Where to dispose of expired or unused medication? And how to recycle them?

What medicines and other products can be safely disposed of or recycled?

Not all medicines and health products are eligible for recycling.

Among the products collected free of charge by pharmacies or other drug take-back organizations are tablets, capsules or suppositories. Creams, ointments and gels, as well as syrups, vials, aerosols, sprays and inhalers can also be recycled (even if the tube or bottle has already been used). All of these products can be recycled regardless of whether they are expired or not, and whether they have been opened or not.

On the other hand, many products are not covered by this recycling system and are therefore not to be taken back to the pharmacy. This is the case for food supplements, special foods (for adults and infants), medical devices (dressings, condoms, compresses, contact lenses, etc.), chemicals and veterinary products. Cosmetics (shampoos, perfumes, moisturizers and sunscreens, make-up, etc.), glasses, prostheses, thermometers and X-rays are also not covered. 

Finally, used needles and syringes are classified as infectious waste and need to be disposed of differently. Used needles or sharps should be collected in a designated sharps container (or a strong, plastic container). When full, the bin can be dropped off at a drop box or supervised collection point, or mailed back to a collection site, depending on your locality. For more information on how to dispose of your used sharps and to find a disposal option in your area, you can visit the SafeNeedleDisposal website here.

How to properly dispose of or recycle your medicines?

The first step in recycling medications is to sort through your medicine cabinet and identify expired or unused products that can be returned to the pharmacy. It is advisable to do this every six months to ensure that you keep only those that are in date and still in use, especially if you are on a regular course of prescription medicine.

The second step is to separate the cardboard packaging and paper inserts from the medicines. Even if only one tablet or capsule remains in the blister pack, pharmacies collect it for disposal. However, the blister packs themselves are not recyclable and should be placed in the trash when empty. The cardboard box and paper leaflets that come with the medicines should be disposed of at home in the recycling bin.

Finally, the third and last step is to take them to a drug take-back location. Drug take-back programs are generally offered in two different ways: periodic events and permanent collection sites. The U.S. Drug Enforcement Administration (DEA) organizes National Prescription Drug Take Back Day in communities nationwide. Many communities also have their own take-back programs, so check with your local law enforcement officials to find a location near you or with the DEA to find a DEA-authorized collector in your area. Many pharmacies are authorized to collect unwanted medications, so make sure to check with your local pharmacy. Before disposing of your prescription medicines, make sure to remove all personal information on the label of pill bottles or medicine packaging.

If you are interested in donating your medication, the National Conference of State Legislatures has a tool to help identify if pharmaceutical donation and reuse programs exist in your state. You can consult it here.

Because a select few pharmaceutical controlled substances, when left unsecure, can pose deadly risks to others in your household, the FDA recommends that these medicines be disposed of by flushing down the toilet only if: your medicine is on the FDA Flush List and a drug take-back location is not readily available. This is because these medicines may be especially harmful, and, in some cases, deadly if used by someone other than the person for whom they were prescribed. Flushing them right away can help prevent others from accidentally taking these potentially dangerous substances.

Why safely dispose of or recycle your medicines and other health products?

There are many advantages to recycling or safely disposing of our medicines:

• The major advantage of drug recycling is the preservation of household health. Unfortunately, poisonings (particularly in children) and medication mix-ups (especially in the elderly) can be frequent. Each year an estimated 50,000 emergency room visits and 450,000 calls to poison control centers are made after children under the age of 6 have found and ingested medicine without supervision. Sorting through one's medicine cabinet, removing expired medicines and those no longer in use (when treatment is over) helps to avoid these risks.
• The benefits of medicine recycling are also ecological and environmental. Indeed, when mixed with household waste, medications could be buried in a landfill and gradually pollute (with the run-off of rain) the local soil, rivers, and water tables.
  Likewise, medications should not be thrown down the sink or toilet where possible, as they could pollute the water supply (especially drinking water), despite the treatment it undergoes in water treatment plants. For example, recycling medicines helps to prevent the presence of antibiotics in tap water that can cause resistance, or hormones that could cause physical changes...   

Who participates in the medicine recycling system?

There are 5 main players in the drug recycling circuit:

• Pharmaceutical laboratories: many pharmaceutical companies are involved in product take-back schemes and are taking steps to become more sustainable in their manufacturing and packaging. In some countries like France, pharmaceutical laboratories pay an eco-contribution of €0.19 per box of medicines sold in pharmacies, which helps fund the medical recycling system.
• Private individuals and consumers: they bring their medicines back to pharmacies after expiry or end of treatment, and place the cardboard packaging and paper leaflets in the selective sorting system.
• Pharmacists: they collect medicines from individuals, while checking that what it returned does not contain products that cannot be recycled (in particular needles and syringes that must be disposed of safely by the local council) and sort them properly.
• Wholesaler-distributors: they store medicines recovered from pharmacies in secure containers and then call transporters when these are full.
• Transporters: they transport the medicines to be recycled between dispensing establishments and waste recycling centers.

Finally, in October 2019, the DEA's Drug Take Back Day brought in 882,919 pounds (almost 442 tons) of unused or expired prescription medications and vaping devices. Adopting a responsible approach to disposing of our medicines can be an excellent tool to help preserve our health and that of our loved ones, as well as to protect the environment and maintain water quality.

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