Following guidelines issued by the American Pharmacists Association in February, the federal government has also issued guidelines
on the disposal of medications, which recommend against flushing unused or expired drugs in a toilet or down the sink. Consumers,
doctors, and pharmacies are now urged to dispose of most drugs in the garbage.
"These are just guidelines, they are not regulations," admitted Jennifer de Vallance, White House Office of National Drug
Control Policy spokeswoman. "We want to empower consumers to do something immediately."
At the recent APhA convention in Atlanta, officials from the U.S. Fish & Wildlife Service announced the launch of SMARxT Disposal,
a national consumer awareness program. The campaign aims to educate consumers. "The good news is that the federal government
is paying attention," remarked Charlotte A. Smith, R.Ph., president of PharmEcology Associates, a consultant who specializes
in pharmaceutical waste management. "There are not a lot of good options, but [flushing] is the worst."
A growing body of evidence indicates that many drugs are ending up in drinking water. The U.S. Geological Survey, for example,
found traces of 22 pharmaceuticals ranging from acetaminophen to fluoxetine to warfarin in Boulder Creek in Boulder, Colo.
Other studies have found that estrogen in the water supply is causing sexual abnormalities in fish. The new guidelines direct consumers to first ensure that the medication cannot be reused. Consumers should crush solid medications
or dissolve them in water and then combine them with cat litter, coffee grounds, or other kitchen materials. The medication
should then be placed in a sealed bag in the trash. The Food & Drug Administration has ruled that some medications can still
be flushed.
APhA and government officials hope that better disposal solutions will be developed down the line. Among them are:
- Establishment of take-back programs in which drugs are taken back to a central location. Three states already have take-back
programs. Controlled drugs can only be taken back to the police in most instances.
- Use of reverse distributors, now employed in some small countries. These firms facilitate the return of drugs to manufacturers
for credit.
"We must think toward the future to address the prescribing practices that led to this waste," concluded Stevan Gressitt,
M.D., a Maine physician who's been actively lobbying on the issue. "There's no way we can solve this problem without the concept
of pollution prevention."
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