For many patients, the use of a medical dermal patch is the best option when deciding how to take their medication. Remembering to take a pill can be difficult, swallowing one can be problematic, and medical dermal patches are designed to provide a slow and steady release of medication for sometimes days with just one application. However, how does one dispose of both the used and expired or unwanted medical dermal patches?
The proper disposal of medical dermal patches has long been debated. Some professionals advocate for throwing used medical dermal patches in the regular trash or other protected containers to prevent environmental impact, while others say that used medical dermal patches should be flushed down the toilet to prevent access and abuse by unauthorized individuals. Which method is truly safest?
Argument in Favor of the Protected Container Method
Unused medical dermal patches are regulated by the Environmental Protection Agency (EPA) as a listed hazardous waste when disposed. Once a medical dermal patch has been applied and removed, “it has been used for its intended purpose and therefore would not be listed hazardous waste when discarded”. However, lingering medication is still present in the medical dermal patches after the scheduled removal, prompting those in favor of the protected container method to advocate against flushing the medical dermal patches down the toilet.
When the United States Geological Survey (USGS) tested water sources for chemical presence, eighty percent of the U.S.’s streams and nearly a quarter of the nation’s groundwater were found to be contaminated with a variety of medications. Examples of medications found included acetaminophen, steroids, hormones, codeine, antibiotics, antimicrobials, and ibuprofen. This is highly problematic, as the increased presence of medications promotes the development of bacterial resistance to antibiotics and also interferes with the natural growth and reproduction cycles of aquatic organisms.
No Drugs Down the Drain, a California sanitation resource, states: “Effects of exposure can include a gender ratio imbalance (e.g. more females than males within a given population); intersex conditions (the presence of both male and female reproductive organs within an individual organism); poor egg hatching success; decreased fertility and growth; and altered behavior (e.g. lethargy and disorientation).”
The increasing development of bacterial resistance to antibiotics can ultimately end up affecting human health. An article published by the Yale School of Forestry & Environmental Studies states that, “in samples from dairy farms where livestock are treated, and from lakes that receive effluent from hospitals, antibiotic-resistant bacteria are up to 70 percent more common than in uncontaminated environments.” Since bacteria share genes across species, an evolved drug resistance in one can then cross to another, more harmful species. This results in the need for the development of stronger medications, furthering the cycle of antibiotic-resistant bacteria.
Argument in Favor of the Flushing Method
If used medical dermal patches with lingering medication or unused and expired medical dermal patches are simply thrown into the trash, those in favor of the flushing method fear that unauthorized individuals have a greater chance to access medication not intended for them. This epidemic is more of an issue than the public realizes. According to Get Smart About Drugs, a DEA resource, more people overdose from pain medicines every year than from heroin and cocaine combined. Unfortunately, prescription drugs are often seen by individuals as the “safe” alternative to drugs such as heroin and cocaine, since a doctor was the original prescriber.
In 2016, the U.S. Department of Health and Human Services conducted a national drug use survey, and the results were staggering: 91.8 million American adults aged 12 and up (37.8%) reported prescription opioid use, and 6.2 million of those users reported misusing them. Every 14 minutes, someone in the U.S. dies from an unintentional drug overdose or accidental poisoning.
Those in favor of the flushing method of disposal of medical dermal patches believe that this is a major step individuals can take in preventing the spread of this prescription drug abuse epidemic. Flushing used and unwanted medical dermal patches down the toilet prevents children, pets, and other individuals from accessing medication not intended for them. The issue of children getting into medication left within their reach is so persistent, programs such as Up and Away were created to raise awareness and educate prescription-holders of the dangers associated with unauthorized medicine access.
Unwanted or expired medical dermal patches should absolutely be disposed of through the U.S. Drug Enforcement Administration (DEA) National Take Back Days. These events held in April and October of every year protect public health by providing safe methods for individuals to anonymously dispose of their unwanted and expired prescription drugs.
Widely acknowledged by federal agencies as the most efficient way to dispose of prescription drugs, take back methods such as PureWay’s system for small generators of waste prevent additional availability to expired medication. Multiple drug take back methods are available year-round, not just for national take back events. DEA-registered collectors are permanent sites built to assist consumers in safely disposing of their unused medicines. These sites may be in retail pharmacies, hospital or clinic pharmacies, and law enforcement facilities.
As of yet, there is no one decided method for disposing of used medical dermal patches. They are not listed as hazardous waste once used, however they may still contain lingering levels of medication that hold potential to both impact the environment and be abused by unauthorized individuals. Unwanted or expired medication should be disposed of on National Take Back Days or at a DEA-registered collector site.