Tips and Techniques

How do we dispose of outdated or no-longer-wanted

Phil Seibert, CVT

For non-controlled drugs such as tablets or capsules, the EPA recommends putting them in a plastic zip lock bag and adding about a teaspoon of water to make them start to dissolve. Seal the bag and dispose of as regular trash. For liquid medications, put some cat litter or absorbent towels inside of a zip lock bag and squirt (or pour) the medication in the absorbent. Dispose of the bag as regular trash.

Disposal of controlled substances depends on whether the amount to be discarded is an unused dose or an unused stock.

• Unused dose is the amount that was drawn up or allocated for a particular patient. The full amount drawn up AND the amount actually administered to the patient should be recorded on the controlled substance log (e.g., 10/8 cc). The unused dose left in the syringe or the unused tablets should be disposed of as for any other drug.
• Unused stock is defined as drugs that were procured for "general use" in the facility or for dispensing to clients which were not used or allocated before they expired.

The DEA has recently changed their procedures for disposing of these drugs. They now require the registrant (that's you) to contract with a REVERSE DISTRIBUTOR to dispose of the drug. A reverse distributor is a company that, for a fee, is authorized to accept and destroy the expired drugs. There is a wide difference in the fees, so shop around. For a select list of Reverse Distributors that will service the veterinary profession check out our web site.

Controlled drugs that have already been dispensed to a client should be discarded as outlined below. The practice should not accept previously-dispensed controlled drugs from clients back into the closed accountability system of the practice. It is the client's responsibility to dispose of unused drugs once they have been dispensed.

Drugs Dispensed to Clients

Once the drugs have left the custody of the practice, it is usually not advisable to take the drugs back. Of course, the practice leadership has every right to make any fee adjustments they wish to extend, but generally, speaking, the practice is prohibited from "re-using" those drugs. This prohibition applies to any re-use, including for charity cases and donations to non-profit organizations.

Normally, the client should be instructed to dispose of the drugs as outlined above, but occasionally the practice may want to take care of the disposal as a service to the client. In that case, the best action would be to dispose as outlined above immediately upon acceptance and not let them sit on the shelf or be "returned to stock" as they could be mistakenly re-dispensed.

The most recent recommendations from the EPA for disposal of patches (from a client or patient use) is to wrap them in tissue, seal them in plastic "zip lock bag" and dispose of regular trash.

The EPA also recommends you avoid flushing them down the toilet since the plastics in the patch itself is not biodegradable.

Chemotherapy waste, including outdated or unused drugs must be disposed of as hazardous medical waste...not BIOhazardous waste. That means it has to be in a YELLOW chemotherapy waste container and not in a red biological waste container. In some instances, biohazardous wastes are "inactivated" by chemical disinfection during processing and since this could produce a reaction with the chemotherapy chemicals, the biohazardous waste system should not be used to dispose of bulk chemicals.

The chemo waste is normally picked up for disposal by a licensed waste transporter just as for the biowaste.

This information is provided as a courtesy of Phil Seibert, CVT, Editor of The Veterinary Safety & Health Digest (www.safetyvet.com)

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