Last week’s Tip discussed the application of quality principles to reduce waste. A related concept is the extraordinary amount of waste piling up as unused medications in the community setting. Unused medications can be found in the homes of many individuals and families. Sometimes many years old, these drugs have lost potency at best, if not become more harmful while deteriorating. Obviously, when used within their expiration date, these drugs can cause harm to persons for whom they were not intended. And unused controlled substances add to the nation’s opioid crisis when others get hold of these drugs and either consume or sell them to others illegally.

Kinrys et al discussed the phenomenon of medication disposal practices in the U.S.¹ They found that most patients and even many clinicians do not know how to properly dispose of prescription drugs. Many assume that they should flush them down the toilet, which is strongly advised against due to increasing toxic levels of some of these drugs in the water supply. They reported one study where over ½ of nurses utilized sewage systems to dispose of medication waste from hospice care. The Secure and Responsible Drug Disposal Act of 2010 helped the Drug Enforcement Administration (DEA) carve out new policies that facilitate drug take-back programs; however, it is the efforts of state and local ordinances, along with increasing numbers of law enforcement and pharmacy organization policies that are really helping spread these take-back programs, including a greater number of venues that will accept these unused medications. The authors reiterate that information is critical and highlight the success of recent initiatives undertaken by pharmacy and public health officials to educate patients.

Medication wastage is an increasingly prominent concern. Pharmacists can be involved in important public health campaigns to educate patients on proper medication disposal. Pharmacy managers should train staff to handle patient questions about unused medications and also seek collaboration with other agencies such as law enforcement to promote safe disposal and create goodwill for the pharmacy.

Additional information about Operations Management and Ensuring Quality in Pharmacy Operations can be found in Pharmacy Management: Essentials for All Practice Settings, 4e. If you or your institution subscribes to AccessPharmacy, use or create your MyAccess Profile to sign-in to Pharmacy Management: Essentials for All Practice Settings, 4e. If your institution does not provide access, ask your medical librarian about subscribing.

¹Kinrys G, Gold AK, Worthington JJ, Nierenberg AA. Medication disposal practices: Increasing patient and clinicians on safe methods. J Intl Med Res. 2018;46:927-939.