Medicine:Unused drug

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Short description: Medicine remaining after the consumer has quit using it

An unused drug or leftover drug is the medicine which remains after the consumer has quit using it. Individual patients may have leftover medicines at the end of their treatment. Health care organizations may keep larger amounts of drugs as part of providing care to a community, and may have unused drugs for a range of reasons. The unused drugs should be destroyed utterly to eliminate the toxic effects of undisposed drugs on flora and fauna. The improper disposal of unused drugs could be the reason for the contamination of Surface, Ground and Drinking Water.[1] Discharge of unused antibiotics and disinfectants in the sewage system may ruin the aquatic life or contamination of drinking water.

The determination of appropriate ways for disposal of unused medications can predict the number of contamination problems of the environment. There are several studies which evidence the toxic effects of medications on the environment which are disposed of inappropriately.[2] [3] [4]

Causes

Various circumstances may cause a consumer to have unused drugs. The consumer might find that their medication is ineffective and quit taking it.[5] The medicine might be effective, but the consumer might not adhere to their treatment and fail to take it for any reason.[5] A patient might die, leaving their medications behind.[5] A patient might move, such as from a hospital to their home, and somehow leave their unused drugs behind with the health care provider.[5]

Some medical professional practices lead to patients having unused drugs.[6] Physicians may prescribe more than they should.[6] Physicians and patients might see each other less often than they should, and the physician might agree to prescribe medication for a longer period of time than is best.[6] The physician might neglect to review what medications a patient already has, and recommend more.[6] The medical office might have confused records about what drugs a patient has, especially for offices without full computer records.[6] Also a physician might provide drugs inappropriately in unnecessary health care.[6]

Scope of the issue

Many consumers store unused drugs.[6] Many health care organizations come to acquire large amounts of unused drugs.[6] The volunteer for health centres must know the importance of proper drug disposal systems. The EPA and the FDA want unwanted or expired drugs disposed of completely.[7] [8]

Responses

Consumer organizations recommend that individuals be thoughtful about their unused drugs. Storing unused drugs at home can be a safety hazard. Drug disposal is often the right choice for consumers. Some regions offer government or nonprofit programs for the collection of unused drugs.

Governments and organizations can have larger stockpiles of drugs than any consumer and a different set of concerns. World-leading organizations such as WHO and UNICEF recommended several appropriate and safe drug disposal options and drug use prevention. With large supplies of drugs, drug pollution and negative environmental impact of pharmaceuticals and personal care products becomes a concern. Also, drug recycling might be a possibility.

Collection

Collection of unused drugs, also called drug return or drug take-back, is any program for individual consumers to dispose of drugs by returning their unused drugs to a collection center. One survey of consumers found that individuals like the idea of pharmacies accepting drug returns.[9]

Drug return programs can reduce the environmental impact of pharmaceuticals and personal care products.[10]

Various research projects have investigated drug return programs at pharmacies in particular regions. Studied places include the United States,[11] Britain,[12] France,[13] Switzerland,[14] Sweden,[15][16] Serbia,[17] and Germany.[18]

Leftover opioids

People in the United States tend to store unused opioids if any remain unused after medical treatment.[19] Keeping unused opioids can be particularly dangerous because of substantial risk of their being misused.[20]

