Safe Medication Disposal

Do you have unused or expired medications sitting in your medicine cabinet? Don’t know what to do with these medications?

Here are 5 great reasons to motivate you to clean out your medicine cabinet and safely dispose of your unused or expired prescription and over-the-counter (OTC) medications:

o   Over 78,000 children under 5 years of age are treated for accidental drug overdose per year.¹

o   Prescription drugs are more commonly abused than ecstasy, heroin, crack/cocaine and methamphetamines combined in adolescents 12 to 17 years of age.²

o   Drug overdose death rates more than doubled from 1999-2010 in those aged 10 to 19 years.²

o   Nearly one-third of people age 12 years and older who used illicit drugs for the first time in 2010 began by using prescription drugs non-medically.³

o   Drugs such as antibiotics, steroids, pain killers, estrogens, blood pressure medicines, and antidepressants were detected in 80% of water samples in 139 streams across 30 states and may be causing harm to fish and other wildlife.⁴

Unused and expired medications may be in the form of capsules, pills, inhalers/aerosols, creams, etc. Improper storage of these medications can lead to accidental use of the wrong medication, overdose (especially in the case of children and pets), or drug abuse by others in the household. A majority of patients continue to dispose of these medications in the trash or flush them down the toilet or sink. The Illinois Environment Protection Agency (IEPA) recommends against flushing a majority of medications down the toilet or sink. These medications wind up in our drinking water system through improper disposal and natural excretion, and our water treatment facilities do not have the expertise to remove medications from our drinking water supply. Several new changes are being implemented for the safe disposal of unused and expired medications, including an expansion in drug take-back programs across the nation.

Medication disposal dos and don’ts:

Dos:

Do reduce pharmaceutical waste whenever possible. Finish the full course of prescribed medications as recommended by your doctor or pharmacist, and only buy as much as you need.

Do store medications safely out of reach of children, pets, and others to prevent accidental overdose, misuse, or abuse.

Do take unused/expired medications to a local take-back program or mail them to a collection agency. To find a participating program:

·      Call your local police department, village, or city administrative office.

·      Check to see if your local pharmacies participate in the national “TakeAway Environmental Return System” mail-in medication disposal program.

·      Call (217) 524-3300 or visit the IEPA website at http://epa.state.il.us/medication-disposal/ for additional information and frequently asked questions.

·      For one-day collection events and long-term collection facilities, contact:

o   City of Chicago, 1150 N. North Branch on Goose Island, Phone: 311 or 312-744-7672

o   Rockford, 3333 Kishwaukee, Rock River Reclamation District, Phone:815-987-5570

o   Naperville, 1971 Brookdale Rd, Fire Station #4, Phone:630-420-6095

·      If you live in Lake County, contact the Solid Waste Agency of Lake County (SWALCO), Phone:847-336-9340

·      Visit the Solid Waste Agency of Northern Cook County (SWANCC) website for programs at over 20 Chicagoland member communities http://swancc.org/programs/pharmaceuticalsharps-disposal

·      Follow these general tips for medication disposal at participating take-back programs:

o   Keep medications in original containers but blacken-out any personal information with a permanent marker.

o   Acceptable items include: unused/expired prescription medications and expired OTC products.

o   Unacceptable items include: Pharmaceutical controlled substances (e.g. Norco, Vicodin, hydrocodone, oxycodone etc.).

o   Check with your local program for guidance on acceptable/unacceptable items.

·      For pharmaceutical controlled substances disposal, visit:

o   DEA website for designated take-back days and a list of pharmaceutical controlled substances:

http://www.deadiversion.usdoj.gov/drug_disposal/takeback/index.html

o   Save A Star’s drug disposal program website for location of disposal boxes and a list of all acceptable items:

http://www.saveastar.org/pages/sas_drugdisposal.html

Don’ts:

Don’t share medications with friends and family.

Don’t store medications in the bathroom as this may compromise the integrity of the product.

Don’t flush medications down the toilet or sink or dispose of in the trash as they end up in our environment and drinking water supply.

Don’t burn medications as this may release toxic fumes and lead to air pollution.

