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Proper Disposal of Medications the Risks of Improper Disposal and the Benefits of Take-Back Programs

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Proper Disposal of Medications the Risks of Improper Disposal and the Benefits of Take-Back Programs Proper Disposal of Medications The Risks of Improper Disposal and the Benefits of Take-Back Programs Tag Words: Medication; Disposal of Medications; Prescription Drugs; Over the Counter Drugs Authors: Brian Estrella, Minhazur Rahman, Kevin Ng with Julie M. Fagan, Ph.D. Summary Both prescription and non-prescription drugs are some of the most common items found in every American household. What many people fail to realize is that these medications have expiration dates and must be properly disposed of. As the use of medication becomes more prevalent in our society a major problem is occurring: what should a person do with expired medication? Recent trends in the United States have shown that children ages 12 to 17 are likely to abuse prescription drugs more than all other illicit drugs except marijuana. These same studies have shown that children in this age group are likely to obtain these drugs from the home. Other studies have been conducted, showing small amounts of antibiotics in groundwater. To combat these issues, the United States government has recently passed a law called The Secure and Responsible Drug Disposal Act. This law allows local pharmacies to take back prescription and over-the-counter drugs for proper disposal. Our goal for this project is to raise awareness among our friends, students, and peers about the dangers associated with improper medical waste disposal. We hope to accomplish this by writing to the corporate headquarters of local pharmacies, compiling this classepedia document, and through the production of documentary and instructional videos on how to properly and safely dispose of any drugs. Video Link Proper Disposal of Medications: http://www.youtube.com/watch?v=eNZSntGbDgA The Issue: Drug Disposal Prescription Drug Abuse among Teens (BE) The abuse of prescription medication by children ages 12 to 17 is a growing problem in the United States. Recent studies have shown that young people ages 12 to 17 abuse prescription drugs more than all other illicit drugs except marijuana. It can be concluded that these adolescents are obtaining the drugs for free from their own homes’ medicine cabinets, and from friends from out of their medicine cabinets. The drugs that are abused the most include prescription drugs, such as pain relievers, tranquilizers, stimulants and sedatives. The most recent research on deaths in the United States due to poisoning over a five year period (1999-2004) shows that nearly all poison deaths in the country are attributed to drugs, and most drug poisoning result from the abuse of prescription and illegal drugs (http://www.theantidrug.com). The Figures below (obtained from http://www.theantidrug.com/pdfs/TEENS_AND_PRESCRIPTION_DRUGS.pdf) document the current drug use among teens 12 to 17 and the most commonly used drugs by children in this age group. The development and implementation of national take back programs can hopefully alleviate the drug abuse problem that is currently occurring among teens. Implementation of these types of programs will, in effect, remove any potential chance for abuse by reducing the amount of prescription pills that are available in the home. Another of our objectives is to raise awareness that pharmacies usually accept these expired drugs and dispose of them safely and in an environmentally safe manner. If people were more consciously aware that these services are provided, the number of prescription abusers can be lowered dramatically. Figure 1: This figure shows the top sources where pain relievers were obtained for non-medical users in the 12-17 age groups. Figure 2: This figure shows the types of illicit drug use among teens aged 12-17 Figure 3: This figure shows, by percentage, the top five drugs used by 12th graders in the past year. Dangers of Expired Medication (KN) When medications are distributed, they come with an expiration date that is set approximately a year following the date of purchase. It has been found that medications often last about five years following the expiration date if the seal has not been broken [12]. Once the seal is broken, the potency of the drugs greatly deteriorates, due to exposure to light, humidity, and temperature variations depending on how the medication is stored. Although the effects of consuming expired medications have not been greatly studied, it is suggested that taking expired medications is not worth the risk, especially medications that are essential and molecularly less stable. Some of the medications that are essential and degrade relatively rapidly consist of nitroglycerin, insulin, EpiPens, and liquid antibiotics, especially those that require refrigeration [12]. Those medications that may be safe to consume after expiration date, such as pain relievers, cold remedies, and sleeping pills, exhibit a decrease in potency and are liable to be abused [12]. If these medications are not used by the expiration date, it is safer to dispose