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How do you get rid of pills?
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jducoeur
I am, very slowly, beginning the process of putting my life and the house back together. Step one is simply cleaning up after two months of purest neglect -- while the live-in aides have been doing "cleaning" in the sense of dishes and Jane's wash and such, they haven't been able to straighten anything, and the house is in a fair disarray. That's a job that really only I can do, because now I'm the only one who knows where anything goes. So as I walk through the house, there is a lot of picking something up and putting it back where it belongs -- less as a sudden whirlwind, and more as a gradual job of picking up the house and slowly shaking it until everything falls into the right slot.

One of the things in some disarray is the damned pill bottles. If you haven't cared for someone with metastatic cancer, you probably cannot imagine how many drugs are involved. (Worsened by all the ills caused by her being bedridden, which caused all sorts of knock-on ailments.) For those last two months, I had to maintain a document (a full page in Word, of 11-point type) that simply laid out the daily schedule of what needed to be given when. (Every time we needed to readmit her to the hospital, I would give the nurses a ten-minute rundown of all the meds and why they were necessary; they were generally pretty bemused.) Plus the dosages of some varied over time, resulting in more scrips, plus things that were tried and didn't work, plus the meds she *had* been on which we stopped during those final months. (Lisinopril, Metformin, Simvastatin -- she had been on lots of meds before things went bad in November and we stopped all of them, and it took a pointless refill or two of each before I realized that I needed to stop the auto-fills.)

So now the house is covered in pill bottles. There are bottles in the bedroom, the master bathroom and the main bathroom from all of her long-term prescriptions. There are bottles in her purses. There are a truly astounding number of bottles in both the family room and living room, where she spent most of her final month. (The piano downstairs was literally covered in medicines.) The hospice took away the Comfort Kit (with the morphine and haldol), but all of the more routine meds, from laxatives to steroids, are left over. All of it is now essentially junk: anything that wasn't cheap and over-the-counter is prescription, and not supposed to be reused.

So I ask my friends in the medical professions: what the heck do I *do* with all this? The hospice nurse said to simply throw it out or flush it down the toilet. The latter squicks me from an environmental perspective -- flushing random medications into the commonweal water supply seems like a bad idea on the face of it. The former seems slightly more plausible, but still leaves me wondering if there's a better approach.

Opinions? Are there correct answers here?
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Perhaps a pharmacy can dispose of them appropriately?

Yes, any pharmacy should be able to do it; flushing or landfilling meds is a very outdated practice and I'm surprised a professional is advocating it.

I know this is not legal or acceptable by many people, but I might consider whether any of the more expensive routine meds were being used by any friends or family members who did not have adequate insurance, and whether they would be able to use them. I guess this varies, but I know quite a few people who have trouble buying their blood pressure or diabetes meds and so forth.

My housemate recently turned in a bunch of old pills, I believe, to the local police station in Salem. I'll check and get back to you. You may want to redact labels first.

The Police station in Salem, MA has a drop off for used meds, etc... you can't turn in needles, etc, but they have a list on their website of what they will take and dispose of properly.

I know the police in Beverly do a once a year drop off for medical stuff including sharps! That was how I got rid of all my syringes.

I know some hospitals and/or doctors offices will as well.

Definitely, check around. There are places!

Definitely have a pharmacy or hospital dispose of them properly - incineration as medical waste is what you want. Landfill or flushing is a *very* bad idea, as you have already deduced.

Yup, flushing is a bad idea. Medicines generally don't break down completely in the waste-processing system. I've heard of police departments running pill drives to collect expired or unwanted medicines, both for proper disposal and to keep them away from kids. A pharmacy is also a good thought.

Another thought would be to gather them all together and ask a friend to find the proper disposal for them--you have enough to worry about already, and if there are things you can offload to friends, don't hesitate.

You are absolutely correct to think flushing them down the toilet is a bad idea. I work for an environmental remediation consulting firm, and I can tell you with confidence that your local sewage treatment facility will not be able to remove most of the chemicals found in prescription medication from the waste stream before they discharge it to the environment. They probably won't even be able to tell they're present. Their treatment systems, and their testing are both geared toward detecting the biological component in human waste and probably a few like soaps and shampoos that get into the waste water stream from sinks and showers.

The MA Depart of Environmental Protection has some advice here:

http://www.mass.gov/dep/toxics/stypes/medshome.htm
http://www.mass.gov/dep/toxics/ppc.htm
http://www.mass.gov/dep/toxics/stypes/ppcpedc.htm

The best answers are probably

1. investigate whether your pharmacist knows of any kind of drug take-back program in your area, where you can drop them off. If you town has one, the pharmacist is probably aware of it.

2. Put them in the trash. Key things for this solution are to make sure they're not visible to anyone who might be trash picking and think they could get high off them, or local children or scavenger animals who might ingest them.

Hope this helps.



(Deleted comment)
If you have a local friend who does clinical work at a hospital, you could ask them to help you get rid of them. I've helped friends with that myself, by taking big bags of pills in for them (with an explanation note from them, just in case someone -- like a policeman on a traffic stop -- had questions) and turned them in to my hospital for disposal.

