By Bryan Foss
According to the White House Office of National Drug Control Policy, the intentional use of prescription drugs for nonmedical purposes is the fastest-growing drug problem in the country. It is believed that properly disposing of unwanted medications would help prevent prescription drug abuse by reducing the accessibility and availability of such drugs.
Because of their potential impact on public safety and the environment, unused and expired pharmaceuticals must be disposed of as part of a routine protocol that all dental practices should follow. Both the Drug Enforcement Administration and the Environmental Protection Agency recommend that health care facilities follow a schedule to dispose of their unused and expired medications on a regular basis. The DEA recommends at least once a quarter.
While nothing substitutes for a thorough understanding of the EPA’s management standards for pharmaceutical waste, here’s an overview of pharmaceutical waste disposal best practices.
Don’t:
Flush your unused or expired medications down the toilet or drain
Per older recommendations, many dental practices would dump expired medications in the trash or down the drain. The EPA now prohibits this practice as this introduces dangerous elements into our wastewaters. Water treatment plants are generally not equipped to routinely remove these medicines, so much of this waste enters rivers and lakes and eventually our water supplies.
In addition, some expired medications qualify as hazardous waste. Several steps must be followed for that waste to be properly recovered and properly destroyed.
Do:
Treat dental carpules with trace pharmaceutical as pharmaceutical waste
Although dental carpules that contain visible blood or are broken should be placed in the sharps container, dental carpules with residual anesthetic should be placed in a container labeled as pharmaceutical waste and properly transported to a waste processor for incineration. Why not the sharps container? Medical waste is first autoclaved and then disposed. The pharmaceutical waste does not break down and will mix with the wastewater produced during the autoclave process. Per EPA guidelines, this can have a negative environmental impact unless properly destroyed by incineration.
Do:
Use a pharmaceutical waste disposal service or reverse distributor
Drug disposal requirements can be confusing, so consider using a professional disposal service. They can provide education on what you need to do and how. Some disposal services offer convenient mail back containers that include step-by-step instructions.
When is it important to use a pharmaceutical reverse distributor?
If your practice purchases controlled substances, the DEA license number of the registered doctor at your facility is accountable to the DEA. That means you’ll need to keep proper documentation that these medications were properly recovered and destroyed if unused or expired. A pharmaceutical reverse distributor can provide you with the necessary paperwork to properly document the removal of these substances from your doctor’s possession.
Do:
Follow these steps for proper waste segregation and disposal of your pharmaceutical waste
Step 1: Segregate your pharmaceutical waste from your biohazardous waste
Be sure that pharmaceutical waste is separated from your sharps and medical waste. These waste streams are treated and disposed of differently from each other. Medical waste is first autoclaved prior to destruction and disposal when pharmaceutical waste is typically incinerated.
Step 2: Identify all controlled substances
Next, you’ll need to separate out any controlled substances (such as opiates and benzodiazepines) from the rest of the pharmaceutical waste. Dispose of these substances via a pharmaceutical reverse distributor. This is very important, as the proper paperwork will be provided in accordance with DEA regulations.
Step 3: Pull out any hazardous waste
Some medications are classified by the EPA as hazardous chemicals. The Resource Conservation and Recovery Act outlines a full list. Hazardous pharmaceutical waste must be disposed of appropriately to reduce the risk to the public. Drugs like warfarin, lindane and mitomycin are considered hazardous waste. These should be disposed of in accordance with local disposal regulations for such waste streams.
Step 4: Contract with a licensed pharmaceutical waste disposal service.
After all the precautions you’ve taken to comply with the EPA and DEA, don’t put it all at risk by partnering with the wrong waste disposal service. The right licensed and knowledgeable partner can help you stay in compliance from delivery to disposal.
HealthFirst is endorsed by ADA Member Advantage for their sharps, medical waste and pharmaceutical disposal services. If you have questions, please contact them at 800.331.1984 or email at sales@healthfirst.com.
Reference Links:
- DEA: Chicago pharmacy technician sentenced to five years in prison for stealing opioids and selling them for profit
- EPA: How to Dispose of Medicines Properly (PDF)
Mr. Foss is the product manager for the Environmental and Infection Control product lines at HealthFirst. He has an extensive background in the waste industry and was instrumental in the development of HealthFirst's Sharps Management, Medical Waste Management, Amalgam and Pharmaceutical Waste Recovery product lines.