1. Proper Disposal of Prescription & Over-the-Counter Medications
Traci SuSong, Ph.D. student
Walden University
PUBH
Instructor: Dr. Jeff Wu
Summer term, 2009
Hello, my name is Traci SuSong and this presentation was created to protect consumers and the environment from the risks associated with improper/unsafe disposal of pharmaceuticals, the objectives of this presentation is to educate and promote awareness. The presentation target audience are older adults and their caregivers. The caregivers may include but not limited to home health aides, nurses, relatives, etc.

2. Has this ever happened to you
Has this ever happened to you? You open the medicine cabinet and the medication has been there so long that you forgot why you had it? The label is worn or you no longer have the ailment that caused you to take the medication in the first place? You are not alone. This presentation was created to solve the mystery of WHAT to do with the medications once it has expired or just plain old.
Bobrin, J. (2006). Prescription drug and personal care products disposal. Retrieved on June 25, 2009 from

3. Purpose and Learning Outcomes
To educate and promote awareness among older adults and their caregivers about the concern of improperly disposing of medications in local water supply and how it effects marine life and human health
Learning outcomes:
Understand what products are classified as PPCPs
How the products enter the water supply
How to properly dispose of PPCPs
Resources to use for more information
The purpose of this presentation is to promote awareness of the concern and educate you on the effects of improperly disposing or medications on the environment and on human health. After this presentation, you will know what is classified as PPCPs (I will discuss later), how the products enter the water supply, how to properly dispose of pill and liquid medications, and where to learn about more information on this subject.

4. Contents Define PPCPs How drugs get in the water supply
Regulatory impact
Environmental & health impact
Proper disposal
Resources
My goal is to teach you how to dispose of your old or expired medication and personal care products. Although many of the examples used in this presentation reference prescription medications, these examples apply to over the counter medications and personal care products as well. I will define PPCPs, show how medication enters the water supply and provide brief information on how disposing of medication effects the environment. Lastly, give examples on how to dispose of PPCPs properly.

5. Definition
Pharmaceuticals and Personal Care Products as Pollutants (PPCPs): used by individuals for personal health or cosmetic reasons or used by agribusiness to enhance growth or health of livestock.
Examples: prescription and over-the-counter therapeutic drugs, veterinary drugs, fragrances, and cosmetics.
Pharmaceuticals and personal care products as pollutants or PPCPS are a diverse group of chemicals that make up what we know as cosmetics, prescriptions, over the counter medications, fragrances and medications for our pets. They may also be used in agriculture to enhance the growth of some of the foods we eat. (

6. How drugs get in our water supply
Drugs enter our water supply in several ways:
Most of these medications are flushed down the toilet or, in the case of liquids, poured down sink drains.
When we take a medication, our bodies absorb some of the drug. The remainder passes through us (in our urine or stool) and is flushed down the toilet
Now you may wonder how the drugs get in our water supply. Most of the medication is flushed down the toilet or poured down the drain. Also, when we take medication, our bodies absorb some of the drug but what isn’t absorbed is passed through in our waste (urine or stool) and is flushed. This process is inevitable and something we can’t control. But what we CAN control is flushing or pouring unused or outdated medications. ”

7. Here is a picture that shows how drugs get in our water supply.
Leftover drugs pose prescription for trouble. (2006, January). Harvard Heart Letter, Retrieved July 11, 2009, from Academic Search Premier database

8. Regulatory Impact
Federal guidelines established in 2007 for proper disposal
Established because of potential hazards to humans, pets and the environment
OLD method of flushing down the toilet is no longer acceptable
Uniform disposal method nation wide
Joint corroboration between The White House Office of National Drug Control Policy (ONDCP), the Department of Health and Human Services (HHS), and the Environmental Protection Agency (EPA)
In 2007, the White House Office of National Drug Control Policy, Dept of Health and Human Services and the EPA developed standard guidelines on how to dispose of medications. This policy was developed to reduce the potential hazards to humans, pets and the environment

9. Environmental Impact
A study conducted four years ago by the United States Geological Survey (USGS) found that 80% of 139 streams sampled across 30 states detected very low concentrations of chemicals commonly found in prescription drugs.
Pharmaceuticals can pass through wastewater treatment facilities into lakes, rivers and streams
A brief background on how these PPCPS effects the environment. As you can see, nearly 80% of 139 streams sampled across 30 states have had some trace of commonly found prescription drugs when tested. According to an Associated Press investigation reported in early 2008, “A vast array of pharmaceuticals —- including antibiotics, anti-convulsants, mood stabilizers and sex hormones —- have been found in the drinking water supplies of at least 41 million Americans. More studies are still being conducted on the effects on the environment.

