Discarding Narcotics: Down the Drain or Another Option?

Recently I wrote about pharmaceuticals reaching the environment and contaminating our drinking water ultimately as a result of normal patient consumption, metabolism, and ways to limit our personal “pharmaceutical footprint." In this article I hope to open a discussion on the current “wasting” of narcotics by purposely disposing in sink drains.

The US Drug Enforcement Agency (DEA) tightly controls nearly every aspect of narcotic use, distribution and destruction and for all the obvious reasons. Without too much detail, the destruction and disposal of partial narcotic doses by end user health professionals (nurses primarily) must be witnessed by at least 2 individuals, documented and conducted in an “irretrievable” manner (DEA requirement). The DEA doesn’t specify exactly what irretrievable is but is aware that for most registrants (hospitals, clinics etc.) the most common and least costly method is to flush or expel partial excess narcotic doses down a drain (sewerage).

Disposal in “sharps” or needle containers or pharmaceutical waste containers do not qualify as “irretrievable” because these methods are not tamper proof. This “sewerage” occurs primarily with injectable doses or tablets when the prescribed dose does not match the total amount in the pharmacy supplied product or container. Sewerage of medications such as fentanyl, morphine, hydromorphone, lorazepam and other controlled medications is very common. Pharmacies could offer the products in more unit of use containers but that is often impractical or the manufacturers don’t offer the plethora of multiple dosage sizes that would be required.

Every day at hospitals and clinics all across the United States, hundreds of thousands, perhaps millions of partial doses of narcotics are purposely “wasted” down the nearest sink drain and as an “irretrievable” method. The DEA is aware of this “sewerage” as a method and is concerned but still leaves the destruction method up to registrants who, up to now, have almost universally chosen the most low cost method of destruction, which is down the drain.

There are alternatives, however, as developers have created secure containers that contain gels that react with these common narcotics and render them “irretrievable” and that are then combined with end collection and environmentally-friendly destruction. These systems are in the early development cycle and admittedly increase the cost of narcotic disposal but spare the environment.

Given our current opioid crisis and increasing concerns about the unavoidable contamination of our water supplies, wouldn’t it seem prudent to avoid purposeful pollution of our waters when practical??

If mandated and with widespread usage and adoption, the costs of environmentally and security friendly disposal methods will decrease.

It’s time to stop discarding narcotics down the drain!!!

*The views and opinions expressed in this article are those solely of Ken Fagerman and do not necessarily reflect the official policy or position of Pharmacy Times, DEA, and/or any pharmacy/hospital/clinic, or medical provider public or private, nor does Ken Fagerman or Pharmacy Times support or promote any commercial disposal agent or company. No inference of malice or disregard of environmental safety is implied by the content of this article.

Fagerman, K. "What is your pharmaceutical footprint?” Pharmacy Times. Oct.21,2017. http://www.pharmacytimes.com/news/what-is-your-pharmaceutical-footprint Accessed 1/24/2018.