Getting rid of unused, unwanted, or expired medications can be a challenge. At this point, the long-term effects of pharmaceuticals in the environment is unknown, but there is a potential for harm. Drugs may enter the environment inadvertently by excretion and washing, or purposefully by disposal into the sewer or trash. This becomes a problem because sewage treatment plants were not designed to remove pharmaceuticals and many drugs may not e completely eliminated. Pharmaceuticals have been identified in surface waters, ground water, marine systems, sand rarely, in drinking water. While the concentration of individual drugs in the aquatic system may be low, there is concern that the presence of multiple drugs with similar mechanisms of action could lead to harmful effects through cumulative, long-term exposure. Unlike pesticide pollutants, where contact with the environment is usually sporadic, drug exposure tends to be more chronic.

Until recently, little help was available in the way of formal guidelines on drug disposal – especially at the level of the final end user – the patient. Once it was common practice to flush unwanted medications down the toilet. This method of disposal was preferred to throwing medications in the trash where children or illicit drug users might find them. Now, while both methods have their disadvantages, flushing in particular may be associated with causing environmental damage.

The White House Office of National Drug Control Policy, the Department of Health and Human Services, and the Environmental Protection Agency jointly published guidelines for proper disposal of prescription drugs. These guidelines are a balancing act between polluting the environment by flushing and risking accidental poisoning or drug diversion by placing expired or unwanted medications in the trash.

New federal prescription drug disposal guidelines urge consumers to:

· Take unused, unwanted, or expired prescription drugs out of their original containers and throw them in the trash.

· Mix the prescription drugs with an undesirable substance, like used coffee grounds or kitty litter. Putting them in impermeable, non-descript containers, such as empty cans or sealable bags, will further ensure the drugs are not diverted. Throw these containers in the trash.

· Flush prescription drugs down the toilet only if the accompanying patient information specifically instructs to do so.

· Take advantage of community pharmaceutical take-back programs.

The current federal prescription drug disposal guidelines state that the following drugs should be flushed down the toilet instead of being disposed of in the trash:

· Atazanavir sulfate (Reyataz)

· Entecavir (Baraclude)

· Fentanyl (Duragesic transdermal patch)

· Fentanyl (Fentora buccal tablet)

· Fentanyl citrate (Actiq oral transmuccosal)

· Gatifloxacin (Tequin)

· Meperidine (Demerol)

· Methylphenidate (Daytrana transdermal patch)

· Morphine sulfate (Avinza)

· Oxycodone (OxyContin)

· Oxycodone/Acetominophen (Percocet)

· Sodium oxybate (Xyrem)

· Stavudine (Zerit oral solution)

For a copy of the new federal disposal guidelines, go to www.whitehousedrugpolicy.gov/publications/pdf/prescrip_disposal.com