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To Flush Or Not To Flush: Agencies Navigate Conflicting Messages On Disposal Of Meds

Keith Srakocic
AP Photo
eople toss unneeded medicines into a bin as part of the Drug Enforcement Agency's National Take-Back Initiative on April 28, 2018 in McCandless, Pa.

Anyone living in the Puget Sound region has likely seen stories about prescription and illegal drugs polluting local waterways. Scientists have found traces of opioids and other pharmaceuticals in shellfish – and they're believed to also harm salmon and other fish.

Yet the Food and Drug Administration continues to advise people to safely dispose of many leftover meds by flushing them down the toilet.

Those instructions are printed in FDA-approved medication guides that pharmacies must give patients when they dispense several dozen kinds of prescription drugs, such as opioids. The risk that the drugs could fall into the wrong hands is greater than any potential environmental risks from flushing, according to the FDA. 

That forces local authorities to send somewhat mixed messages about how to dispose of these drugs, especially in light of the current opioid epidemic.

“Actually, we recommend a lot of different options at Kaiser Permanente,” says Katherine Bergman, the director of clinic pharmacy operations at KP Washington.

She says the organization has a dozen kiosks in their pharmacies across King County where anyone can safely dispose of unused meds. They promote events such as the National Take Back Day, arranged by the Drug Enforcement Administration. And Bergman says they’re rolling out a mail-back program that should be ready by the end of the year.

However, when it comes to opioids, Bergman says flushing may be the safest option for some people. “If they can’t get to a Kaiser Permanente Pharmacy – there may be options patients need. And it is an option.”

In fact, she added, having this option could actually save lives. But she says Kaiser Permanente also promotes their take-back kiosks and events with flyers in their pharmacies.

Meanwhile, Washington state is working on a new statewide drug take-back program, which may be one of the first in the country. Blake Maresh with the Washington State Department of Health says he expects it will provide many alternatives to flushing unused meds into local waterways.

“Having drugs flushed down the toilet is certainly better than having them fall into the wrong hands," Marest said. "But we think that there are other alternatives out there that are probably more ecologically friendly for disposing of unused medications like opiods.”

He says the state’s new program will certainly include secure kiosks like the ones offered by pharmacies at Kaiser Permanente and several other large chains, as well as some police departments.

But, Maresh notes, if you need to get rid of unused meds right away, you can also place them in a bag or container of used coffee grounds or kitty litter and throw them in the trash.    

Bellamy Pailthorp covers the environment for KNKX with an emphasis on climate justice, human health and food sovereignty. She enjoys reporting about how we will power our future while maintaining healthy cultures and livable cities. Story tips can be sent to