Proper Disposal of Prescription Drugs

Many people toss expired or unused medications in the trash or flush them down the toilet. Some components of these drugs end up in our lakes, streams, and water supplies. According to the U.S. Fish and Wildlife Service, “The improper disposal of unused medications by flushing them or pouring them down the drain may be harmful to fish, wildlife, and their habitats.” Additionally, throwing medications away in the garbage may be dangerous since they can end up in the mouths of children or household pets.

Too Many Medications
JerryPDX / Getty Images

According to an Associated Press investigation reported in early 2008, “A vast array of pharmaceuticals — including antibiotics, anti-convulsants, mood stabilizers and sex hormones — have been found in the drinking water supplies of at least 41 million Americans.”

Since the amount of the drugs found in our water supply is hundreds or thousands of times lower than the quantity found in the medications that we take, it is not clear what the potential harm is to humans. However, research has shown that there can be effects on animals that live in the water such as fish and frogs.

How Medications Get Into Our Water

Drugs enter our water supply in several ways:

  • Many of us have medications that we no longer take, that have expired, or were used by someone who died. Most of these medications are flushed down the toilet or, in the case of liquids, poured down sink drains.
  • When we take a medication, our bodies absorb some of the drug. The remainder passes through us (in our urine or stool) and is flushed down the toilet.

In both cases, the wastewater is treated by our local sewage facilities before it is discharged into local reservoirs, rivers or lakes. Most of these water treatments do not remove the entire drug residue. Some of this water then may go to drinking water treatment plants and piped to our faucets.

Federal Guidelines

The U.S. Food and Drug Administration (FDA) and the White House Office of National Drug Control Policy issued the following guidelines in 2007 for the proper disposal of prescription medications:

  • Follow any specific disposal instructions on the drug label or patient information that accompanies the medication. Do not flush prescription drugs down the toilet unless this information specifically instructs you to do so.
  • If no instructions are given, throw the drugs in the household trash, but first: Remove the drugs from their original containers and mix them with an undesirable substance, such as used coffee grounds or kitty litter. The medication will be less appealing to children and pets, and unrecognizable to people who intentionally may go through your trash.
  • Put the drugs (or the mixture of drugs with an undesirable substance) in a sealable bag, empty can, or other container to prevent the medication from leaking or breaking out of a garbage bag.
  • Take advantage of community drug take-back programs that allow the public to bring unused drugs to a central location for proper disposal. Call your city or county government's household trash and recycling service (see the blue pages in a phone book) to determine if a take-back program is available in your community.

As part of the aforementioned policy, the government recommends the following drugs be flushed down the toilet instead of thrown in the trash. The goal is to reduce the danger of unintentional use or overdose and illegal abuse.

  • Actiq (fentanyl citrate)
  • Avinza Capsules (morphine sulfate)
  • Baraclude Tablets (entecavir)
  • Daytrana Transdermal Patch (methylphenidate)
  • Duragesic Transdermal System (fentanyl)
  • Fentora (fentanyl buccal tablet)
  • Meperidine HCl Tablets
  • OxyContin Tablets (oxycodone)
  • Percocet (Oxycodone and Acetaminophen)
  • Reyataz Capsules (atazanavir sulfate)
  • Tequin Tablets (gatifloxacin)
  • Xyrem (Sodium Oxybate)
  • Zerit for Oral Solution (stavudine)

DEA National Drug Take Back Day

Ever since 2010, the DEA has hosted a national drug take back day. In 2016, this initiative reaped almost 366 tons of prescription medications. Many of these medications were controlled substances, including tranquilizers, stimulants, and painkillers. If these drugs were to be used improperly, they could fuel dependence, abuse, and misuse. Specifically, according to the DEA, 4 of 5 users of heroin started out by taking painkillers.

Ever since this program started, it has collected an astounding 7.1 million pounds of drugs. There are more than 5200 collection sites nationwide.

Take-back programs are the best way to dispose of drugs found in your dresser, medicine cabinet or draws.

According to the DEA: “Take back programs offer a safe, simple, and anonymous way to keep dangerous prescription drugs out of the wrong hands and prevent substance abuse.”

Disagreement With Federal Drug Flushing Policy

Some states and environmentalists do not agree with the federal government’s policy on flushing certain medications. The Florida Department of Environmental Protection states that “Although this method of disposal prevents immediate accidental ingestion, it can cause contamination in our aquatic environment because wastewater treatment systems, including septic tanks, are not designed to remove many of these medications.”

Instead, this Florida agency outlines a step-by-step method for the safe disposal of all prescription and over-the-counter medications.

For Pills and Liquids:

  1. Keep the medicines in the original container. This will help identify the contents if they are accidentally ingested.
  2. Remove your name and prescription number to safeguard your identity.
  3. For pills, add some water or soda to start dissolving them.
  4. For liquids, add something inedible like cat litter, dirt or cayenne pepper.
  5. Close the lid and secure with duct tape or packing tape.
  6. Place the bottle(s) inside an opaque (non see-through) container like a coffee can or plastic laundry bottle.
  7. Tape that container closed.
  8. Hide the container in the trash. Do not put in the recycle bin.

Major Points

  • Do not give drugs to anyone else.
  • Do not flush drugs down the toilet.
  • Do not put drugs in the trash without disguising them; human or animal scavengers may find them and misuse them.
  • Do make use of local drug take-back programs. In particular, keep an eye ot for the DEA National Prescription Drug Take Back Day.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  • DEA Drug Disposal Information. National Take-Back Initiative. DEA website.

  • Headquarters News. Americans Flock to National Drug Take Back Day. October 28, 2016. DEA website.

By Michael Bihari, MD
Michael Bihari, MD, is a board-certified pediatrician, health educator, and medical writer, and president emeritus of the Community Health Center of Cape Cod.