What should you do with unwanted pharmaceuticals?

Many of us have medicine cabinets full of unused over-the-counter or prescription medicines. Some of these products are past their expiration dates, others may no longer be wanted or necessary. What should be done with them in order to achieve the least environmental hazard?  This is not a trivial problem. About 90 million kilograms (200 million pounds) of pharmaceuticals are disposed of each year. Steven Skerlos and his colleagues from the University of Michigan compared three options for disposing of unused drugs: throwing them in the trash, flushing them down the toilet, and returning them to the pharmacy for incineration.

To be clear, these three choices are not as distinct as they first appear. Some materials from both regular trash pickup and sewage get sent to incinerators. Drugs collected as solids from sewer systems and the ash from incinerated drugs end up in landfills along with drugs tossed in the trash. In addition, the authors considered how the drugs are transported at each stage, via private vehicle, commercial truck, or sewage line. Thus, sorting out the effects of these various alternatives can be rather complicated.

Incinerating 100% of all drugs may eliminate the risk of drug residues leaching into our soil, but the transportation from the home to the pharmacy to the incinerator to the landfill greatly increases gas emissions. On the other hand, flushing drugs all but eliminates transportation costs, but greatly increases environmental contamination with pharmaceuticals.

The ideal solution would be to have a sewage system that could thoroughly neutralize all pharmaceuticals.  Barring that, the next best option seems to be to throw drugs in the trash. That makes me feel good, since that’s what I’ve been doing anyway.  Of course, I haven’t been opening my bottles and mixing the contents with other trash within low-density polyethylene bags, as recommended by the White House Office of National Drug Control Policy.  Oops.