Unused drug

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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.

Contents

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]

Related Research Articles

<span class="mw-page-title-main">Medication</span> Substance used to diagnose, cure, treat, or prevent disease

A medication is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy (pharmacotherapy) is an important part of the medical field and relies on the science of pharmacology for continual advancement and on pharmacy for appropriate management.

<span class="mw-page-title-main">Over-the-counter drug</span> Medication available without a prescription

Over-the-counter (OTC) drugs are medicines sold directly to a consumer without a requirement for a prescription from a healthcare professional, as opposed to prescription drugs, which may be supplied only to consumers possessing a valid prescription. In many countries, OTC drugs are selected by a regulatory agency to ensure that they contain ingredients that are safe and effective when used without a physician's care. OTC drugs are usually regulated according to their active pharmaceutical ingredient (API) rather than final products. By regulating APIs instead of specific drug formulations, governments allow manufacturers the freedom to formulate ingredients, or combinations of ingredients, into proprietary mixtures.

<span class="mw-page-title-main">Pharmacist</span> Healthcare professional

A pharmacist, also known as a chemist or a druggist, is a healthcare professional who specializes in the preparation, dispensing, and management of medications to ensure safe and effective use, while also providing medication counseling and guidance to patients and healthcare providers. Also, pharmacists often serve as primary care providers in the community, and may offer other services such as health screenings and immunizations.

<span class="mw-page-title-main">Pharmacy</span> Clinical health science

Pharmacy is the science and practice of discovering, producing, preparing, dispensing, reviewing and monitoring medications, aiming to ensure the safe, effective, and affordable use of medicines. It is a miscellaneous science as it links health sciences with pharmaceutical sciences and natural sciences. The professional practice is becoming more clinically oriented as most of the drugs are now manufactured by pharmaceutical industries. Based on the setting, pharmacy practice is either classified as community or institutional pharmacy. Providing direct patient care in the community of institutional pharmacies is considered clinical pharmacy.

<span class="mw-page-title-main">Prescription drug</span> Medication legally requiring a medical prescription before it can be dispensed

A prescription drug is a pharmaceutical drug that is permitted to be dispensed only to those with a medical prescription. In contrast, over-the-counter drugs can be obtained without a prescription. The reason for this difference in substance control is the potential scope of misuse, from drug abuse to practicing medicine without a license and without sufficient education. Different jurisdictions have different definitions of what constitutes a prescription drug.

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<span class="mw-page-title-main">Polypharmacy</span> Use of five or more medications daily

Polypharmacy (polypragmasia) is an umbrella term to describe the simultaneous use of multiple medicines by a patient for their conditions. Most commonly it is defined as regularly taking five or more medicines but definitions vary in where they draw the line for the minimum number of drugs. Polypharmacy is often the consequence of having multiple long-term conditions, also known as multimorbidity. An excessive number of medications is worrisome, especially for older patients with many chronic health conditions, because this increases the risk of an adverse event in those patients.

A veterinary pharmacist is a specially trained pharmacist who dispenses veterinary drugs and supplies or products and advice to owners of companion animals and livestock. In addition, they advise the regulatory bodies and are involved in the formulation of veterinary drugs. Veterinary pharmacy is a field of pharmacy practice, in which veterinary pharmacists may compound medications, fill prescriptions, and manage drug therapies for animals. Veterinary pharmacists are licensed pharmacists who specialize in the distribution of medications for animals.

<span class="mw-page-title-main">Clinical pharmacy</span> Branch of pharmacy for direct provision

Clinical pharmacy is the branch of pharmacy in which clinical pharmacists provide direct patient care that optimizes the use of medication and promotes health, wellness, and disease prevention. Clinical pharmacists care for patients in all health care settings but the clinical pharmacy movement initially began inside hospitals and clinics. Clinical pharmacists often work in collaboration with physicians, physician assistants, nurse practitioners, and other healthcare professionals. Clinical pharmacists can enter into a formal collaborative practice agreement with another healthcare provider, generally one or more physicians, that allows pharmacists to prescribe medications and order laboratory tests.

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A pharmacy is a retail shop which provides pharmaceutical drugs, among other products. At the pharmacy, a pharmacist oversees the fulfillment of medical prescriptions and is available to counsel patients about prescription and over-the-counter drugs or about health problems and wellness issues. A typical pharmacy would be in the commercial area of a community.

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An equianalgesic chart is a conversion chart that lists equivalent doses of analgesics. Equianalgesic charts are used for calculation of an equivalent dose between different analgesics. Tables of this general type are also available for NSAIDs, benzodiazepines, depressants, stimulants, anticholinergics and others as well.

<span class="mw-page-title-main">Environmental impact of pharmaceuticals and personal care products</span> Effects of drugs on the environment

The environmental effect of pharmaceuticals and personal care products (PPCPs) is being investigated since at least the 1990s. PPCPs include substances used by individuals for personal health or cosmetic reasons and the products used by agribusiness to boost growth or health of livestock. More than twenty million tons of PPCPs are produced every year. The European Union has declared pharmaceutical residues with the potential of contamination of water and soil to be "priority substances".[3]

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<span class="mw-page-title-main">Environmental persistent pharmaceutical pollutant</span> Environmental term

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<span class="mw-page-title-main">Deprescribing</span> Medical condition

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<span class="mw-page-title-main">Drug disposal</span> Safe disposal of unused drugs

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Prescription drug addiction is the chronic, repeated use of a prescription drug in ways other than prescribed for, including using someone else’s prescription. A prescription drug is a pharmaceutical drug that may not be dispensed without a legal medical prescription. Drugs in this category are supervised due to their potential for misuse and substance use disorder. The classes of medications most commonly abused are opioids, central nervous system (CNS) depressants and central nervous stimulants. In particular, prescription opioid is most commonly abused in the form of prescription analgesics.

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. S2CID   25407749.
  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 .{{cite journal}}: Cite journal requires |journal= (help)
  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. S2CID   25014908.
  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. S2CID   22741778.
  5. 1 2 3 4 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. 1 2 3 4 5 6 7 8 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". US EPA. Retrieved 2020-12-31.
  8. ↑ Research, Center for Drug Evaluation and (2020-09-23). "Disposal of Unused Medicines: What You Should Know". FDA. Retrieved 2020-12-31.
  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 (ed.). 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; McCarthy, Meg; Nettesheim, Todd G.; Sykes, Kathy; Thompson, Virginia G. (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. S2CID   29570765.
  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.
  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. S2CID   28069909.
  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". Consumer Reports. Retrieved 30 March 2017.
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