If you do not have access to a local take-back or mail-in program, the IEPA recommends disposing of unused/expired medicines in the trash to avoid accidental overdose, misuse, and abuse by following the steps below:

·      Remove medications from original containers or blacken-out any identifying information on the label

·      Mix medication with a small amount of alcohol or water to dissolve or grind them up with kitty litter or coffee grounds

·      Place them in a plastic bag, and dispose of them in the trash

Drug abuse and misuse of prescription and OTC medications has become a significant problem. The medicines we take are increasing ending up in our environment and may be causing harm to wildlife. The previous recommendation to flush unwanted medications down the toilet or sink or dispose of in the trash may no longer be effective in addressing this problem. It is currently recommended to dispose of expired and unused medications at local or mail-in medication collection programs.

Protect your loved ones, drinking water sources, and the earth--dispose of your medications in a safe and environmentally-friendly manner.

References:

1.     Nettesheim T, Boehme SE, Malloy EH. Disposal of unwanted medications. Illinois-Indiana Sea-Grant website. http://www.istc.illinois.edu/special_projects/ppcp-env/1315-boehme.pdf. Accessed October 31, 2013. 

2.     Disposal of unwanted or unused pharmaceuticals fact sheet. IEPA’s medication disposal website. http://www.epa.state.il.us/medication-disposal/facts.html. Accessed October 30, 2013.

3.     A response to the epidemic of prescription drug abuse. Whitehouse drug policy website. Published April 2011. http://www.whitehouse.gov/sites/default/files/ondcp/Fact_Sheets/prescription_drug_abuse_fact_sheet_4-25-11.pdf. Accessed October 31, 2013.

4.     Results from the 2011 national survey on drug use and health: Summary of national findings, NSDUH series H-44, HHS Publication No. (SMA) 12-4713. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2012.

5.     A national action plan for child injury prevention: reducing poisoning injuries in children. CDC website. http://www.cdc.gov/safechild/NAP/overviews/poison.html. Updated April 1, 2013. Accessed October 31, 2013.

6.     Barnes KK, Kolpin DW, Meyer MT, et al. U.S. geological survey website. 2002. http://toxics.usgs.gov/pubs/OFR-02-94/index.html. Accessed October 29, 2013.

7.     How to dispose of unwanted medicine and personal care products. Illinois-Indiana Sea-Grant and University of Illinois Extension website. http://web.extension.illinois.edu/unusedmeds/. Accessed October 30, 2013.

8.     Medication disposal programs offered across the nation. NABP website. http://www.nabp.net/news/medication-disposal-programs-offered-across-the-nation. Updated August 26, 2011. Accessed October 30, 2013.

Masooma Razvi

Doctorate of Pharmacy Candidate, 2014

What is Mental Health?

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What is mental health?

Mental health encompasses many aspects of our overall health and well-being and is made up of emotional, psychological, and social components.¹ Emotion well-being refers to how satisfied an individual is with their current life situation, happiness, and peacefulness. Psychological well-being includes components such as self-acceptance, personal growth, openness to new experiences, optimism, and self-direction. An individual’s social well-being includes social acceptance, personal self-worth in society, and sense of community. Our mental health plays an integral role in how we function on a day-to-day basis and impacts our thoughts, feelings, and actions. It can also determine how we handle certain situations and has an impact on our personal relationships. Mental illness refers more specifically to a diagnosable mental disorder.² Common mental illnesses include anxiety disorders, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, eating disorders, mood disorders, personality disorders, and schizophrenia. Depression is the most common mental illness, affecting more than a quarter of the U.S. adult population.

When to see your doctor or mental health provider.

Although it may be difficult to recognize when something is impacting your mental health, there are a few signs that may suggest it is time to have a discussion with your doctor or a mental health provider.³

Mood: Mood swings from feelings of “highs” to feelings of “lows” may be a sign of poor mental health. Also, persistent feelings of sadness, depression, or irritability lasting beyond two weeks may be an indication that it is time to speak with your healthcare provider about your mental health. Feeling more tense, nervous, or anxious than usual are also signs of many mental health concerns. Other changes in mood could include the inability to cope with daily problems or stress, feelings of guilt, or excessive anger, hostility, or violence.

