National Clean Out Your Medicine Cabinet Day

Easy Steps for Getting Rid of Unused Medication

The risks for misuse and abuse increase with every bottle of pills you keep. 

Here’s how to safely dispose them.

Consumer Reports / Ginger Skinner / March 20, 2017

Today is National Clean Out Your Medicine Cabinet Day, and chances are you haven't given much thought to the unused medications taking up space in your medicine cabinet.

A new Consumer Reports Best Buy Drugs nationally representative survey of 1,006 American adults found that about one-third of Americans haven't cleaned out their medicine cabinets in a year or more; and nearly a fifth (19 percent) haven't done so in three years.

But those leftover pills are far from harmless.

Taking a drug not intended for you (or one taken by your child accidentally) could mean a trip to the emergency room—and can even prove deadly. Of particular concern are leftover opioids—narcotic painkillers such as Oxycontin, Percocet, and Vicodin.

A survey last June published in JAMA Internal Medicine suggests that there are a lot of opioids in people's medicine cabinets: 60 percent of respondents who had been recently prescribed an opioid reported holding on to the drugs for future use. Almost half said that they weren’t aware of how to properly store or dispose of opioids.

Don’t Hang on to Your Meds

Dan Budnitz, M.D., M.P.H., director of the Centers for Disease Control and Prevention's Medication Safety Program, suggests doing a yearly inventory of what’s in your medicine cabinet and discarding unused meds. Doing so will cut down on the risk of someone misusing a medication in your home—and not just young children, but teenagers, too.

When it comes time to clean out the cabinet or drawer, you might be tempted to just toss pills or other drugs into the trash. But because pills can easily be fished out of the garbage by a kid, you’ll want to take safer precautions instead:

1. Return unused medication to your pharmacy. (Or you can return it to a hospital, clinic, long-term-care facility, or narcotic treatment program.) New rules in 2014 from the Drug Enforcement Administration allow pharmacies to voluntarily take back your medications. This is an especially good option for opioids, ADHD drugs, and benzodiazepines (think: Xanax). Places that accept your unused medications are usually part of take-back programs, such as DisposeMyMeds, that collect and destroy (usually by incineration) unused drugs.

If you’re not sure what pharmacies accept meds, you can search for an authorized collector near you at DisposeMyMeds.org or DEAdiversion.usdoj.gov and search for "drug disposal." Or call the DEA’s Registration Call Center at 800-882-9539. It can also point you to fire and police departments, community hospitals, independent pharmacies, and other collection sites.

2. Drop off unused meds during National Prescription Take-Back Day on Saturday, April 29. Twice a year, the Drug Enforcement Agency holds National Prescription Take-Back Day, where you can drop off all your leftover medications at designated police departments, fire stations, and other specially designated facilities in your community for proper disposal. Drop-off is completely free and anonymous. If you miss this one, the DEA hosts a second one in the Fall.

3. Mail medication to a collection site. Costco, CVS, and Rite-Aid pharmacies sell postage-paid envelopes for customers to mail any prescription, including opioids, and over-the-counter medications to a disposal facility.

4. Use a self-service disposal kiosk. Walgreens offers free, anonymous, and secure kiosks in almost all states, and you can drop off any medication. To use one, remove your personal information from the bottle or packaging and drop your unwanted or expired medication, including controlled substances, in the slot.

5. Be responsible if you put pills in the trash—hide them in coffee grounds, sawdust, or kitty litter, then seal both in a plastic bag. If your local pharmacy won't accept your medication and drop-off at an authorized location is not an option, you can toss most pills in your household trash—just be sure to mix them with a substance that makes them less recognizable. (Don’t do this with opioids or other dangerous meds—it’s too easy for kids to fish these out of the trash and ingest them.)

6. For dangerous drugs, the FDA says flushing is an option. But trace amounts of drugs can end up in the water supply and possibly harm aquatic life. Flush dangerous drugs such as opioids only if there is absolutely no other choice.

