"Saturday, October 26, marks the next National Prescription Drug Take Back Day, an essential initiative designed to provide a safe, convenient, and responsible way to dispose of unused or expired medications," said professional fiduciary and certified elder law Attorney RJ Connelly III. "This event is scheduled to take place from 10 am to 2 pm on that day, providing all individuals, especially seniors, with a structured opportunity to declutter their medicine cabinets. This initiative aims to ensure that potentially harmful substances are managed appropriately."
National Take-Back Days occur biannually, typically in the spring and fall, with the inaugural event launching in 2010. Four days after that first event, Congress took significant action by amending the Controlled Substances Act, empowering the DEA to establish this event permanently. This legislation affirms the commitment to providing a secure method for disposing of excess medication to safeguard public health.
In addition, e-cigarette products and vaping devices are now included in the items eligible for take-back. This change reflects the DEA's proactive approach to addressing the growing health concerns related to vaping, which have surfaced across the nation. On the official Drug Take-Back website, these items are classified under "paraphernalia," highlighting the seriousness with which this issue is being treated.
Dangers in the Cabinet
Understanding the importance of disposing of medications responsibly is critical. The opioid epidemic has certainly driven much of the awareness surrounding this issue, but many other medications found in a senior’s medicine cabinet can also pose risks of abuse. Often, family members may mistakenly focus solely on opioids, unaware that other substances can be dangerous when misused. Individuals can proactively protect themselves and their loved ones from potential harm by participating in Take-Back Day.
Opioids - Opioids, including codeine, hydrocodone (Vicodin), morphine (MS Contin), oxycodone (Oxycontin, Percocet), hydromorphone (Dilaudid), and fentanyl (Duragesic), are commonly prescribed for pain management. While effective for severe pain, prolonged use can lead to tolerance, requiring higher doses for the same relief, potentially worsening pain over time. Extended use also risks physical dependence, causing withdrawal symptoms if the medication is suddenly stopped. This risk concerns seniors, who may already be managing multiple health issues. Side effects such as constipation, respiratory problems, confusion, and increased fall risk further complicate treatment. Research shows that seniors using opioids are four to five times more likely to experience falls or fractures compared to those using non-opioid alternatives. Awareness of these risks is crucial for informed pain management in older adults.
Benzodiazepines - Benzodiazepines, such as alprazolam (Xanax), diazepam (Valium), clonazepam (Klonopin), and lorazepam (Ativan), are often prescribed for sedation, muscle relaxation, and anxiety reduction. Although over 2,000 benzodiazepines have been developed, only about 15 are FDA-approved in the U.S. Misuse of these drugs is concerning due to their accessibility, with individuals abusing them for extended periods or overdosing in emergencies. While benzodiazepine abuse rarely leads to severe health issues on its own, combining them with alcohol or other drugs can be life-threatening. Chronic abuse may also mimic dementia symptoms in older adults, complicating diagnoses and treatments. This highlights the importance of careful monitoring and responsible prescribing practices.
Z Drugs - The Z-drugs, such as Lunesta, Ambien, and Sonata, act as benzodiazepine receptor agonists, mimicking the effects of traditional benzodiazepines to treat insomnia. Developed to offer a safer alternative, these non-benzodiazepine medications aim to reduce addiction risks and side effects. However, users should be wary, as physical dependence can develop within just two weeks, whether used as prescribed or misused. This can lead to tolerance, requiring larger doses for the same effect, and withdrawal symptoms may arise if the medication is stopped or dosage reduced, causing discomfort.
Stimulants - These medications, though not frequently prescribed for seniors, are important for treating attention-deficit/hyperactivity disorder (ADHD) and some sleep disorders like narcolepsy. Key drugs in this category include methylphenidate (e.g., Ritalin, Concerta), amphetamine (e.g., Adderall XR, Mydayis), and dextroamphetamine (e.g., Dexedrine). Despite their different chemical structures, amphetamines and methylphenidates produce similar effects when abused. Healthcare providers choose between these stimulants based on individual patient needs and desired effects. It's essential to recognize that these stimulants are among the most misused prescription medications, but other substances in home medicine cabinets also carry a risk of abuse.
Muscle Relaxers - Centrally acting skeletal muscle relaxants, like carisoprodol (Soma) and cyclobenzaprine (Flexeril), are increasingly misused, often in combination with other CNS depressants like narcotics and alcohol. This dangerous mix can lead to severe consequences such as respiratory depression and coma. Soma is particularly addictive and often used with opiates and benzodiazepines, creating a euphoric effect known as the "Houston Cocktail." Flexeril, while prescribed for muscle pain, also poses a risk of addiction, highlighting the dangers of these medications.
Psychotropics (Psychiatric Meds) - Many psychiatric medications, including Seroquel, can be abused, especially by those with substance use disorders. Seroquel is used to treat mood disorders and schizophrenia, but some misuse it for its calming effects, often to ease withdrawal symptoms or counteract illicit drug side effects. As an atypical antipsychotic, Seroquel is widely prescribed, with over fifty-four million prescriptions issued in a year. On the street, it’s known as "Susie Q," "Squirrel," or "baby heroin." Misusers may crush and snort the tablets or inject the dissolved medication, both of which can significantly increase the risk of adverse effects and overdose.
