Expired medications are a common occurrence in homes and healthcare facilities. As drugs reach their manufacturer-designated expiration dates, questions arise about what to do with these unused or unwanted pharmaceuticals.
Safe disposal of expired drugs is essential to protecting public health and the environment.
The Problem of Expired Drugs
Expired or unused medicines present a significant challenge in healthcare. With drug wastage estimated to cost the NHS over £300 million annually, there is an urgent need for strategies that improve drug supply management and reduce the financial losses from expired drugs. But safe and sustainable disposal of pharmaceuticals, once expired, is equally important.
The Need for Appropriate Drug Disposal
Proper disposal of expired drugs is vital for a few key reasons:
- Preventing accidental poisoning: If old medicines end up in the trash or water system, people or animals could mistakenly ingest them and be harmed.
- Avoiding misuse: Outdated prescriptions that accumulate in homes can potentially be misused or abused if they fall into the wrong hands.
- Protecting the environment: Allowing medications to enter waterways or landfills untreated can pollute drinking water, creating antibiotic resistance in bacteria and ecosystem imbalance from disrupted hormonal systems and reproductive processes in wildlife.
- Ensuring legal compliance: By law, healthcare facilities must dispose of expired drugs safely and responsibly.
Responsible Disposal Methods
Various techniques are utilised for pharmaceutical waste disposal, depending on the types of drugs and local regulations. Common methods include:
Returning Unused Drugs to Pharmacies and Manufacturers
Returning unused medication to pharmacies is a compliant, eco-friendly choice for individuals. However, many patients find this inconvenient, prompting continued home storage. On a larger scale, healthcare facilities and institutions can return unusable drugs to the supplier or manufacturer.
Landfill Disposal
Landfill disposal is banned in many countries due to the risks of toxic pharmaceuticals leaching into surrounding environments before degrading. Where permitted, landfilling requires extensive pre-treatment. Landfilling should only occur after rendering drugs inert and non-hazardous. Medium-temperature incineration or chemical decomposition pre-processing allows landfilling afterwards.
Wastewater Disposal
Sewer disposal of liquids is another approach. It involves diluting certain liquid medications or intravenous preparations for disposal down the sewer. Allowing drugs to metabolise through wastewater treatment plants or become highly diluted in surface waters avoids direct environmental dumping.
Yet wastewater disposal also has its detractors. This method is only suitable for inert, non-toxic drugs, as standard municipal wastewater systems do not fully destroy medications. Furthermore, scientists have linked effluent contamination to disturbing wildlife reproductive changes from endocrine disruptors.
Chemical Decomposition
Chemical decomposition of drugs breaks down pharmaceuticals using other chemicals such as acids, alkalis, oxidising agents, or reducing agents. This approach can neutralise specific drug groups.
However, the drawbacks are the generation of chemical effluent requiring further neutralisation before final disposal and the inability to treat a wide variety of drug types within the same process.
Waste Immobilisation: Encapsulation and Inertization
- Encapsulation of pharmaceuticals involves immobilising expired drugs within a sealed drum, typically filled 75% with waste drugs and 25% with an inert material like cement. The cement mixture encapsulates the medications into a solid block inside the drum, which is then landfilled.
- Inertization of waste involves grinding up solid drug waste into a paste using cement, lime, and water. The inert paste solidifies and then gets transported to and deposited in landfills.
High Temperature Incineration
With drawbacks to burial and wastewater disposal, high temperature incineration has become the preferred solution for most expired pharmaceuticals, even for antineoplastic drugs disposal. Incineration using an engineered incinerator at over 1200°C completely destroys medications into their basic atomic elements. No toxic ashes remain, requiring landfilling.
Compared to landfills and wastewater systems, incineration reduces expired drug volumes entering the environment by 95% or more. High-temperature burning in oxygen-rich environments leaves behind no complex pharmaceutical compounds to threaten ecosystems or health.
Cement Kiln Incineration
Cement kiln incineration represents another high-temperature option that takes advantage of required temperatures over 2000°C in cement manufacturing. By feeding pharmaceutical waste into active cement kilns, drugs get fully decomposed in the process.
This approach is cost-effective, particularly for larger-scale controlled drugs disposal programmes, although there will be extra transportation costs.
Medium Temperature Incineration
Medium temperature incineration between 800-1200°C can be suitable for less hazardous drugs. This still ensures the complete breakdown of pharmaceuticals. Medium temperature incinerators provide economical and compact solutions for smaller clinics and pharmacies.
Key Disposal Considerations
It’s essential to consider the following factors when selecting an expired drug disposal method:
- Drug category: The hazards and regulatory requirements depend on the medication’s category and toxicity. Carcinogenic, radioactive, or otherwise highly dangerous drugs undergo the strictest control procedures.
- Biohazard risks: Infectious, cytotoxic, or radioactive drugs require special handling to protect employees and limit the environmental impact of expired drugs during processing and disposal.
- Required temperatures: The temperatures needed to thoroughly break down active ingredients determine the optimal disposal method. Heat levels must effectively neutralise all drug components.
- Emission control: Incinerators must use modern emission control systems to scrub flue gases, removing pollutants before release into the atmosphere after high-temperature waste treatment.
- Documentation & witnessing: In some cases, meticulous record keeping and witnessing destruction are needed for process compliance and accountability, especially for controlled substances.
By considering these factors, health services can match the appropriate disposal techniques to safely, legally, and sustainably destroy their expired pharmaceutical stocks.
The Role of Pharmaceutical Waste Management
Pharmaceutical waste management requires systematically tracking medicines from manufacture to patient use, including monitoring expiry dates and retrieving unused stock. Health service utilisation data gathered through e-prescribing and centralised stock inventory control systems can strengthen oversight across the supply chain.
Some drug management system options then exist for redirecting drugs before expiry, such as returning medications to suppliers when appropriate or redistributing them to areas with greater need.
Ensure Safe Drug Disposal with Inciner8
Expired pharmaceuticals require responsible destruction to protect public health and the planet. Incineration technology provides the most complete, scalable solution by totally destroying expired medications before chemical contamination spreads through landfills or water systems.
As a global leader in high temperature incineration, Inciner8 provides complete medical and pharmaceutical waste solutions. Our versatile range of pharmaceutical incinerators offers advanced thermal decomposition to eliminate expired drugs and healthcare waste safely.
Contact us today to discuss an integrated incinerator solution matching your facility’s requirements for responsible drug disposal. Our team will provide responsive customer service and expert guidance on achieving full regulatory compliance.
