If your medicine cabinet is brimming with prescription medications you never used, you might be wondering what, if anything, you can do with them. Flush them? No—this has many environmental risks, according to the FDA. Give them to a friend? Never (this is not safe or legal, says Dr. Sean D. Sullivan, professor and dean of the University of Washington School of Pharmacy). Take them back to the pharmacy for a refund? Not an option.
This leaves two choices: dispose of them at a safe collection site (enter your zip code in the National Association of Boards of Pharmacy Drug Disposal Locator to find one near you), or donate them.
Donating might seem like the way to go, considering the amount of medication that goes to waste each year in the United States: $5 billion worth per year, says Kiah Williams, co-founder of Sirum, a non-profit organization that helps collect and redistribute surplus medications from pharmacies and healthcare facilities to low-income individuals. However, it isn’t as simple as rounding up your pill bottles and dropping them off at a local charity. Rules and opportunities vary by state. The National Conference of State Legislatures reports that 38 states have passed laws allowing for the establishment of medication donation and re-use programs as of 2018, but not all 38 have programs in place. Among those that do, only a few have avenues for individuals to donate. Fortunately, some accept out-of-state donations by mail.
One of those is the Wyoming Department of Health, which accepts donations of sealed medication that is five or more months out from its expiration date. Donors collect and prepare the bottles, fill out a public medication donation form and ship (or, if you live in Wyoming, the donation can be dropped off at a collection site). Iowa’s SafeNetRX program is similar. And if you happen to be in Louisiana, you can take prescription donations directly to St. Vincent de Paul Community Pharmacy between the hours of 8:30 a.m. and 12:30 p.m. Additional details on programs and regulations across various states are listed on the NCSL website.
Sirum also provides information on donation programs, but it is important to note that they do not facilitate donations between individual consumers and the organizations that provide them to people in need, says Williams—only healthcare facilities, pharmacies, manufactures, wholesalers, and other related entities.
“We have been called a Match.com for unused medicines,” Williams says. “We work with hundreds of organizations who have surplus medications, and community clinics and charitable pharmacies are on the receiving end.”
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Nonetheless, Williams says individuals can still help out by encouraging places you do business with, like a family member’s assisted living facility for example, to donate.
“You can ask ‘what happens to unused medications here?’ or ‘are you donating?’” she says, adding that ideally this would lead to more and more facilities and organizations getting on board the donation train.
Williams also points out that whether you are an individual seeking to donate a medication that was prescribed but never used or a healthcare facility with a surplus, there are two important rules that apply to every program in existence. First, expired and/or opened medications are never accepted. They must be in their original, sealed containers. And likewise, don’t attempt to donate opioids—these drugs are not eligible. Most other types of prescription medications are accepted, says Williams, but the ones that seems to come through the program most frequently are “the kind of medications people need for chronic diseases on an ongoing basis.”
“The surplus … mirrors the medications that are most needed,” she says. “So we are looking at medications for things like diabetes, heart disease, high blood pressure, high cholesterol, asthma, COPD, and mental health or behavioral health medications.”