Feds Suggests Mixing Leftover Medication and Used Cat Litter to Curb Drug
Abuse
Monday, November 5, 2007    13:49 PST

WASHINGTON, D.C. --  It's time to pooper-scoop your leftover medicine.
Mixing cough syrup, Vicodin or Lipitor with cat litter is the new advice on
getting rid of unused medications _ preferably used cat litter.

It's a compromise, better for the environment than flushing and one that
renders dangerous medicines too yucky to try if children, pets or drug
abusers stumble through the trash.

A government experiment is about to send that advice straight to thousands
of patients who use potent painkillers, sleeping pills and other controlled
substances.  Why?  Prescription drug abuse is on the rise, and research
suggests more than half of people who misuse those drugs get them for free
from a friend or relative.

In other words, having leftovers in the medicine cabinet is a risky idea.
Anyone visiting your house could swipe them. So 6,300 pharmacies around the
country have signed up for a pilot project with the Substance Abuse and
Mental Health Services Administration.

When patients fill prescriptions for a list of abuse-prone medicines, from
Ambien to Vicodin, the pharmacist also will hand over a flyer urging them to
take the cat-litter step if they don't wind up using all their pills.

Not a cat owner?  Old coffee grounds work, or doggie doo,  even sawdust.
Just seal the meds and the, er, goop in a plastic bag before tossing in the
trash.

"We don't want to assert that this is a panacea for the larger problem,"
says SAMHSA's Dr. H. Westley Clark. "It just provides them with a caveat
that these are not things you can just lay around."

But the concern isn't only about controlled substances.  How to best dispose
of any medicine, whether prescription or over-the-counter, is a growing
issue.

Unfortunately, "we don't have a silver bullet," says Joe Starinchak of the
U.S. Fish and Wildlife Service.

No one knows just how many unused drugs Americans dump each year, or how
many are hoarded because patients simply don't know what to do with them or
that they should dispose of them.

Once, patients were told to flush old drugs down the toilet. No more - do
not flush unless you have one of the few prescriptions that the Food and
Drug Administration specifically labels for flushing.

That's because antibiotics, hormones and other drugs are being found in
waterways, raising worrisome questions about potential health and
environmental effects. Already, studies have linked hormone exposure to fish
abnormalities. Germs exposed to antibiotics in the environment may become
more drug-resistant.

Some communities set aside "take-back" days to return leftover doses to
pharmacies or other collection sites for hazardous-waste incineration. The
Environmental Protection Agency recently funded a novel pilot program by the
University of Maine to see if consumers will mail back unused drugs - a
program that local officials estimate could cull up to 1.5 tons of
medications.

But it's not clear if incineration is better for the environment than the
slow seepage from a landfill, cautions the Fish and Wildlife Service's
Starinchak.

Plus, take-back programs require legal oversight to make sure what's
collected isn't then diverted for illegal use.

Starinchak calls the yucky-bag disposal method interim advice - the top
recommendation until more research can determine the best way to balance the
human health, environmental and legal issues.

So early next year, Fish and Wildlife will team with the American
Pharmacists Association for a larger campaign called SMARxT Disposal. The
campaign will spread this latest advice through even more drugstores, to
purchasers of all types of medicine.

"There is a $64,000 question here: Whether people really will get rid of
it," says Carol J. Boyd, director of the University of Michigan's Institute
for Research on Women and Gender and a well-known specialist on drug
diversion.

Say you're prescribed a week's worth of Vicodin for pain after a car crash,
and you use only three days' worth. Most people would keep the rest, to
avoid paying for more if they suffer serious pain for some other reason
later. Boyd isn't sure how to counter that money issue.

But keeping the leftovers makes them accessible for misuse by children,
other relatives or visitors.  Stealing aside, Boyd's research uncovered that
friends and family openly share these pills - "Use this, it helped me" -
even with teens and college students, apparently not realizing there could
be serious health consequences.

"The public needs to know this," Boyd says of the disposal advice. "What's
not easy is, we don't know if it's working."