Managing Unused Medicines in the Home – Something Everyone Should Know

How many bottles of prescription medicines are in your medicine closet? How many do you actually take?

Central New Hampshire VNA & Hospice, Margaret Franckhauser, Lakes Region Award Winning VNA

Margaret Franckhauser, CEO
Central New Hampshire VNA & Hospice

The New Hampshire Board of Pharmacy reports that 2 of every 3 people who visit a physician walk out with at least one prescription. Advances in healthcare technology and enhanced marketing by pharmaceutical companies have driven the use of prescription and over-the-counter drugs by Americans to record levels. Today, over 45% of Americans take at least one prescription drug. Generally, people over age 65 take more medicines in an attempt to manage the chronic diseases that often accompany aging.
At Central New Hampshire VNA & Hospice, we see lots of medicines in people’s homes, and we see an enormous number that are no longer being used – but still have a home on the patient’s shelf. Why is that? Well, doctors and nurse practitioners often change medications when a patient’s condition is not well controlled using the first drug. Sometimes patients fail to take the all drugs they are prescribed for infections or pain, leaving leftovers in the bottle. And…being thrifty New Englanders, if we paid for it, well, we are not inclined to throw it away.
My advice as a nurse: if you’re not using it, and your healthcare provider does not plan to return you to it soon, throw it out! But…do so safely – more about that at the end of this article. Why should you throw it out?
1) It is not safe to keep prescription medication. Prescription medicines all have some risk of danger. If that was not true, you would be able to use them without a prescription. When it lingers in your house, you or someone else might take it – accidentally or on purpose. But you would be taking it without the supervision of a skilled practitioner, and that is dangerous. Even non-prescription medicines have very serious risks if taken in large doses. Emergency rooms are full of people who took someone else’s drug – unsafely.
2) It is very easy to confuse medicines and take the wrong thing, sometimes with dangerous results. The drug name Celexa – used for depression looks a lot like the name Celebrex – used for arthritis. Taking one when the other was indicated can be dangerous. There are dozens of “little white pills”, but the shape and color tell you nothing about what is in them. Given the visual decline that accompanies aging, one of the most common problems we see in home care involves patients taking the wrong drug, sometimes with disastrous results. The patient thought he was taking a water pill, but he accidentally took an overdose of a blood thinning agent.
3) Controlled substances such as narcotics and anti-anxiety agents can place you at risk for theft and your community at risk for illegal drug use. Prescription drug abuse is in epidemic proportions in the United States, and New Hampshire has a serious problem with the street sale of narcotics, often diverted from people’s homes. US. In fact, NH is the only state where drugs related deaths exceeds death from traffic accidents.
4) Young children and pets might accidentally take them and risk injury or death. Medication ingestion is the leading cause of childhood poisoning in the United States. Each year, 60,000 are taken to the emergency room because they have ingested a parent or grandparents medicines (prescription and non-prescription). Pills are often beautifully colored and attractive to children. Worried about Fido? Nearly 50% of calls to pet emergency centers are due to the ingestion of human medications. It does not take much medicine to injure or kill a child or a pet.
5) Sooner or later, they don’t work as expected. No medicine maintains its therapeutic potency forever. That old blood pressure medicine? If it is past the expiration date, there is no assurance that it will work. Plus, it is much easier to dispose of a small quantity of old meds than a large quantity.
How to Discard Old Medicines
How should you get rid of that old medicine?
First, know that you cannot give it back to the pharmacy unless the manufacturer has issued a recall. Where controlled substances (such as narcotics) are concerned, federal law specifically prohibits the transfer of drugs back to a prescriber, a pharmacist or others for reverse distribution. The only legally authorized transfer is to a law enforcement official. Therefore, even home health and hospice nurses cannot take the medicine off your hands.
Don’t flush old medicines down the toilet! The water you flush down the toilet becomes part of the groundwater of your community. The presence of medication in surface water and in ground water is becoming a serious environmental concern in New Hampshire and the rest of the country. Evidence of medication in ground water is abundant. The more medicines people have to dispose, the greater the concern. Lakes Region, VNA, Visiting Nurse, Hospice,
Two methods of medication disposal are approved:
1) Take the medication and place it in a plastic bag with old coffee grounds or kitty litter. Seal the bag closed and dispose of it in your regular trash. Most of this waste is later incinerated.
2) In the Lakes Region, take them to the Police office in Laconia Police Department at 126 New Salem Street, Laconia. The disposal box is in the foyer and is accessible for disposal 24 hours a day. No questions are asked. Only pharmaceuticals (prescription and non-prescription meds) are to be disposed in this box. Please DO NOT dispose needles in this manner.
3) Many towns, such as Alton and Wolfeboro, have added household hazardous waste collection days to their calendar to allow for collection and proper disposal of pharmaceuticals. Alton and Wolfeboro request that households visit the Solid Waste Facility to get a free pass prior to attending the special disposal events. Check with your town office about their options for medication disposal. It has become such an issue, that all towns will have some advice for you to discard your medication safely.

If you want to know more about the risks and proper methods of handling old and unused medicines, the state of New Hampshire Department of Environmental Services has published an excellent report. It can be accessed on line at the following link:
http://des.nh.gov/organization/commissioner/pip/publications/wmd/documents/unused_medicine.pdf
Finally, maintain awareness of the dangers of medication in your home. While they do many wonderful things, they become a source of community concern when they are no longer used by the person. Take great care in your own home to avoid the risks of unused medicines. Your action may save your life or someone else’s.
ABOUT the Author: Margaret Franckhauser is Chief Executive Officer of Central New Hampshire VNA & Hospice. The Mission of Central New Hampshire VNA & Hospice is “Promoting dignity, independence, and well-being through the delivery of quality home health, hospice and community-based care services.” Central New Hampshire VNA & Hospice serves Lakes Region communities in Belknap and Southern Carroll County and provides Home Care (nursing and rehabilitation services in the home); Pediatric Care (direct health care, education and support services for children and families); and a comprehensive, team-based Hospice program. Central New Hampshire VNA & Hospice is a not-for-profit, Medicare-certified provider of home care and hospice services, licensed by the State of New Hampshire. The agency is governed by a volunteer Board of Trustees and supported by private and corporate donations.

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