Medical waste doesn’t just come from hospitals. As much as two-thirds of all prescription medications sold in the United State goes unused. That means after patients receive treatment and often start feeling better, leftover medication ends up sitting on a shelf, or in a drawer. All these surplus drugs constitute a major waste problem in two ways. There is the upfront waste of manufacturing and purchasing drugs that are never used therapeutically, but there is also the issue of these drugs becoming waste, specifically, medical waste.
Medical waste represents a serious public health problem, as life-saving drugs and supplies can become life-threatening hazards when they are neglected or improperly disposed of. Hanging on to expired pills and prescriptions creates the potential for abuse or accidental poisoning. But getting rid of these drugs can create its own risks when people take shortcuts like flushing old pills down the toilet or just throwing them out in the trash.
Can You Flush It?
Unused and expired medications often end up in the water supply–including drinking water. Although we generally have robust water sanitation systems, people are simply dumping too many of their old prescriptions down the drain. Most of the time, these residual chemicals are extremely diluted. It is only recently that scientists have had equipment sensitive enough to detect them. However, “a 1999 and 2000 study by the U.S. Geological Survey found measurable amounts of one or more medications in 80% of the water samples drawn from a network of 139 streams in 30 states.” While these trace chemicals are not usually concentrated enough to harm humans, some scientists worry it may be having a negative effect on animal and plant life, especially aquatic species like fish.
Overwhelmingly, these trace chemicals come from good intentions gone wrong: people trying to dispose of their expired and unused drugs by flushing them down the toilet. The mistake is somewhat understandable because of how toilets are used. Old and unused pharmaceuticals are a kind of waste, but they should be disposed of in a much different manner.
Instead, many people make an ultimately dangerous mistake when throwing away medical waste. More often than not, household trash containing medical waste ends up in landfills. Again, landfills are meant to hold garbage but only certain types of garbage. Medical waste like prescription drugs still poses an environmental and public health threat when it ends up in landfills, where it can find its way into the groundwater supply or be ingested by local wildlife.
It Has to Go Somewhere
There are a variety of reclamation and disposal programs specifically addressing the issue of old and unused medications. Hospitals, police stations, fire departments, and local sanitation companies are all common partners in containing and safely disposing of surplus medications. Many communities also have targeted drug take-back programs that provide centralized locations to accept drop-offs. Some even send out mobile collectors to accept old and unused drugs, preventing them from being flushed or dumped down the drain.
Controlling the risks of hazardous waste isn’t just a matter of keeping drugs from getting into the water supply. Needles, by the very nature of their design and utility, pose a unique health threat following their use.
Syringe needles are sharp, small, and covered with bodily fluids. Millions of people continue tossing used needles into their household trash which heightens the risk of spreading contaminants through accidental contact. Again, this isn’t an isolated risk. Janitors, trash collectors, as well as children, pets, and the environment at large, are all impacted by needles mixed in with general waste.
This is why needles have been grouped into a special category of waste materials known as sharps. As the name suggests, sharps are objects that can cut, puncture, and otherwise lacerate someone handling waste. They also bear an elevated risk of carrying contaminants, chiefly blood.
It is no great challenge, however, to locate a sharps disposal container. Hospitals and many public facilities have sharps disposal boxes, which are usually just rigid plastic containers that prevent needles and other sharps from poking through and escaping, and are lidded to protect anyone handling the containers from an accidental cut or stick. They are also sealed to prevent any fluids or other contaminants from leaking, and are generally not reusable, so their contents remain safely isolated upon disposal.6
Talking Trash in Healthcare
All this medical waste also represents a lot of money being effectively flushed down the toilet–as much as $5.4 billion dollars annually in unused medications. Much of this waste comes from a lack of patient literacy about both how to follow the instructions of their caregivers, as well as how to handle any unused medications or supplies following their use. With better adherence to instructions, patients can cut down on the generation of much medical waste upfront, saving money as well as reducing the number of drugs that need to be reclaimed.
While healthcare professionals can control these factors in a clinical environment, there is clearly a need for more experienced health leaders, especially nurses, to educate patients on how to take care of themselves, the environment, and their medical supplies. Nurses are not only on the frontlines of patient care and public health but also play a critical role in training patients on how to take care of their own medical waste in a safe, sanitary way. As experienced nurses from every specialty can attest, nursing is as much about educating patients as it is providing patient care.
Medical waste like old prescriptions and used needles are simply too hazardous to be dealt with by flushing them down the toilet or tossing them in a garbage can. Nurses and their healthcare teams can effectively reduce waste by helping promote safe waste disposal practices.
For students who aspire to an advanced career in nursing, Ohio University’s online Master of Science in Nursing helps them gain the skills and experience necessary to take their nursing careers to the next level.
Researchgate.com “Taking stock of medication wastage: Unused medications in US households”
World Health Organization, “Pharmaceuticals in drinking-water”
Harvard.edu, “Drugs in the water”
Take Back Your Meds.org, “Medicine Disposal Myths and Facts”
FDA.gov, “For Consumers”
FDA.gov, “Best Way to Get Rid of Used Needles and Other Sharps”