References

  1. ↑ Fick, Jerker; Söderström, Hanna; Lindberg, Richard H.; Phan, Chau; Tysklind, Mats; Larsson, D.G. Joakim (2009). "Contamination of Surface, Ground, and Drinking Water from Pharmaceutical Production". Environmental Toxicology and Chemistry 28 (12): 2522–2527. doi:10.1897/09-073.1. ISSN 0730-7268. PMID 19449981. http://dx.doi.org/10.1897/09-073.1. 
  2. ↑ Quantitative StructureRetention Relationship Models To Support Nontarget High-Resolution Mass Spectrometric Screening of Emerging Contaminants in Environmental Samples. doi:10.1021/acs.jcim.5b00752.s001. 
  3. ↑ Ashauer, Roman; Caravatti, Ivo; Hintermeister, Anita; Escher, Beate I. (2010-03-30). "Bioaccumulation kinetics of organic xenobiotic pollutants in the freshwater invertebrate Gammarus pulex modeled with prediction intervals". Environmental Toxicology and Chemistry 29 (7): 1625–1636. doi:10.1002/etc.175. ISSN 0730-7268. PMID 20821614. http://dx.doi.org/10.1002/etc.175. 
  4. ↑ aus der Beek, Tim; Weber, Frank-Andreas; Bergmann, Axel; Hickmann, Silke; Ebert, Ina; Hein, Arne; Küster, Anette (2016-02-25). "Pharmaceuticals in the environment-Global occurrences and perspectives". Environmental Toxicology and Chemistry 35 (4): 823–835. doi:10.1002/etc.3339. ISSN 0730-7268. PMID 26666847. http://dx.doi.org/10.1002/etc.3339. 
  5. ↑ 5.0 5.1 5.2 5.3 Nelson, Roxanne (June 2015). "The Excessive Waste of Prescription Drugs". American Journal of Nursing 115 (6): 19–20. doi:10.1097/01.NAJ.0000466308.08390.7b. PMID 26017994. 
  6. ↑ 6.0 6.1 6.2 6.3 6.4 6.5 6.6 6.7 Cromarty, Evelyn; Downie, George (29 September 2001). "Drug wastage — what is acceptable?". The Pharmaceutical Journal 267 (7167): 424. 
  7. ↑ US EPA, OLEM (2015-03-23). "Collecting and Disposing of Unwanted Medicines" (in en). https://www.epa.gov/hwgenerators/collecting-and-disposing-unwanted-medicines. 
  8. ↑ Research, Center for Drug Evaluation and (2020-09-23). "Disposal of Unused Medicines: What You Should Know" (in en). https://www.fda.gov/drugs/safe-disposal-medicines/disposal-unused-medicines-what-you-should-know. 
  9. ↑ Thach, Andrew V.; Brown, Carolyn M.; Pope, Nathan (September 2013). "Consumer perceptions about a community pharmacy-based medication take back program". Journal of Environmental Management 127: 23–27. doi:10.1016/j.jenvman.2013.04.025. PMID 23669605. 
  10. ↑ Niquille, A; Bugnon, O (2008). "Pharmaceuticals and Environment: Role of Community Pharmacies". in Kümmerer, Klaus. Pharmaceuticals in the environment : sources, fate, effects, and risks (3rd ed.). Berlin: Springer. ISBN 978-3-540-74663-8. 
  11. ↑ Glassmeyer, Susan T.; Hinchey, Elizabeth K.; Boehme, Susan E.; Daughton, Christian G.; Ruhoy, Ilene S.; Conerly, Octavia; Daniels, Rebecca L.; Lauer, Lisa et al. (April 2009). "Disposal practices for unwanted residential medications in the United States". Environment International 35 (3): 566–572. doi:10.1016/j.envint.2008.10.007. PMID 19081631. 
  12. ↑ Mackridge, A. J.; Marriott, J. F. (17 July 2007). "Returned medicines: waste or a wasted opportunity?". Journal of Public Health 29 (3): 258–262. doi:10.1093/pubmed/fdm037. PMID 17579236. 
  13. ↑ Aloy, B.; Siranyan, V.; Dussart, C. (November 2009). "Arrêt de la valorisation humanitaire des médicaments non utilisés : enjeux et perspectives". Annales Pharmaceutiques Françaises 67 (6): 414–418. doi:10.1016/j.pharma.2009.08.002. PMID 19900605. 
  14. ↑ Gehler Mariacher, G; Rota, M; Hersberger, KE (21 October 1998). "[Return of unused drugs to pharmacies].". Praxis 87 (43): 1441–3. PMID 9844489. 
  15. ↑ Ekedahl, Anders B. E. (13 January 2007). "Reasons why medicines are returned to Swedish pharmacies unused". Pharmacy World & Science 28 (6): 352–358. doi:10.1007/s11096-006-9055-1. PMID 17221141. https://lup.lub.lu.se/record/164915. 
  16. ↑ Persson, Matilda; Sabelström, Emma; Gunnarsson, Bo (July 2009). "Handling of unused prescription drugs — knowledge, behaviour and attitude among Swedish people". Environment International 35 (5): 771–774. doi:10.1016/j.envint.2008.10.002. PMID 19013646. https://doaj.org/article/2721ca648d23464db99f10d596ac6866. 
  17. ↑ Kusturica, Milica P.; Sabo, Ana; Tomic, Zdenko; Horvat, Olga; Šolak, Zdravko (30 May 2012). "Storage and disposal of unused medications: knowledge, behavior, and attitudes among Serbian people". International Journal of Clinical Pharmacy 34 (4): 604–610. doi:10.1007/s11096-012-9652-0. PMID 22644600. 
  18. ↑ Bronder, E; Klimpel, A (November 2001). "Unused drugs returned to the pharmacy--new data.". International Journal of Clinical Pharmacology and Therapeutics 39 (11): 480–3. PMID 11727967. 
  19. ↑ Kennedy-Hendricks, Alene; Gielen, Andrea; McDonald, Eileen; McGinty, Emma E.; Shields, Wendy; Barry, Colleen L. (1 July 2016). "Medication Sharing, Storage, and Disposal Practices for Opioid Medications Among US Adults". JAMA Internal Medicine 176 (7): 1027–9. doi:10.1001/jamainternmed.2016.2543. PMID 27295629. 
  20. ↑ Hendel, Chris (15 June 2016). "6 Out of 10 Americans Taking Opioids Keep Leftovers". http://www.consumerreports.org/drugs/6-out-of-10-americans-taking-opioids-keep-leftovers/. 



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