Friday, December 8, 2017

Old Medications a Potential Health Threat

Expired or unused prescription medications are a common sight in the medicine cabinet of a typical American home, but public health experts say leftover medications are an increasing health risk. A December Texas Medicine magazine article says patients who hold on to old prescription drugs might not understand the risk they pose for poisoning and misuse, but getting rid of old medications poses challenges too. The danger of keeping old medicine, or its improper disposal, is complex. If not disposed of correctly, medicine thrown in the trash or flushed down the toilet can eventually enter local waterways and hurt the environment. Yet teens and adults can abuse or misuse easily accessible medications in the home, experts say.

"Our medicine cabinets are the number one source of medications for teens to experiment [with] or abuse," said Jeanie Jaramillo-Stametz, PharmD, an assistant professor of pharmacy practice at Texas Tech University Health Sciences Center-Amarillo. "And there's a misperception by teens that it's better and safer to abuse a prescription medication than it is illicit drugs ― marijuana, heroin, cocaine ― when really these can be just as dangerous. Even regular non-narcotic prescriptions and over-the-counter medications can be abused and cause harm."

Old, unused prescriptions are a factor in the national opioid crisis. According to the 2013 National Survey on Drug Use and Health, 53 percent of people obtained opioids for nonmedical use from a friend or relative, 10.6 percent bought them from a friend or relative, and 4 percent stole them from someone they knew.

To confuse matters, in some cases, experts still advise flushing drugs away. For example, the Food and Drug Administration (FDA) says people should flush opioids like fentanyl because the drugs depress breathing in children who accidentally touch them.

Some participants in the health care system contribute to the problem of too many leftover drugs. Laredo gastroenterologist Sunny Wong, MD, who has worked with the Texas Medical Association (TMA) on effective ways to dispose of unused medicines, says many health insurance policies force patients to buy more medications than they need or know what to do with.

Pharmacist Dr. Jaramillo-Stametz agrees. "A lot of this is driven by the insurance industry," she said. "The physicians are doing what they can, and they're trying to provide their patient with the appropriate medication at the best rate that the patient would like. [The patients] want the $10 copay for a 90-day supply; they don't want the $10 copay for a 30-day supply. ... It's very difficult for [physicians] to manage all that and find a compromise where the patient will be happy without creating the problem of over-dispensing and accumulation."

"The cost of health care is going up," Dr. Wong said. "And one of the problems is the amount of drugs being given out ― whether they are used or not."

Federal and state agencies recommend disposing of medications at drop-off sites. But, currently, there is no all-inclusive program in Texas or at the national level that allow people to dispose of old medications at their convenience. There are some local options to drop off unused medicine across the state, including medication clean-out events Dr. Jaramillo-Stametz organizes in west Texas, but many Texans still do not have consistent options for safe drug disposal. Wong says disposing of old medications should be as easy as dropping mail in the mailbox. "The ideal situation for practices and patients is to [follow] the concept of a toner cartridge being shipped back to the manufacturer at no cost to the consumer," he said.

Dr. Jaramillo-Stametz says the best thing physicians can do now is educate themselves on ways to minimize the problem. "The physicians are doing what they can, and they're trying to provide their patient with the appropriate medication at the best rate that the patient would like. It's very difficult for [physicians] to manage all that and find a compromise where the patient will be happy without creating the problem of over-dispensing and accumulation."

Resources for Safe Drug Disposal:

Texas Medicine lists searchable websites to locate safe medicine disposal and drug take-back programs across Texas. In addition, local city and county government websites may also provide information on safe drug disposal.

To search local disposal sites, visit:



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