10. Environmental Impact cont’d
Studies have linked hormone exposure to fish abnormalities.
Male fish have been feminized when exposed to hormones.
Anti-depressants and beta-blockers reduce fertility or affect spawning in certain aquatic organisms
A few examples of how these chemicals or medications have effected the fish and marine life.

11. Health Impact Potential for humans and pets to get to old medication
Drug resistant bacteria might develop
Long-term exposure to low levels of antibiotics might results in the evolution of, or selection for, drug-resistant microbes and bacteria
Our bodies may become resistant or immune to certain antibiotics from long term exposure. This effects us if we eat fish or marine life that may be exposed to drugs in the system.

12. Proper Disposal - Pills
Add water or soda to start dissolving them.
Close the lid and secure with duct tape or packing tape.
Place the bottle(s) inside an opaque (non see-through) container like a coffee can or plastic laundry bottle.
Tape the container closed.
Hide the container in the trash. Do not put in the recycle bin
Now you ask yourself, how do I dispose of the old medication or personal care products properly. Here is an example of how to dispose of pills.
Keep the medicines in the original container. This will help identify the contents if they are accidentally ingested. Some "wrap and trash" campaigns suggest keeping the medication in its original container but blacking out all personal information and disguising the container when wrapping it. The goal of either method is to make the medicine unusable and unrecognizable. 
* Avoid crushing pills as some medications can be harmful in powder form.

13. Step One Step Two Step Four Step Three
Here, these photos give you a better view of the entire process.
Images Courtesy of: New Jersey Department of Environmental Health (n.d.). Guidelines of proper disposal of household medications. Retrieved July 28, 2009 from

14. “Yucky” Bag Method - Pills
Place pills in a sealable plastic bag
Mix with cat litter, ashes, dirt, cayenne pepper or any other undesirable product.
Dispose of in trash
The “Yucky” Bag method is used to mix your medications as well. Be careful not to mix with foods because animals or anyone looking through your trash may get the medication. This may be a good source for many medications to dispose of. You will want to mix the pills in a sealable plastic bag and add dirt, ashes or cat litter. Be careful of large amounts of pepper as you may be sneezing a lot.
Photo: FDA (2008). How to dispose of unused medication. Retrieved July 11, 2008 from

15. Proper Disposal - Liquid
Add inedible products like cat litter, table salt, dirt or cayenne pepper (or any nontoxic spice) to the bottle.
May mix with other liquids (water, soda, milk, etc.)
Close the lid and secure with duct tape or packing tape.
When disposing of liquid, flushing down the toilet or pouring down the drain use to be the way most individuals did it. Now the preferred method is to mix the liquid with an undesirable substance so NO one wants to drink it. Again, you will want to mix the medication with something undesirable like spices, cat litter, salt or something as simple as dirt.

16. Additional Safety Tips
Dispose of drugs as close to your trash collection day as possible to avoid misuse and/or misdirection
Do not give prescribed medications to friends or family members.
Doctors prescribe drugs based on a person's specific symptoms and medical history. A drug that works for you could be dangerous for someone else.
Scratch out your name and address with permanent marker from all labels.
When in doubt about proper disposal, contact your pharmacist or health department.
Here are some additional tips to ensure that your medications are disposed of properly. Try to dispose of the items close to your trash collection day, never give prescribed medication to family or friends and scratch out your name and address to protect your identiy. Lastly, if you are unsure on how to dispose of any of the PPCPs, contact your local pharmacy or health department.

17. Photo reference: New York Department of Environment Conservation
Photo reference: New York Department of Environment Conservation. (2009). Proper disposal of household prescriptions and over-the-counter drugs. Retrieved on June 25, 2009 from

18. Questions?
Are they any questions I can answer for you?

19. Resources Contact your local pharmacy Cleveland Board of Health
CVS, Walgreens, Rite Aid, Wal-mart
Cleveland Board of Health
Ohio Department of Health
Finally, for more information, you may contact your local pharmacy, the Cleveland Board of Health or the Ohio Department of Health. Thank you for your time.

20. References Food and Drug Administration (www.fda.gov)
Environmental Protection Agency (
Cleveland Health Department (
Office of the Washtenaw County Drain Commission (
Raloff, J. (2007, April 7). New solutions for unused drugs. Science News, 171(14), Retrieved July 11, 2009, from Academic Search Premier database.