of these medications properly. Left alone, they are prone to abuse by minors because of their ease of access. If, in the future, there is a need for these medications, it is better to obtain a new prescription. The new medication will be more potent and effective than the medication left in the home after the expiration date. And any other medications essential for health should be disposed of accordingly when it appears discolored, has a potent smell, or has turned powdery [12]. Because most drug prescriptions are not written for an excess of medication, they are intended to be used entirely. Since there should not be any extra medication, it is much safer to properly dispose of any extra medication than to store the medication in the home. Bacterial Resistance: Kevin Ng Flushing antibiotics down the toilet could lead to future health risks because sewage and wastewater treatment are not designed to cleanse water of passing antibiotics. When antibiotics are flushed down the toilet, the antibiotics are deposited into ground water, eventually making it into drinking water. It was once common practice for doctors to teach us to flush unused medicines and antibiotics down the toilet. It was thought safe, and was a better alternative to leaving the drugs in the medicine cabinet where they could be abused by adolescents. However, this old method for disposing antibiotics has been speculated to have an adverse effect on the environment. The concentration of antibiotics in the groundwater is currently at a harmless level, but given time to accumulate, the increase in the amount of antibiotics in groundwater can lead serious health problems in the future. The main concern with the constant intake of antibiotics via drinking water deals with the human body and the many micro-organisms that exist within our bodies. With the constant increase of antibiotics in drinkable water, virulent strains of infectious bacteria can evolve to become resistant to antibiotics. If certain bacteria grow a resistance to antibiotics, the viability of antibiotics as an antibacterial greatly decreases, resulting in the nullification of antibiotics as a treatment for certain illnesses. To present a little background on the beneficial aspects of bacteria and micro-organisms for humans, we look at what antibiotics can do to disrupt the homeostatic relationship between the human body and the micro-organisms that live within the body. The presence of bacteria within our ground water is nothing out of the ordinary because they generally carry out beneficial processes, but certain bacteria and micro-organisms such as viruses have a harmful effect on the human body. The human body consists of many micro-organisms which have become key components to our bodies, competing with other micro-organisms that may cause disease and providing key mechanisms for the continuous functionality of the body. Groundwater can also be host to many pathogens that disrupt the homeostatic relationship between certain micro- organisms and the human body, which pose a great risk for the future when dealing with the rise of antibiotics within the groundwater. As the level of antibiotics within groundwater continues to rise, the constant exposure of antibiotics with certain pathogens allow the pathogens to mutate accordingly, increasing the pathogens’ immunity towards antibiotics. This nulls the effect of antibiotics to treat certain pathogens because the pathogens may have mutated to become resistant to the beneficial effects of antibiotics. The ability for pathogens to grow an immune response to antibiotics is of great concern. With the possibility of negating our current antibiotics in mind, we must deal with the problem before it becomes irreversible. Environmental Concerns (BE and KN) There are some environmental concerns that are raised in regards to how prescription medication is disposed. Recent studies have found that there is a trace amount of drug residue found in surface water, such as rivers and lakes, and in some community drinking water supplies. Despite this recent discovery the Federal Drug Administration and its own researchers remain adamant that this increase is caused primarily by people taking and naturally metabolizing drugs and then passing them into the environment by feces or urine. Another source of antibiotics found within groundwater deals with the production of animals as food. The use of antibiotics as an additive to the feed for livestock has also been found as a source of antibiotics within groundwater. Like humans, remnants of the antibiotics are passed through the livestock to the environment and eventually into the groundwater via the livestock’s excrements [13]. It was found that trace amounts of the antibiotics tylosin, tetracycline, and chlortetracycline were present in the groundwater and field runoff from livestock farms [13]. Trace antibiotics were also found in agricultural fields that make use of livestock manure as fertilizer. Food livestock is another huge contributor to antibiotics in the environment. Any medication seeking FDA approval must pass an assessment test, which tests how the medication’s use would affect the environment.
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