Medication Literacy: Drug Disposal

Older adults are commonly prescribed multiple drugs – 42 percent of adults ages 65 and older take five or more drugs monthly – and are likely to accumulate unused or unwanted drugs. Too many Americans often improperly dispose of unused drugs or hold on to them indefinitely, both of which can have serious consequences.

This report examines proper drug disposal— the safe and timely removal of unused or unwanted drugs from an individual’s possession according to US Food and Drug Administration (FDA) standards—and what can make it difficult. Specifically, it considers the importance of proper disposal of prescription drugs for older adults, examines barriers that may limit older adults’ access to drug disposal options, and identifies solutions to help older adults properly dispose of their unused or unwanted drugs. 

Why Proper Disposal Matters

Drug disposal is a vital component of good drug management. For this reason, the Centers for Medicare & Medicaid Services (CMS) incorporates disposal as the final step in Medicare’s Medication Therapy Management (MTM) program and has requirements for health care providers and health plans to provide MTM participants with specific information about the safe disposal of controlled substances and other prescription drugs.

Failing to properly dispose of prescription drugs can have serious consequences. These could include:

• Increased risk of adverse drug events, which include unintentional medication errors, intentional misuse, or drug reactions.
• Pharmaceutical ingredients leeching from landfills into waterways when drugs are disposed of directly into the trash.
• People for whom the drug was not prescribed accessing the product.

Barriers: Awareness and Access

Awareness – among consumers as well as pharmacists – about these risks and about proper drug disposal has remained low despite attempts at both the federal and state levels to boost communication and improve education on drug disposal. Federal regulations encourage approved US Drug Enforcement Agency (DEA) disposal locations to educate consumers about proper disposal of drugs, and the FDA has developed educational materials for consumers and pharmacists. Also, some states have put in place educational programs about drug disposal, and some state boards of pharmacy publish lists of disposal locations.

Identifying and accessing a DEA-approved disposal location can be challenging. Although some older adults may learn about locations directly from a provider, most must find the information on their own. Despite the large number of DEA-approved locations across the US (over 14,000), older adults  have varying access to approved locations depending on where they live, and may have to travel some distance to find one.

Conclusion

Too often, older adults do not know about proper disposal options, or the options are inconvenient. The danger is that unused, unwanted, and expired drugs get mixed into an older adult’s current drug regimen, fall into the hands of others, or contaminate the environment when disposed of improperly.

Proper drug disposal is not as easy as it could be. Barriers can be reduced if providers and policymakers redouble their efforts in areas such as making disposal convenient, enhancing education and outreach, training providers about disposal, and considering consumers’ experiences with disposal.