II. Precautions: Controlled Substance Storage
- Prescription Opioids should be in locked cabinet, away from children in the home
-
Opioids are a risk for unintentional Overdose and Substance Abuse by teens and children
- Opiates are the most common ingestion requiring hospitalization in children under age 6 years old
- Safe storage guideline is followed in only one third of households with young children (12% with older children)
III. Precautions: Expired Medications
- Most medications (esp. tabs, capsules) maintain their potency for years past their expiration date
- Medications stored in vials or under adverse conditions (e.g. excessive heat) may degrade more quickly
- Lyon (2006) J Pharm Sci 95(7):1549-60 [PubMed]
- Toxicity from Expired Medications is very rare and limited to case reports
- In this case, the Tetracycline formulation has since changed and is no longer a risk
- Gross (1963) Ann Intern Med 58:523-8 [PubMed]
- For some critical medications, possible decreased potency after expiration date may be unacceptable
- Insulin
- Antiepileptics
- Contraceptives
- Epinephrine Autoinjector
- Naloxone
- Nitroglycerin
- Some medications once opened and started require following the "Beyond Use Date"
- Dry Powder Inhalers after foil rapping is removed
- Reconstituted Antibiotics
- References
- (2020) Presc Lett 27(6):36
IV. Precautions: Medication Disposal
- Do not flush medications down toilet
- Controlled substances are an exception (see below)
- Dispose of non-controlled substances in the trash
- Check product labels for safe disposal recommendations
- Adverse effects of medications contaminating waste water
- May have toxic effect on wildlife and humans
- May contribute to Antibiotic Resistance
- Needle disposal
- Sharps Container
- Needle and auto-injector disposal
- SafeNeedleDisposal.org
- Resources
- EPA Information on Pharmaceuticals and Personal Care Products
V. Precautions: Unused Controlled Substance Disposal
- Only case in which Flushing medication down toilet may be appropriate (other options below are preferred)
- Collection receptacles at retail pharmacies
- Syringes and Inhalers are not allowed in disposal bins
- Dispose with medical waste at clinic
- DEA take-back program
- http://www.deadiversion.usdoj.gov/drug_disposal/takeback/
- Law enforcement stations may also have Medication Disposal receptacles
- Mail-back programs
- Pharmacies may have pre-addressed, pre-paid packaging available
- Google Maps (Query "Drug Disposal Near Me")
VI. References
- (2014) Presc Lett 21(11): 65