To Flush or Not to Flush

In which I deal with a drug problem

Like many of us, especially those of us on the, um, more mature side, I recently found myself with some leftover pills I needed to dispose of. Not a lot, 60 or 70 maybe, leftovers from three of four prescriptions, enough to fill a small bottle about 3" high and an inch across. Now, five years ago I probably would have just flushed them down the loo, like we all did. But recent public information campaigns from, e.g., the EPA and CalRecycle have emphasized the hazards of promiscuous disposal of prescription medications. They get in the water, they get in the fish, they get in us. So I didn't want to just flush 'em this time. (Fifty years ago we would have dumped our used motor oil into the sewer; I don't do that anymore either.)

So I put all the pills into that bottle and ambled down to a local branch of a national pharmacy chain, figuring, y'know, they sell the stuff, it's 2012, there's all this attention about medication disposal, that would be the place to take them. Not so much, it turned out.

The fella there told me they did not in fact accept old medications for disposal, then mentioned that San Francisco had such a program; I'm not sure if he was suggesting I go into the city, or perhaps he just thought that I might work there or otherwise go there regularly (I don't).

I had two immediate thoughts. First, it irritated me that this huge pharmacy chain did not, as a matter of public relations, have a prescription medication disposal service; second, it irritated me that San Francisco had this kind of program but Alameda County did not.

I still had the meds I wanted to dump; my search continued, somewhat amplified by increasing curiosity about this apparent gap between public health and waste management into which disposal seems (ironically enough) to have fallen. The pharmacy at one of our regional supermarkets couldn't dispose of them. I stopped off at the ACI office on Blanding to ask them; who better, one would think. They referred me to the Household Hazardous Waste facility on E. 7th St.; you know, the one that's only open 12 hours a week, none of them convenient. Besides, it wasn't like I wanted to get rid of a bucket of paint or old motor oil (see above) or a truckload of asbestos; it was a literal handful of pills.

That's when I started composing this post. How stupid is that, I said to myself. I really don't want to just dump the pills in the toilet, yet it's intimidatingly inconvenient to dispose of such a small quantity "properly." But the quantity that I have is, I would argue, comparable to the quantity that your typical consumer would want to dispose of. Something wasn't working the way it needed to.

But wait, there's more.

The early version of this post that was in my head was outrage that the drugstores don't voluntarily have a disposal program, and how the County should institute one like San Francisco and grumble grumble grumble, and I thought that (in good journalistic manner) I'd stop at Versailles Pharmacy, the last independent pharmacy in Alameda, and ask them about the situation. Imagine my surprise when the Nice Lady told me that they used to take old medications, but they had to stop. They were told, said the N.L., that they would have to have an actual police officer on duty there in order to accept them.

Well, that sounded bizarre. I wondered if there was concern about drugs being stolen, but who wanted to steal old diabetes medicine? Upon returning home, I decided to hit the old Google machine and see what I could find regarding "medication disposal." I found this, which confirmed the dearth of convenient disposal locations, but I was taken by the number of entries — pretty much all of them — that state "Does not accept controlled substances."

"Controlled substances"? Aren't all prescription medications "controlled substances" (a prescription is required, after all)? I decided to call the Household Hazardous Waste folks and see if they could tell me what that meant in this context. I wound up speaking with the Household Hazardous Waste Program manager, Bill Pollock.

The sticking point seems to be, believe it or not, the Drug War.

Mr. Pollock informed me that, for the purposes of disposal, anyway, "controlled substance" means anything on the DEA's List of Controlled Substances, which does not in fact include all prescription medications. It's interesting and somewhat entertaining to look through that list. My diabetes medications are not on the list, nor my thyroid supplement, nor your hypertension and cholesterol drugs, nor many of the prescription meds one sees advertised on the tube. It includes, beside the Usual Suspects (heroin, LSD, etc.), some of the old faves like Miltown and Nembutol, painkillers like Oxycontin and Vicodin (Dr. House, call your service), things like Valium, steroids, and current chart-toppers like Lunestra and Ambien.

To be honest, on those occasions when I do have some Valium or Vicodin, I tend not to have any left over. But I do have some Prozac in that bottle, and when I asked Mr. Pollock about it, his response was that Prozac was controlled, which points up one of the flaws of the current situation.

Now, I want to be fair, we were on the phone, his responses were off the cuff, I wasn't looking for a legal opinion…

But, um, Bill, you appear to be wrong there. I see neither fluoxetine (Prozac) nor paroxetine (Paxil) on the list.

And that's my point. If the guy who runs the program has trouble keeping them straight, how are we supposed to know to sort out the Lunestra from the Celexa, the levomethorphan from the levothyroxine, the clorazepate from the chlorpheniramine? According to Mr. Pollock, the only place in the county to drop off controlled substances is at the main Sheriff's office in Santa Rita.

The problem is that according to DEA regulations, these substances can only be transferred in the presence of a police officer. That's why Versailles was told they needed one. The reason seems to be that they're afraid of people stealing them. Yeah, stealing the half-dozen or so valium or Tylenol-3s that someone wants to throw out, that's a giant risk.

Indeed, looking around some web sites, one repeatedly sees the phrase "people who intentionally may go through your trash," and as reported by these guys, the 2007 Federal guidelines recommend against trashing, and instead flushing, oxycodone, fentanyl, and several others. Apparently we're so afraid of someone stealing these drugs that we'd rather put 'em in the water so we'll all get a taste.

That's insane.

I've concluded that the thing for me to do is, next time I clean out the ol' cat box, dump that bottle into the bag, shake it up real good and drop it in the black bucket.

P.S. Bill Pollock sent me a few web sites to peruse for more information:




That last appears to relate to a proposal currently before the Board of Supervisors. Contact Lena Tam's office for more on that, I guess.

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Mr. Anonymous July 12, 2012 at 07:33 PM
Seriously, if you take all of your pills, mix them up in a large bottle and drop it in the box at APD, is anyone going to know that you have a controlled substance in the mix? And further, will anyone care (or check)?
Jeff Mark July 12, 2012 at 08:02 PM
"Beating the system" isn't the point. The point is to have a system that doesn't need to be evaded. My point is that our hysteria about "DRUGS" is a hindrance to that goal.
CJ July 15, 2012 at 03:52 PM
http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm101653.htm or look at kp.org (get rid of old medications)...
Jeff Mark July 26, 2012 at 07:13 PM
The comment thread on "Drug Disposal Law Approved by Alameda County Supervisors" has become a fetid cesspool of disgusting online behavior, so I won't bring this up there, but the article is unclear what the ordinance specifies regarding so-called "controlled substances". I think I'll send a message to Bill Pollock.
Jeff Mark July 26, 2012 at 08:08 PM
From Bill Pollock, Program Manager, Alameda County Household Hazardous Waste Program: Until the DEA changes the regulations controlled substances can only be handled by law enforcement – The ordinance requires the industry to fund any law enforcement agency in the county that wants to set up a controlled substances collection.


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