Disposal of unused pain medications
Don't save your leftover pain pills. Prompt disposal of opioids is crucial and may include flushing them down the toilet.By Mayo Clinic Staff
If you've ever had surgery, there's a good chance that you have a partially used bottle of prescription pain medication in one of your bathroom cupboards.
Pain medications known as opioids are often prescribed for a sudden, acute episode of pain that occurs after surgery or a traumatic injury, such as a broken bone.
Many people who have been prescribed opioids hang on to any leftovers, just in case they need them in the future. But this practice can have deadly consequences if children or pets accidentally ingest these drugs.
That's why officials with the U.S. Food and Drug Administration (FDA) recommend that people dispose of leftover opioids as quickly as possible. There are many methods of disposal, including flushing them down the toilet if other options aren't available.
The U.S. Drug Enforcement Administration sponsors take-back programs for prescription medications. Authorized collectors may include local law enforcement agencies, hospitals and pharmacies. Take-back options may include:
- Take-back events. Many communities designate a specific day for people to bring in unused prescription drugs to a central collection point.
- Disposal by mail. Some pharmacies offer mail-back envelopes for prescription drug disposal.
- Collection receptacles. Secure collection receptacles are located in many communities. Call your local law enforcement agency to see if there are any in your community.
Some types of prescription drugs can be disposed of in your household trash. Mixing the medications with used coffee grounds or cat litter is often recommended. But the FDA says that opioids are too dangerous to dispose of within household garbage because even one dose to the wrong person can sometimes be fatal.
Illicit use of opioids
In addition to the risk of harm to children or pets accidentally ingesting them, pain medications containing opioids can be stolen and used to get high. Leftover prescription opioids from friends and relatives can easily be diverted for illicit use.
According to the Centers for Disease Control and Prevention, nearly half of all opioid overdoses in the U.S. involve a prescription opioid. In 2015, more than 15,000 people died from overdoses involving prescription opioids.
The most common drugs involved in prescription opioid overdose deaths are methadone, oxycodone (OxyContin, Percocet, others) and hydrocodone (Vicodin, Norco, others).
Flushing is a disposal option
If a take-back program is unavailable and the medication appears on the FDA's "flush list," don't hesitate to flush it down the toilet or sink. Flushing should also be considered when the medication cannot be safely and securely stored until disposal via a take-back program, or when there are risks in waiting to do so.
The FDA's "flush list" includes medications that contain:
- Sodium oxybate
Some of these medications come in the form of patches that adhere to the skin. Used fentanyl patches can be deadly to small children, so the patches should be flushed as soon as you take them off your skin. Fold the sticky sides together before flushing.
Will flushing drugs harm the environment?
Traces of prescription medications, including opioids, have been found in streams and lakes. But FDA officials say that most of these traces come from the urine and feces of people who are taking these drugs.
Weighed against the known risk of harm that unused opioids present via accidental or illicit use, the potential harm to the environment caused by flushing opioids is believed to be negligible.
Oct. 31, 2019
See more In-depth
- Khan U, et al. Risks associated with the environmental release of pharmaceuticals on the U.S. Food and Drug Administration "flush list." Science of the Total Environment. 2017;609:1023.
- Prescription opioids. Centers for Disease Control and Prevention. https://www.cdc.gov/drugoverdose/opioids/prescribed.html. Accessed Nov. 2, 2017.
- AskMayoExpert. Opioid prescribing. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2017.
- Flushing of certain medications. U.S. Food and Drug Administration. https://www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/ensuringsafeuseofmedicine/safedisposalofmedicines/ucm576167.htm. Accessed Oct. 25, 2017.
- Drug disposal: Questions and answers. U.S. Food and Drug Administration. http://www.fda.gov/drugs/disposal-unused-medicines-what-you-should-know/drug-disposal-questions-and-answers. Accessed Oct. 11, 2019.
- Disposal Act: General public fact sheet. U.S. Drug Enforcement Administration. https://www.deadiversion.usdoj.gov/drug_disposal. Accessed Oct. 25, 2017.
- Prescription opioid overdose data. Centers for Disease Control and Prevention. https://www.cdc.gov/drugoverdose/data/overdose.html. Accessed Oct. 25, 2017.
- Krieger CA (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 10, 2017.
- Fentanyl patch can be deadly to children. U.S. Food and Drug Administration. https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm300803.htm. Accessed Nov. 3, 2017.