Disposal of unused medicines, a trivial issue, but a matter of concern

Article contributed by our subscriber, Shri Maniprasad 

[Shri Maniprasad has been in Delhi for 45 years. While in service, he was closely associated with different Societies and Associations. He has always been of a helping nature, especially in guiding the subordinates to be better in work and in life. After a long tenure in man management, general administration and in event management, he is presently working as Consultant, Business Development, Career & Training Development and Event Management.(tvmanis47@yahoo.com)]
 
There are varied reasons for having unused medicine in any house….patient cured; new doctor advised different set of medicines, patient moved to another city, leaving medicines at old place, so old ones purchased kept aside or unfortunate death of patient. These medicines should not fall into the hands of those who are not to have them, especially children. Even elders, in case of need, without seeing the expiry date may consume the medicine and get into complications. So such unused medicines are to be disposed off. Accidental exposure to these medicines could be harmful or sometimes deadly,  if they are used by someone other than the person the medicine was prescribed for.

Mostly the family prefers to flush them away..for whatever it is worth.
Some go back to the market and put them in a box kept by some NGO or Medical Shop itself. Or wait for some one to come and collect them for re use later by someone else.

The NGOs and or Medical shops may see the validity (rather should see) and give to the needy. Often the check does not take place; the donor feels of doing a great job, the receiver is happy as it has come free for him. But one should understand the risks involved in the philanthropy mentioned. Let us do it the way it should be.
World across, the Researchers recommend that a few, select medicines be disposed of by flushing down the sink or toilet. However, in many countries abroad there are specified Agencies authorized to collect unwanted/unused medicines and they dispose it off in a scientific way.

There is strong need of education and awareness for the public to understand the potential impacts associated with improper disposal of unused medicines.  The damage to the environment including water in the disposal system has to be studied and remedial action taken.  

In fact, the Environmental Bodies  do not recommend putting the medicine in drain pipes; it has been proved that the sewage treatment plants may not be able to clean all medicines out of the water. This may harm fish and wildlife.

The American Pharmacists Association (APhA) and the U.S. Fish and Wildlife Service say just three small steps can make a huge difference:

1. DO NOT FLUSH unused medications. …..this could be having an adverse impact on the environment. While the rule of thumb is not to flush, the Food and Drug Administration (FDA) has determined that certain medications should be flushed due to their abuse potential.

2. When tossing unused medications, protect children and pets from the potentially negative effects. APhA recommends that consumers:

• Crush solid medications or dissolve them in water (this applies for liquid medications as well) and mix with kitty litter or sawdust (or any material that absorbs the dissolved medication and makes it less appealing for pets or children to eat), then place in a sealed plastic bag BEFORE tossing in the trash. (Plastic bag: should be out of question, now!!)
• Remove and destroy ALL identifying personal information (prescription label) from the medication container.
• Check for approved state and local collection programs or with area hazardous waste facilities. In certain states, you may be able to take your unused medications to your community pharmacy.

3. Talk To Your Pharmacist. Research shows that pharmacists are one of the most accessible healthcare professionals. As the medication experts on the healthcare team, pharmacists are available to guide you on how to properly dispose of your unused medications.

But how far the above three principles would apply in Indian context is a big question.

In India we may have more and more of Omkarnath, the  one goes round in residential colonies in Delhi and collects unused medicines and donates with the help of few NGOs, but he ensures that the dates are not expired. But there is a strong case for a regular mechanism on disposal of outdated /expired medicines and also those which could be used by any one else.

‘By medicine, life may be prolonged, yet death will seize the Doctor also’- William Shakespeare

But why should we invite the inevitable by using wrong medicines or outdated medicines, even if it is free!!