How to Dispose of Old Medications Safely: What You Can and Cannot Flush

Why disposal matters

Unused medications in homes are a leading source of accidental poisoning in children and pets, of intentional misuse by teenagers and household members, and of theft. Flushed medications contribute to pharmaceutical contamination of water systems. Medications thrown directly into trash can be retrieved or accessed by pets and children.

The preferred option: drug take back programs

The best way to dispose of medications is through a drug take back program. These programs accept most medications, including controlled substances, no questions asked, and dispose of them through environmentally responsible processes.

Several types of take back programs are available in Mississippi:

• DEA National Prescription Drug Take Back Day, held twice yearly at sites across the state.
• Permanent take back collection boxes at many Mississippi pharmacies, police stations, and hospitals.
• Mail back programs sponsored by some pharmacies and health plans.

Fairview Pharmacy accepts unused medications for safe disposal year round, including controlled substances. No questions asked.

What the FDA says is okay to flush

The FDA maintains a short flush list of medications that present such a serious risk of accidental ingestion that they should be flushed immediately if a take back program is not available. The list includes:

• Opioid pain medications including oxycodone, hydrocodone, morphine, methadone, fentanyl patches, and several others.
• Some other controlled substances including certain anxiety medications.
• Specific medications where the risk of accidental ingestion is exceptionally high.

If a take back program is available, that is still preferred. Flushing is only the recommended fallback when no take back option is accessible.

What should not be flushed

Most medications not on the flush list should not be flushed because of environmental concerns. This includes most blood pressure medications, antidepressants, antibiotics, OTC products, vitamins, and supplements.

At home disposal when take back is not available

If you cannot get to a take back program and the medication is not on the FDA flush list, the recommended at home disposal process is:

• Remove the medication from its original container.
• Mix the medication with something undesirable like dirt, used coffee grounds, or used cat litter.
• Place the mixture in a sealed container or bag.
• Throw the sealed container in the household trash.
• Remove or black out any personal information from the original prescription label before discarding the empty bottle.

This makes the medication unappealing and unrecognizable, reducing the chance of accidental ingestion.

Special disposal categories

Sharps and needles

Used insulin needles, lancets, and other sharps should be placed in a hard sided container with a tight fitting lid (a commercial sharps container is ideal, but a sturdy laundry detergent bottle works). Many pharmacies and the Mississippi State Department of Health offer programs for sharps disposal. Do not put loose needles in household trash or recycling.

Inhalers

Most empty inhalers contain residual propellant and should not be put in regular trash where they could be punctured or incinerated. Some pharmacies accept used inhalers for disposal. Manufacturer take back programs exist for some products.

Patches

Medicated patches (fentanyl, nicotine, hormone, lidocaine, others) often retain significant medication after use. Fold the patch with the adhesive sides together so it cannot be inadvertently applied or licked by a pet or child, then dispose. Fentanyl patches specifically should be flushed if no take back is available, per the FDA flush list.

Where pharmacy fits

Fairview accepts unused medications for safe disposal, including controlled substances. We will dispose of them through DEA approved channels at no charge to you. Serving Hattiesburg, the Pine Belt, Central Mississippi, and South Mississippi.

When to call a pharmacist

• You have unused opioids or controlled substances at home.
• A family member has died and you need to dispose of their medications.
• Your medicine cabinet has accumulated expired prescriptions over years.
• You have unused sharps and need a disposal plan.
• You are unsure whether a specific medication can be flushed.

This article is for general information only and is not a substitute for personalized medical advice. Before starting or changing any medication, including over the counter products and supplements, talk with your pharmacist or physician about your specific situation.