In response to a well-meaning suggestion above, I'd also be wary about sharing pills with anyone else -- aside from the legal issues (especially regarding DEA Schedule medications, the list of which go way beyond just the obvious narcotics), there's also sometimes subtle (but clinically important) differences between different brands of the same medications, or between genetic and Brand name versions of the same medications. As well as having to make sure there wasn't a mixup between standard release preparations vs extended release preparations, or splittable forms vs. not splittable, etc.

Before one could theoretically share pills, one would have to be *absolutely* certain the pills you were sharing were truly identical (and appropriate) to the supply the recipient already had, lest mistakenly and unintentionally giving someone a stock of what turned out to be the wrong sub-type of a particular medication and causing them medical harm. And taking on that responsibility -- and legal liability -- isn't something we would ever ask our patients to shoulder on themselves.



(Hello - a year ago, you very generously made me feel very welcome when I visited Carolingia for an evening. I very much enjoyed that evening and my conversations and dancing with you. And I am very, very sorry to hear of your loss.)


the two chemists next to me say take it to the pharmacy.

Hi. Friendly non-local pharmacist here.

No, although the MA enviro page does say to "disguise" them and put them in the trash, you don't really want to do that. We're talking about some potentially very dangerous stuff here. One Oxycontin can kill a child. And then there are the legal ramifications: you don't want to leave even "disguised" narcotics in the trash, since it's a federal offense to "transfer" those to anyone other than (a) the patient, pursuant to a prescription or (b) a "licensed entity" pursuant to a DEA-222 form (which is how I get them). Negligently allowing someone to pick them from your trash is "transferring".

A store I previously worked at would grind up pills and mix them with coffee grounds. That's not a bad DIY choice, but it's still going into landfill.

I know you deal with one of the larger chains, one that I've briefly worked for, in fact. They have policies for everything, and I'm sure they have one for dealing with your situation. Call your friendly pharmacist and ask if they'll dispose of the stuff for you. Unclear whether they'll take back the narcs, but if they do, I wouldn't worry about the legalities in that case: no one's going to question that, and then it's their problem.


Locally for us (Northern California) the household hazardous waste disposal section of the local waste processing plant (pre processing to the landfill) will take medical waste including sharps and medications.

They grind and high temperature burn it all.

If you can't get the pharmacy to take them, my method is to mix them into the dirty cat litter and put them out with the trash. (Admittedly, I have far, far fewer pills than you need to deal with.) In this part of the state, all of our trash is burned to generate energy.

I talked my pharmacy into taking my unused Darvocet to dispose of. They said, for that med, they didn't have to do it, but they took it as a favor (and possibly to get me to stop standing at their counter, taking their time). They said the next time I wanted to dispose of stuff, I should fill the pill bottle with water, the pills would dissolve, and then I should throw them in the trash. My local trash is incinerated, I believe.

YMMV, of course, but it's another data point.


I just spoke with my brother-in-law, who had to do this very thing recently. The only thing he added to what has already been offered, is talk to your primary care physician. The were able to get rid of some things that way. He also said that no one solution worked for all medications.


A pharmacy or a local medical clinic would probably be best. And, if anything is unopened, sometimes it can be reused. My cousin recieved some meds once at our clinic for free that way -- to see how it would work for her.

But, could a family member do this for you? I worry that the last thing you need right now is to get that one receptionist that wants to argue with you for no good damn reason.

And --

All of my sympathy. My cousin sends her sympathy too. With some understanding -- when her mother passed, the officials distracted her father by having him catalog her meds for them. It took him over 20 minutes.

((hugs))

My local pharmacy told me I had to take my meds to hazardous waste. After reading the other comments I'll double-check that at a different pharmacy (especially given that I've had problems with them before).

I know that Dana Farber takes sharps (I had needles for coumadin), and I'm fairly sure that the pharmacy at and hospital is likely to do likewise. I also expect they'll take unused meds.

If you have extra nutrient drinks that you don't want, I'm pretty sure there's an organization that will put you in touch with people in need, though nobody will be willing to act as your middleman there. We gave away a case of stuff to someone we contacted that way. Meredith found that, so if you need it, I can ask her what she did to find them, or you can ping her directly.

Hadn't even thought about that, but I do have a few nutrient drinks sitting in the fridge going begging. If it's straightforward, I'd be happy to give them to somebody...

Even the FDA website is saying to dissolve them in water or soda and then mix them with something "undesirable" like coffee grounds or cat litter, seal them in a watertight baggie, and dump them in the regular trash.

I would think there's a better way but sheesh, I guess not. Googling turns up next to nothing. Burlington had a drug takeback day back in September but there's no indication if or when they will have another.

If you want help handling them all, let me know.

Thanks. CVS turned me down flat, so it sounds like something of the sort needs to be done (CVS told me approximately what you say above), and I'd appreciate a hand with it...

My local Walgreens here in FL (Tampa Bay area) has pre-addressed envelopes out on the pharmacy department counter in which you can mail outdated medications to a facility that will dispose of them for you. I vaguely remember seeing something similar in the Walgreens up in CT when I was visiting my sister over the holidays so possibly they have them in MA as well. The envelopes there appeared to be for sale for a few dollars although there was no charge for the ones I got down here. I'm not sure why the difference except that we do have a substantial elderly population here and they tend to accumulate a lot of excess medications. There were some restrictions on the drugs they'd accept listed on the envelope, though I don't remember what they were. I'll check around and see if I can find where I put on of the ones I picked up.

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