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Are you disposing of medications properly?

Multiple colorful medications before being disposed of

By Holly Carlson MS, RN, CCRN

Water source contamination of prescription medications is a looming threat for the human population. To date, aquatic life found in rivers, streams, and lakes have measurable levels of prescription medications in their bodies. In addition to aquatic life, measurable levels of medications are found in the water sources all around us. Every medication is toxic in high enough levels.

The primary sources of water contamination are:

  • Waste water and landfills
  • Livestock
  • Direct leaching from manufacturing companies
  • Healthcare

Each source has its own unique method for contaminating the environment.

Waste Water and Land Fills

Water is originally contaminated by human use, sink, and toilet waste. The human body only absorbs a small portion of prescribed medications, the remaining is processed through the kidneys and liver and then eliminated through the normal human waste process. Medicated lotions, creams, and medications are simply washed down drains by handwashing, bathing, or deliberate dumping of medications down drains. Medicated lotions, creams, and liquid medications enter drains at toxic levels because they are in an unprocessed form and it take such a high dose to absorb a little bit through the skin.

Human kidneys, livers, and albeit slow, the skin are all processors’ medications breaking them down to useable levels. Medications directly introduced into landfills or water sources are not reliably filtered out in the landfill process or in the treatment of sewage. Unfortunately, the medications are then consumed by animals and insects in the environment through their normal feeding process which ultimately contaminates the entire food chain.


Large herds of livestock often require the use of pharmaceutical medications to sustain the herd. These medications prevent the spread of diseases that can wipe out entire herds. The loss of entire herds of animals are catastrophic for famers and impact the food chain that we all rely on. But livestock do contaminate the environment with measurable levels of medications because of overtreatment, leaching from excrement, opportunistic ingestion by predators, and careless dumping.

While the ground can serve as a type of filter, it is dependent on the lengthy time for decomposition of animal byproduct, the type of soil that is being depended on as a filter, and how close a water source is to the exposed medication. Time and distance are not usually on the safe side of naturally processing the medication. A bird may feed on a decomposing animal that was treated with a medication that was ultimately toxic and the cause of death. Contaminated excrement may be washed away into a nearby stream by a rainstorm.

Direct Leaching

While regulations have become stricter over the years, direct leaching occurs for many reasons. A few reasons are accidental spills, improper storage, or intentional dumping. Scientist have found that the ground is not as effective in filtering and keeping chemicals out of water supplies as once was originally thought. Spills, improper storage, and intentional dumping come with huge fines and legal restitution.


It is no surprise that healthcare facilities are the largest wasters of medications. The primary partner in health, particularly as we age, is medication. There are many variables to why healthcare medication waste is so high:

  • Shear volume of medication use and the inevitable waste that comes with use.
  • Purchasing contracts that don’t align with variable doses.
  • Variable dosing that requires partial dose administration.

Community-based care is the highest medication polluter of the environment because of the lack of drug neutralizing product use, take back programs, and quantity of medications consumed. Community-based facilities often purchase medications in bulk for cost savings, however, the catch is cost-effective processes and procedures are not in place for disposing unused or expired medications.

Managing Medication Waste

Here are a few easy solutions to responsible medication wasting.

Binding to deactivate:

  • Place used coffee grounds in a gallon bag (wet), and mix until mostly dissolved and put in the regular trash.
  • Put kitty litter in a gallon bag and pour liquid medications into it then place in regular trash.

Commercial Neutralizing Agents:

  • Single use pouches. (Deterra ©, NarcoPouch©)
  • Multi-use quart to gallon sized jugs. (DrugBuster© , RX Destroyer©, Pharma Safe ©)

Drug take back programs:

Most large hospitals or commercial pharmacies have a drug take back program where you can drop off the medications and they will dispose of them properly. Click on the link to find a location near you.

The impact of medication waste on humans is not a current issue, it is a future issue. An issue that if addressed with a little effort can prevent a health crisis in the future. We are unfortunately being warned by the effects that careless wasting is having on wildlife that drink the water that is being contaminated. While it isn’t the one or two pills flushed down the toilet. Or the little bit of liquid medication washed down a sink. Overtime, the one or two pills will be the difference. Let’s validate the warning our environment is giving us and waste responsibly.

Holly Carlson registered nurseHolly Carlson MS, RN, CCRN is a freelance writer and owner of HDC Consulting.  Holly is a registered nurse with 25 years of healthcare experience in both acute and post-acute healthcare environments. Her experience includes direct care, organizational leadership, facility management, and organization culture development.


Drugs in the water. (2020). Harvard medical school. Retrieved from

United States Geological Survey (nd). Pharmaceuticals in water. Retrieved from


Food and Drug Administration (2013). How to dispose of unused medicines. Retrieved from


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