Clarifying MedSafe

Medication disposal can be confusing. The practice is regulated by many government agencies, and there are a number of rules to follow to ensure you are correctly disposing of any unused medications. Sharps Compliance’s MedSafe is a collection receptacle for ultimate-user medication disposal. This article will clarify the rules and regulations of disposing of medications in MedSafe and other similar kiosks.
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Medication Disposal in Long-Term Care

Nurses practicing in senior care have very busy work schedules. From caring for patients to distributing medications to updating records, their days can become overwhelming. One of the more time-consuming tasks is the disposal of unused medication.

When a resident’s medication is permanently discontinued, it must be properly disposed. Prior to updates to the 2014 Drug Enforcement Agency’s regulations which implemented the Secure and Responsible Drug Disposal Act of 2010, few safe, efficient and environmentally-preferred options were available to communities for controlled drug disposal. Typically, the Director of Nursing and another nurse would itemize the drugs to be destroyed and then undertake the time-consuming task of emptying them out of their containers or blister packs. Removing individual pills from blister packs can not only be time-consuming (and therefore, costly) but also painful and difficult. Once removed, the drugs were typically placed into the toilet or mixed with an undesirable substance, such as kitty litter or dissolved in a chemical prior to putting them into the trash. After all of the medication was removed and destroyed, the residents’ identifying information on the packaging had to be concealed and disposed of safely to prevent disclosure of protected health information.

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Management of Pharmaceuticals at Healthcare Facilities

Medicines improve our quality of life, but there are some important issues regarding the proper disposal of unneeded or unwanted medicines. The disposal of pharmaceuticals when no longer needed poses a threat to our environment. Sharps Compliance has developed a program to manage these unwanted pharmaceuticals safely and in compliance with all federal, state, and local laws and regulations.

One of the ramifications of mismanagement of unused medications is the environmental effects resulting from poor pharmaceutical disposal practices. Through the years, pharmaceuticals have been largely discarded through either flushing or “sinking” them into the wastewater stream or discarding them into the solid waste stream. In the first instance, the wastewater is treated to remove physical, chemical, and biological contaminants, such as sediment, bacteria, and viruses. However, this treatment does not remove all organic molecules, which are inherent in pharmaceuticals. Thus, many of these molecules remain entrained in the treated waste water which is discharged into reservoirs, rivers, or lakes. Likewise, drugs disposed of as solid waste (into landfills) may leach these organic molecules into aquifers and into the fresh water supply.

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Medication Disposal for Long-Term Care Facilities — Including Controlled Substances

On September 9, 2014, the Department of Justice published the final rules for the Secure and Responsible Drug Disposal Act of 2010 allowing proper controlled substance disposal. The regulations go into effect October 9, 2014. The amended rules (found here) allow registered collectors, such as closed-door and retail pharmacies to place receptacles in long-term care facilities to collect and dispose of controlled substances (Schedules II-V). Before the rule update, solutions for disposal in long-term care facilities were minimal and often messy and environmentally unsustainable.

Flushing Medications

Flushing controlled substances, while acceptable in some states, should be avoided as the long-term effects of pharmaceuticals in rivers and streams are unknown. In 2008, the Associated Press found pharmaceuticals in the drinking water of 24 major metropolitan water supplies. Other studies have shown changes in aquatic life such as gender changes in fish, due to pharmaceuticals in the water.

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