To Flush or Not To Flush

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FDA lists meds for trash or toilet.

A recent post here on the subject of illegal bong water in Minnesota—coupled with a perceptive comment by a reader about drugs in the water supply—got me thinking again about what gets thrown in the sink or flushed down the toilet.

I was surprised to discover that, according to the Food and Drug Administration (FDA), consumers are better served by flushing some drugs down the toilet. The FDA has put up a web site dedicated to the proposition that flushing drugs is the preferred method for certain kinds of drugs—but not for every kind of drug.

While noting that “flushing is not recommended for the vast majority of medicines,” the FDA asserts at druginfo@fda.hhs.gov that “certain medicines may be especially harmful and, in some cases, fatal in a single dose...” To dangerous, in other words, to leave around the house or in the trash.

The potential for fatal overdose, particularly with prescription morphine and its derivatives, suggests that flushing will be the preferred method of disposal unless or until communities and pharmaceutical companies get serious about take-back programs and other medicine disposal services.

Specifically, drugs recommended for flushing include:

--Morphine Sulfate (Morphine, Avinza, Embeda, Kadian, MS Contin, and Oramorph).

--Fentanyl Citrate (Actiq, Duragesic, Fentora, Onsolis).

--Meperidine Hydrochloride (Demerol).

--Methylphenidate (Daytrana).

--Hydromorphone Hydrochloride (Dilaudid).

--Methadone Hydrochloride (Methadone, Methadose, Dolophine).

--Oxymorphone Hydrochloride (Opana).

--Oxycodone Hydrochloride (Oxycontin, Percocet, Percodan).

-- Sodium Oxybate (Xyrem).

The FDA says that the disposal of “these select, few medicines by flushing contributes only a small fraction of the total amount of medicine found in the water. FDA believes that any potential risk to people and the environment from flushing this small, select list of medicines is outweighed by the real possibility of life-threatening risks from accidental ingestion of these medicines.”

The preferred disposal method for all other drugs, says the FDA, is to mix them with kitty litter or coffee grounds, place the mixture in a sealed plastic bag, and throw the container in your household trash.

Photo Credit: www.pri.org

drugs

"Rogue Pharmacies" on the Internet

You've got drugs!

No prescription? No problem. Of 365 web sites advertising or selling controlled drugs, fully 85 percent do not require a written prescription, according to the 5th annual White Paper from the National Center on Addiction and Substance Abuse at Columbia University (CASA).

Although the overall number of drug-peddling web sites declined from 2007, the report found that benzodiazepines like Xanax and Valium were the most frequently offered online drugs, followed by painkillers like Oxycontin and Vicodin. 27 percent of the sites also offered Ritalin, Adderall, and other stimulants.

The paper, entitled "'You've Got Drugs!' V: Prescription Drug Pushers on the Internet," reported that only two of the 365 sites were certified by the National Association of Boards of Pharmacy, an official body which represents state pharmacy examination boards. The total number of drug sites was down from 581 such web sites in 2007.

"This problem is not going away," said Joseph A. Califano, Jr., chairman and president of CASA, and a former secretary of Health, Education and Welfare under President Jimmy Carter. "It is morphing into different outlets for controlled prescription drug trafficking like Internet script mills and membership sites that sell lists of online pharmacies, and different payment methods like eChecks, COD and money orders."

In addition, some of the sites sell "medical consultations" which can be used to procure controlled drugs without a formal prescription. In 2007, 80 percent of prescriptions filled by Internet pharmacies were for controlled substances. According to figures from the Drug Enforcement Administration (DEA), only 11 percent of business at traditional pharmacies involves scheduled drugs.

In April, the U.S. Senate passed a bill endorsed last year by the Senate Judiciary Committee, which seeks to control the Internet traffic in prescription drugs. The bill, introduced by Senators Diane Feinstein (D-CA) and Jeff Sessions (R-AL), now goes to the U.S. House. According to Senator Feinstein, "This [CASA] report emphasizes the need to take immediate action to stop rogue pharmacies on the Internet.... Our Internet pharmacy legislation has passed the Senate. It's time for the House to take action and pass this important bill."

Photo Credit: Next Thing