaudid, Exalgo)

• Oxycodone (OxyContin, Roxicodone, Percocet, Percodan, others)

• Oxymorphone (Opana)

• Morphine (Kadian, MS Contin, others)

• Methadone (Dolophine, Methadose)

• Meperidine (Demerol)

• Diazepam (Diastat)

• Methylphenidate transdermal patch (Daytrana)

• Tapentadol (Nucynta)

• Sodium oxybate (Xyrem oral solution)

Environmental Impact of Drug Disposal   

Pharmaceuticals in Water Supply  

Medications can enter the environment and contaminate water in many ways, including:

• Flushing of unused prescription medications down the sink or toilet.

• Passage of medications through human bodies and into sewage through bodily wastes like urine and stool.

• Medications, such as antibiotics, given to livestock. 

• Waste from drug manufacturing processes.

Properly disposing non-flush-list unwanted, unused, or expired medicines through a drug take back program can help to reduce environmental harm. 

Steps to Minimize Environmental Harm  

Ensure medications that are unused, unneeded, or expired are safely disposed of through a drug collection method, such as a drug take-back program, that protects not only public health but also the environment. Remember, most medications should not be flushed down the sink or toilet. Only flush dangerous medications that are on the FDA’s Flush List due to a high risk of misuse or death if taken improperly. Never flush a medicine down the toilet or sink that is not on the Flush List.

Regulations and Guidelines  

Federal Regulations for Safe Disposal  

Federal regulations for the safe disposal of controlled substances are in place to provide prompt, safe, and effective disposal methods while effectively controlling the diversion of controlled substances.

Implementation of the Secure and Responsible Drug Disposal Act of 2010 has expanded the options available to collect controlled substances from ultimate users for the purpose of disposal, including: 

• Take-back events

• Mail-back programs

• Collection receptacles 

DEA regulations allow authorized manufacturers, distributors, reverse distributors, narcotic treatment programs (NTPs), hospitals/clinics with an on-site pharmacy, and retail pharmacies to voluntarily administer mail-back programs and maintain collection receptacles. In addition, authorized hospitals/clinics and retail pharmacies can voluntarily maintain collection receptacles at long-term care facilities. This rule also reorganizes and consolidates previously existing regulations on disposal, including the role of reverse distributors.”

State-Specific Disposal Guidelines  

All states nationwide follow the U.S. Food and Drug Administration (FDA) and Environmental Protection Agency (EPA) guidelines for the safe disposal of drugs.

Community and Pharmacy Initiatives  

CVS Programs 

CVS Pharmacy has in-store medication disposal kiosks at 3,900 locations nationwide. These units accept unused medications, including both prescription and over-the-counter medications in pill and liquid form. 

Items not permitted include Schedule I controlled substances (illegal drugs), syringes, needles, sharps containers, inhalers, aerosol cans, medical devices, batteries, chemicals, and devices that contain mercury.

CVS also offers a take-home drug deactivation packet called DisposeRx which is available at select locations for specific prescriptions. DisposeRx turns pills into a biodegradable gel when combined with warm water. This gel can be safely discarded in household trash. 

Walgreens Programs  

Walgreens offers a safe medication disposal kiosk where you can dispose of your unwanted, unused, or expired medication by dropping it off in a mailbox.

Accepted items include unwanted medicines (prescription medications and over-the-counter medicines), including pills, ointments, liquids, lotions, and patches. You can also drop off pet medications. Aerosol cans and inhalers are allowed as well.

Items not permitted include illegal drugs, needles, thermometers, and hydrogen peroxide.

Finding Local Safe Medication Disposal Options

Look for safe medication disposal kiosks in your community that accept unused medicines. These should be DEA-authorized collection sites such as retail pharmacies, hospitals, clinics, and law enforcement facilities. You can drop off your unwanted medications at these collection sites through on-site drop boxes or mail-back programs or pick up other in-home medication disposal methods.

Step-By-Step Guide to Dispose of Unused or Expired Medicine

1. Take unwanted medications to the nearest drug take-back location, program, or site immediately. 

2. If you do not have access to a drug take-back option, check the prescription label and patient information leaflet:

   1. If the medications are on the FDA Flush List, immediately flush them down the toilet or sink.

   2. If the medications are not on the FDA Flush List, remove the medications from their original containers, mix them with something undesirable like used coffee grounds or kitty litter, place them in a leak-proof sealed container, and discard them in household garbage.