What About Needles?

Most collection sites won’t accept asthma inhalers, needles, insulin syringes or any other syringes, marijuana, mercury thermometers, and medications containing iodine.

In some areas you can put asthma inhalers in the trash or recycling, but in other municipalities they’re considered hazardous waste and can’t be tossed in the regular trash. Check with your local sanitation company, recycling facility, or the health department for the rules where you live.

For disposal information and drop-off locations for syringes, needles, and other injectables—for example, expired EpiPens—go to Safe Needle Disposal or call 800-643-1643.

When in doubt about how to safely dispose of a medication or medical device, check with your pharmacist.

Editor's Note: This article and related materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

What You Need to Know About Expired EpiPens

Consumer Reports / Ginger Skinner / August 26, 2016

Are they safe? And will they be effective in an emergency?

Anne McMaster, a retired nurse in Seattle with a serious allergy to bees, used to buy a new EpiPen every year when her current one expired. That stopped about three years ago when her out-of-pocket costs for the potentially life-saving medication spiked and she couldn't afford the higher price. Instead, she just kept her old injector, figuring an expired EpiPen is better than no EpiPen at all.

"I would never tell anyone else to do it because of the risks of it not working," McMaster says. "But for me, it was a risk I had to take."

Although there are some lower-cost alternative injectors on the market, and Mylan, the maker of EpiPen, says it is introducing programs to make the device more affordable for consumers, many Americans are wondering whether it is indeed okay to use expired EpiPens.

It's important to replace your epinephrine injector before the expiration date stamped on the pen. That’s because epinephrine deteriorates over time and relying on an outdated one (past the standard 12- to 18-month expiration date) can leave you with an auto-injector that's less effective, or not effective at all, when you most need it.

But what should you do if you are having an allergic emergency and the only injector you have is an expired one? It's probably better to use it than not, some experts say.

"If a patient were to experience an allergic emergency that required use of epinephrine and the only injector available was an outdated one, I would use it," says Andrew Murphy, M.D., a board-certified allergist at the Asthma, Allergy and Sinus Center in West Chester, Pa. "The risk would be that the epinephrine would have degraded and you may not get an optimal dose."

An April 2015 study in the Annals of Allergy, Asthma & Immunology looked at 35 expired EpiPens and found that injectors that were up to two years past their expiration date could retain 90 percent or more of the initial dose listed on labeling.

Murphy stresses that you shouldn't use any injector, even if it's technically not expired, if the medicine is pink or brown (instead of colorless), cloudy, or contains solid particles. In that case, "the medicine clearly has decayed and the injector should not be used at all," Murphy says.

Murphy also says that anytime you use an auto-injector—expired or not—you should call 911 or go to the emergency room, even if the shot seems to be working. That's because severe allergic reactions can require more than just a shot of epinephrine.

Storing and Disposing EpiPens
Be sure to store epinephrine auto-injector properly. And that doesn't mean in the refrigerator: Extremes of heat or cold can degrade the medicine, as can exposure to light and humidity. So while you might need to carry one around with you, when you are at home or work store it at room temperature in a dry, dark place. And while it might be tempting to keep a spare in the glove compartment of your car, that's probably not a good idea because it can get too hot or cold, in there. If your child needs one while at school, ask the nurse to keep it. Many schools have special lockers for such medicines.

It's also important to properly dispose of expired EpiPens or used injectors, says Barbara Young, Pharm.D., of the American Society of Health-System Pharmacists.

Auto-injectors thrown into in your household trash could prick or injure people or pets in your home. Instead, if you've used the injector, give the device to the healthcare professional you saw afterward. Take expired EpiPens to a doctor’s office, hospital, or pharmacy for disposal, Young says.

You can find a drop-off location near you at SafeNeedleDisposal.org.

A final tip: When filling an EpiPen prescription, ask the pharmacist to give you auto-injectors with the latest expiration date.


Editor's Note: This article and related materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).