Loss of interest or pleasure: A recent loss of interest or pleasure in activities, hobbies, or work that you once enjoyed is a common sign that you may need to discuss your mental health with your doctor. You may also find that it is more difficult to complete tasks or assignments in an efficient manner. Withdrawal from friends and family can also signify a significant mental health problem.

Appetite: Changes in eating habits such as eating too much or too little may indicate that it is time for a mental health checkup. Craving certain types of foods that are high in fat or sugar is also a stress response that could result in lower levels of energy and could have an even more negative result on your mood. A significant amount of weight loss without attempting to lose weight or a significant weight gain could be diagnostic of a mental health problem.

Sleep: Recent changes in sleep patterns or habits may also signify a problem with your current mental health. When faced with higher amounts of stress, people often respond with having trouble either falling asleep or staying asleep throughout the night. The quality of sleep could also be impacted and you may find yourself waking up without feeling re-energized. In comparison to not being able to sleep well at night, sleeping more than the normal amount of 7 to 9 hours per night can also be a symptom of a mental health problem.

Feeling of restlessness or being slowed down: You may feel that you are unable to sit still and must always be up moving. You could also experience feeling shaking or have unusual movements. By contrast, you could also feel slowed down and not able to move as quickly or as graceful as you normally would.

Energy: Along with problems getting the appropriate amount of sleep each night, feelings of not having enough energy to get through the day are also common with many mental health problems. Many patients with depression or anxiety issues complain of feelings of significant fatigue and low energy and are not able to complete things that they either must do or want to do.

Concentration: Many mental health issues can contribute to an individual’s ability to focus and concentrate. You can recognize your ability to concentrate by noticing if your productivity levels have decreased, if you’re unable to make deadlines, or if you’re unable to complete simple daily tasks such as housework. You may also find that you are unable to make appropriate decisions in a timely manner.

Physical symptoms: some mental health illnesses may manifest with physical symptoms such as stomach pain, back pain, headaches, and other general body aches and pain.

Preparing for your first visit.

Experiencing even just a few of these signs and symptoms is a reason to see your doctor or a mental health provider, especially if they are interfering with your ability to function on a day-to-day basis. You may choose to discuss your mental health concerns with your primary care doctor or you may go directly to a mental health provider, such as a psychiatrist or psychologist. In preparation for your first appointment, you should think about a number of questions that your doctor may ask you. These include:

When did you first notice your symptoms?

Has your day-to-day life been affected by your symptoms?

What have you tried to treat your symptoms on your own?  

Do you notice anything that makes you feel worse? Do your symptoms have a specific trigger?

Have your friends or family members commented on your mood?

Does mental illness run in your family?

What do you expect from treatment?

What medications, supplements, or herbs to you currently take?

Do you drink alcohol or use illegal (street) drugs?

It is important for you to think about the types of questions you should ask your doctor or other mental health provider prior to your first appointment. Examples of the types of questions to ask your doctor include:

What type of treatment will I receive?

Will counseling or therapy help?

Are there medications that will help?

How long will it take for my treatment to start working?

Is there anything I can do on my own to help myself?

Do you have any brochures that I can have to read?

Suicide Prevention.

If you feel that you are in a crisis or having thoughts of killing yourself please call the Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255) immediately. The Suicide Prevention Lifeline is a 24-hour service available to anyone in need of help.

Where to find more information.

If you would like to find out more about mental health or mental illness, below are a few helpful resources:

American Psychological Association: http://www.apa.org/

National Institute of Mental Health: http://www.nimh.nih.gov/index.shtml

American Psychiatric Association: http://www.psychiatry.org/mental-health

Mental Health America: http://www.mentalhealthamerica.net/

National Alliance on Mental Illness: http://www.nami.org/

Maggie Thomas

Doctor of Pharmacy Candidate

College of Pharmacy, University of Illinois at Chicago

UIC Pharmacy

November 2013

References

1.     What is mental health? U.S. Department of Health and Human Services. http://www.mentalhealth.gov/basics/what-is-mental-health/index.html. Accessed November 12, 2013.

2.     Mental health. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/depression/index.shtml. Accessed November 12, 2013.

3.     Warning signs of mental illness. American Psychiatric Association. http://www.psychiatry.org/mental-health/more-topics/warning-signs-of-mental-illness. Accessed November 12, 2013.