The Safe Disposal of Medications in Maryland: A Small Glitch in Deprescribing
Written By: Rudi Lamy, MLS, MAS, consultant to the Peter Lamy Center on Drug Therapy and Aging
Has one or more of your prescriptions been deprescribed?
Do you have expired or “leftover” medications in your house?
Have you been the caregiver for someone who is now in an assisted living, memory care, or hospice facility but still have their medicines at your home?
If you answered yes to any of these questions, read on to learn more about how to dispose of them safely.
In this blog post, I will discuss deprescribing, the process of weaning off a medication that is no longer needed. Although the process of prescribing medicine and medication adherence is important as we age, deprescribing can be just as important for positive health outcomes.
Here is a more thorough description of deprescribing from an article in the journal American Family Physician:
“Monitoring patients’ active medication lists and deprescribing any unnecessary medications are recommended to reduce pill burden, the risks of adverse drug events, and financial hardship. Physicians should view deprescribing as a therapeutic intervention similar to initiating clinically appropriate therapy. When deprescribing, physicians should consider patient/caregiver perspectives on goals of therapy, including views on medications and chronic conditions and preferences and priorities regarding prescribing to slow disease progression, prevent health decline, and address symptoms. Point-of-care tools can aid physicians in deprescribing and help patients understand the need to decrease medication burden to reduce the risks of polypharmacy.” 1
While at the library recently, I saw a flyer from the Maryland Department of Health on medication safety and learned two tips. First, safe storage of medications means not comingling them in your medicine cabinet or leaving them in a place where children or pets could get into them. They should be in a safe and secure location.
Second, you should dispose of expired and unused medications in drug drop boxes.
- A list of disposal sites across Maryland
- Medication/drug disposal options through the University of Maryland, Baltimore
The flyer also mentioned what to do if you don’t have access to a drug drop box. In that instance, you can mix your pills, capsules, and liquids with coffee grounds, cat litter, or sawdust, remove all identifying personal information from the medicine container, seal it in a bag, and put in your trash.
I do not practice well what I preach here, but this is a good reminder for us all to improve on medication safety. If I went by the mantra of “What would my father (Peter P. Lamy) say?” I would have emptied the bathroom medicine cabinet and two shelves of the linen closet a while ago. Although I have been disposing of old pharmaceuticals, it has been a slow process.
Some of my wife’s old medications remain at home, though she is in care at a full-time, skilled nursing facility in charge of her medications. It’s time for me to clean the house of those unneeded medications as the New Year approaches.
Finally, a note from Nicole Brandt, PharmD, MBA, BCGP, FASCP, executive director of the Peter Lamy Center on Drug Therapy and Aging: The Lamy Center has partnered with the Maryland Poison Center to educate older adults about their medications and has numerous resources on questions to ask as well as disposing of your medications. These can be found online under the medicine disposal section.
Thanks for reading.
Rudi
Reference
1 Am Fam Physician. 2019 Jul 1;100(1):32-38. Polypharmacy: Evaluating Risks and Deprescribing. Anne D Halli-Tierney 1, Catherine Scarbrough 2, Dana Carroll 3 PMID: 31259501 Free article.
Possible Readings:
Google Books Search
PubMed Search
Varisco TJ, Fleming ML, Bapat SS, Wanat MA, Thornton D. Health care practitioner counseling encourages disposal of unused opioid medications. J Am Pharm Assoc (2003). 2019 Nov-Dec;59(6):809-815.e5. doi: 10.1016/j.japh.2019.07.010. Epub 2019 Aug 29.
Makki M, Hassali MA, Awaisu A, Hashmi F. The Prevalence of Unused Medications in Homes. Pharmacy (Basel}. 2019 Jun 13;7(2}:61. doi: 10.3390/pharmacy7020061.
Barenie RE, Leav K, Edward Johnson WT 3rd, Wheeler JS. Review and assessment of drug disposal state statutes in the United States, 2022. J Am Pharm Assoc (2003}. 2022 Nov-Dec;62(6}:1865-1869. doi: 10.1016/j.japh.2022.06.001. Epub 2022 Jun 9.
Harbaugh CM, Malani P, Solway E, Kirch M, Singer D, Englesbe MJ, Brummett CM, Waljee JF. Self-reported disposal of leftover opioids among US adults 50-80. Reg Anesth Pain Med. 2020 Dec;45(12}:949-954. doi: 10.1136/rapm-2020-101544. Epub 2020 Oct 6. PMID: 33024006
WorldCat Search
Kinrys G. Gold A. K. Worthington J. J. & Nierenberg A. A. (2018). Medication disposal practices: increasing patient and clinician education on safe methods. Journal of International Medical Research 927–939. https://doi.org/10.1177/0300060517738681
Jankie S. Stuart A. V. Barsatee N. Dookhan V. Sookdeo K. Hernandez S. & Mohammed C. (2022). Pharmacists knowledge perception and practice regarding medication disposal. Exploratory Research in Clinical and Social Pharmacy. https://doi.org/10.1016/j.rcsop.2022.100202