Cost-Effective Medication Disposal in Long-Term Care

Medication Disposal in Long-Term Care

This is an update of the article originally published on November 3, 2015. Regulations change frequently. That’s why Sharps Compliance monitors updates and communicates any changes to its customers.

Nurses practicing in senior care have very busy work schedules. From caring for residents to distributing medications and updating records, their days can become overwhelming. One of the most important tasks is the disposal of unused medication.

When a resident’s medication is permanently discontinued, per the 2014 Drug Enforcement Agency’s (DEA) Disposal of Controlled Substances Final Rule, it must be properly disposed of within three business days. Prior to the 2014 DEA regulation updates, the most common ways to dispose of a resident’s medication was either flushing medications down the sink or toilet (sewering) or placing them into a drug disposal pouch and placing it into the trash. However, these options are costly, inefficient, and unsafe for the environment.

Reducing costs is key to the success of any business. So, paying Clinical Directors, Directors of Nursing, and nurses up to $50/hour to pop pills out of blister packs to flush them down sinks or toilets or place them into disposal pouches is certainly not the best use of their time, skill set, and salary expense. This practice can cost a community upwards of $14,000 annually in nursing salary alone. Additionally, the ability to streamline disposal options for multiple medication waste streams can reduce the expense of managing multiple disposal solutions by over $2,700 annually. This action reduces disposal solutions from four or five solutions down to only two.

Secondly, sewering drugs or placing them into disposal pouches are an inefficient use of the highest-paid staff’s time and efforts. Nursing Directors, Clinical Directors, and nurses in the long-term care setting are spending, on average, 4 hours a week removing pills from their packaging in order to prepare them for disposal, which takes significant time away from direct resident care. Also, after disposing of the pills, the staff is still responsible for disposing of the medication packaging in a HIPAA compliant manner to protect the resident’s protected health information, further contributing to time away from residents in need.

Lastly, neither sewering nor disposal pouches are environmentally friendly disposal options. In August 2019, the EPA Management Standards for Hazardous Waste Pharmaceuticals and Amendment to the P075 Listing for Nicotine made it illegal to sewer hazardous waste pharmaceuticals in all 50 states due to the environmental hazards. Plus, there have been several studies published on the fact that medications are showing up in our water streams and that water treatment facilities are not equipped to remove pharmaceuticals as part of their treatment processes.

Furthermore, though used drug disposal pouches are designed to be placed directly into the trash, many states have outlawed businesses from landfilling such waste since there is no way to verify the sludge contents within the pouch, which has implications for leachate and its impact on the environment. So, businesses not only pay for the pouches themselves but then must pay a second time to dispose of the pouches as regulated or hazardous waste, which is extremely costly.

Fortunately, thanks to the promulgation of both the DEA and EPA rules, there are more efficient, environmentally safe, and cost-effective methods to dispose of controlled, non-controlled, and hazardous waste pharmaceuticals (HWPs) upon adoption of the new EPA rule by each state. The first is the use of a DEA-compliant drug collection receptacle like our MedSafe.

With MedSafe, there is no need for your highest-paid employees to spend their time popping pills for disposal. Rather, you simply dispose of the blister pack or pill bottle full of controlled, non-controlled, or HWPs (once the state has adopted the new EPA rule) into the securely locked collection receptacle, which provides the extra benefit of reducing the possibility of diversion. Once the inner liner is full, it is sent directly to our treatment facility via prepaid postage by common carrier. Upon receipt, all liners are incinerated, meeting the DEA and EPA disposal standards. Plus, since all contents are incinerated, the resident’s protected health information is destroyed in a HIPAA compliant manner.

Like MedSafe, the DEA also allows for individuals to utilize mail-back envelopes, like our TakeAway Medication Recovery System Envelopes, in their home to dispose of their unwanted medications, controlled and non-controlled, via USPS. An individual simply takes the nondescript envelope, fills it with their unwanted medication bottles and blister packs, seals the envelope, and places it in the mailbox or gives it to the mail carrier. With the prepaid postage, the envelope is sent directly to our treatment facility, where it is incinerated – again, meeting the DEA and EPA destruction standards as well as HIPAA.

By using MedSafe or TakeAway Medication Recovery System Envelopes, communities will not only remain compliant with DEA, EPA, and HIPAA, but they also save long-term care communities money, potentially as much as $17,000 annually, with the reduction in the various expenses related to medication disposal. Additionally, these easy, efficient, and time-saving methods of disposal will give nursing staff their valuable time back to care for residents rather than spending their time popping pills out of blister packs.

Contact us today at 800.772.5657 to learn more about how we can help your community save money on medication disposal.

Wanda Lingner

Author: Wanda Lingner

Wanda Lingner holds a BA in Nursing from Texas Woman’s University and a BBA in Management from Texas A&M University. She has over 20 years of clinical practice in both hospitals and private practice in a variety of medical specialties. As Clinical Specialist, she assists Sharps’ customers in evaluating current federal and state-specific medical and pharmaceutical waste regulations, developing medical waste management plans, and implementing compliant regulated medical and pharmaceutical waste management processes.