Barbiturates - Barbiturates are highly addictive substances primarily used by older adults, often stored in medicine cabinets. Common types include amobarbital (Amytal), secobarbital (Seconal), and phenobarbital (Donnatal), as well as combinations like butalbital/acetaminophen/caffeine (Esgic or Fioricet). As sedative-hypnotics, they can effectively induce sleep and reduce anxiety, but they pose significant risks due to the difficulty in determining safe dosages. Even slight overdoses can lead to severe consequences, including coma or death, while withdrawal after prolonged use can be life-threatening, making dependency a serious concern.
Gabapentin - Gabapentin, marketed as Neurontin, is an anticonvulsant in capsules, tablets, and oral solutions. It's commonly prescribed for seizure disorders and neuropathic pain, especially post-herpetic neuralgia. The extended-release version, Horizant, treats restless leg syndrome (RLS). Recently, gabapentin overdoses have increased as it's increasingly prescribed for pain management in place of opiates. Unlike opiate overdoses, there is no specific antidote for gabapentin toxicity. Its long half-life keeps it in the body longer, heightening overdose risks. Immediate medical attention is crucial for overdose complications, making awareness of its effects important for patients and healthcare providers.
Antibiotics - The inappropriate use of antibiotics can lead to serious health issues, including the rise of antibiotic resistance, which results in harmful bacteria that are hard to treat. Overusing antibiotics can also upset the balance of beneficial gut bacteria, leading to side effects like diarrhea and yeast infections. This is especially problematic for seniors and those with weakened immune systems, who are at risk for life-threatening infections like C. difficile (C-diff). C-diff can cause severe diarrhea and dangerous colon inflammation, potentially leading to toxic megacolon and sepsis. C. difficile is highly contagious and spreads easily through contaminated surfaces and hands in hospitals and nursing homes. Maintaining strict hygiene is essential to prevent its transmission.
Expiration and Potency
A significant concern regarding medications stored in home cabinets is their potency over time. While previous beliefs indicated that expired drugs lose their effectiveness, a study published in the Journal of the American Medical Association in 2012 revealed that many medications may retain their potency even decades after expiration. Nonetheless, this remains a contentious issue, as research supports varying perspectives.
This issue is highlighted to draw attention to a troubling trend observed among the senior population: the retention and sharing of unused medications. This practice poses significant health risks and warrants serious discussion. Many seniors find themselves holding onto prescriptions that are no longer necessary, often due to the high costs associated with acquiring new medications. With limited financial resources, many individuals in this age group resort to keeping these unused drugs as a form of emergency stock.
In addition, variations in health status among older adults can manifest as new symptoms, which may indicate the onset of different medical conditions. As these changes occur, the likelihood of severe drug interactions increases. Seniors may inadvertently combine medications that could have harmful effects, particularly when taken without proper guidance or oversight from healthcare professionals.
Disposal of Medication
As mentioned previously, this event takes place bi-annually, providing a valuable opportunity for individuals to declutter their medicine cabinets. It's important to regularly review your medications and dispose of any that are no longer necessary or have surpassed their expiration dates. In the past, flushing unused medications down the toilet was widely accepted as a safe disposal method; however, many municipalities have since prohibited this practice due to growing environmental concerns and its potential impact on water supply.
To ensure that you dispose of your medications in a safe and eco-friendly way, consider following these straightforward steps:
Combine the medications (ensuring not to crush tablets or capsules) with an unappealing substance, such as soil, cat litter, or leftover coffee grounds. This method effectively deters any potential misuse or diversion of the medications from the waste stream.
Carefully transfer the mixture into a sturdy container, like a zip-top or sealable plastic bag. Press out any excess air to avoid leaks. Once securely sealed, dispose of the bag in your household trash, ensuring it is placed where it won't be easily exposed or accessed.
When disposing of a prescription vial, it is essential to carefully remove the label and ensure that all personal information on it is completely scratched off or obliterated. This step is crucial in protecting your privacy and preventing identity theft, as it helps to eliminate any identifiable information linked to your medications.
To ensure the safe and environmentally friendly disposal of unused or expired medications, it's important to utilize pharmacy "take-back" programs or solid waste management initiatives. Many local pharmacies offer designated days for collecting unwanted medications, allowing you to drop them off without hassle. Additionally, various municipalities have solid waste programs with specific pharmaceutical waste disposal guidelines. Participating in these programs helps prevent potential misuse of medications and protects our water supply and ecosystem from contamination. Always check with your local pharmacy or waste management office to find out about available options.
To find a Take Back location near you, click on the logo below and enter your zip code to get the information.
A Final Word
"It's important to recognize the health risks associated with keeping unused medications in the home, especially in households with young children, teenagers, and seniors," stated Attorney Connelly. "While child-resistant containers are intended to prevent accidental access, they are not completely child-proof, and incidents of accidental exposure can still happen. Research shows that 45% of accidental medication exposures in children involve medications stored in these containers. We encourage all families to participate in next Saturday's Prescription Takeback Day."
Please note that the information provided in this blog is not intended to and should not be construed as legal, financial, or medical advice. The content, materials, and information presented in this blog are solely for general informational purposes and may not be the most up-to-date information available regarding legal, financial, or medical matters. This blog may also contain links to other third-party websites that are included for the convenience of the reader or user. Please note that Connelly Law Offices, Ltd. does not necessarily recommend or endorse the contents of such third-party sites. If you have any particular legal matters, financial concerns, or medical issues, we strongly advise you to consult your attorney, professional fiduciary advisor, or medical provider.
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