Is your medicine cabinet full of expired drugs or medications you no longer use? How should you dispose of them?

Some prescription drugs such as powerful narcotic pain relievers and other controlled substances carry instructions for flushing to reduce the danger of unintentional use and illegal abuse.

A small number of medicines may be especially harmful if taken by someone other than the person for whom the medicine was prescribed. Many of these medicines have specific disposal instructions on their labeling or patient information leaflet to immediately flush them down the sink or toilet when they are no longer needed.

For example, the fentanyl patch, an adhesive patch that delivers a potent pain medicine through the skin, comes with instructions to flush used or leftover patches. Even after a patch is used, a lot of the medicine remains in the patch. Too much fentanyl can cause severe breathing problems and lead to death in babies, children, pets and even adults, especially those who have not been prescribed the medicine.

The FDA website has a list of medicines recommended for disposal by flushing.

Following these guidelines for disposing of prescription and over-the-counter medicines will reduce harm from accidental exposure or intentional misuse:

• Follow disposal instructions on the prescription drug labeling or patient information that accompanies the medicine. Do not flush medicines down the sink or toilet unless this information specifically instructs you to do so.
• Take advantage of programs that allow the public to take unused drugs to a central location for proper disposal. Call your local law enforcement agencies to see if they sponsor medicine take-back programs in your community. Contact your city or county government’s household trash and recycling service to learn about medication disposal options and guidelines for your area.
• Transfer unused medicines to collectors registered with the Drug Enforcement Administration (DEA). Authorized sites may be retail, hospital or clinic pharmacies, and law enforcement locations. Some offer mail-back programs or drop-boxes. Visit the DEA website for more information and to find an authorized collector in your community.

If no disposal instructions are given on the prescription drug labeling and no take-back program is available in your area, throw the drugs in the household trash following these steps:

• Remove them from their original containers and mix them with an undesirable substance, such as used coffee grounds, dirt or kitty litter (this makes the drug less appealing to children and pets, and unrecognizable to people who may intentionally go through the trash seeking drugs).
• Place the mixture in a sealable bag, empty can or other container to prevent the drug from leaking or breaking out of a garbage bag.
• Scratch out all identifying information on the prescription label to make it unreadable. This will help protect your identity and the privacy of your personal health information.
• Do not give medicine to others. Doctors prescribe medicines based on your specific symptoms and medical history. Something that works for you could be dangerous for someone else.

When in doubt about proper disposal, ask your pharmacist.