April 26 is National Prescription Drug Take Back Day

Attorney RJ Connelly III

"Tomorrow, Saturday, April 26, marks the spring 2025 National Prescription Drug Take Back Day, an important initiative that provides a safe, convenient, and responsible method for disposing of unused or expired medications," stated professional fiduciary and certified elder law attorney RJ Connelly III. "This event is scheduled from 10:00 AM to 2:00 PM, offering all individuals, particularly seniors, an organized opportunity to declutter their medicine cabinets. The primary goal of this initiative is to ensure the proper management of potentially harmful substances."

National Take-Back Days are conducted biannually, typically in the spring and fall, with the inaugural event launched in 2010. Following this initial event, Congress took decisive action by amending the Controlled Substances Act, thereby granting the Drug Enforcement Administration (DEA) the authority to permanently establish this event. This legislation demonstrates a commitment to providing a secure method for disposing of excess medication, thereby protecting public health.

E-cigarette products and vaping devices have now been included among the items eligible for take-back. This modification demonstrates the DEA's proactive stance in addressing the escalating health concerns associated with vaping that have emerged nationwide. On the official Drug Take-Back website, these items are categorized under "paraphernalia," indicating the seriousness with which this matter is being regarded.

Dangers in the Cabinet

Understanding the significance of responsible medication disposal is essential. The opioid epidemic has certainly heightened awareness regarding this issue; however, numerous other medications commonly found in the cabinets of seniors can also pose risks of misuse. Family members often inadvertently concentrate solely on opioids, remaining unaware that various other substances can be hazardous when improperly used. By participating in Take-Back Day, individuals can take proactive measures to safeguard themselves and their loved ones from potential harm. Below is a list and brief description of the meds to be aware of in the medicine cabinet.

Opioids - Opioids, such as codeine, hydrocodone, morphine, oxycodone, hydromorphone, and fentanyl, are commonly prescribed for pain management. While effective for severe pain, long-term use can lead to tolerance, requiring higher doses for the same relief, and may worsen pain over time. Extended use also increases the risk of physical dependence, especially for older adults with multiple health issues. Side effects like constipation, respiratory problems, cognitive impairment, and a higher risk of falls complicate treatment. Research shows that seniors on opioids are four to five times more likely to experience falls or fractures compared to those on non-opioid alternatives.

Benzodiazepines - Benzodiazepines, such as alprazolam (Xanax), diazepam (Valium), and lorazepam (Ativan), are often prescribed for their sedative and anxiolytic effects. Despite over 2,000 being developed, only about fifteen are FDA-approved. Their misuse poses significant risks, especially when combined with alcohol or other substances, leading to potentially life-threatening situations. Chronic abuse can also mimic dementia symptoms in older adults, complicating diagnosis and treatment.

Z Drugs - The Z-drugs, including Lunesta, Ambien, and Sonata, act as agonists at benzodiazepine receptors to treat insomnia, offering a potentially safer alternative to traditional benzodiazepines. However, users should be cautious, as physical dependence can develop within two weeks, leading to tolerance and requiring higher doses for the same effect. Discontinuing or reducing the medication may also cause withdrawal symptoms, resulting in discomfort.

Stimulants - Certain medications, though not commonly prescribed for the elderly, are vital for treating ADHD and sleep disorders like narcolepsy. Key examples include methylphenidate (e.g., Ritalin, Concerta) and amphetamines (e.g., Adderall XR, Mydayis). Despite their different chemical structures, these stimulants can have similar effects when misused. Healthcare professionals choose between them based on individual patient needs. It's important to note that these stimulants are among the most commonly misused prescription medications.

Muscle Relaxers - Centrally acting skeletal muscle relaxants like carisoprodol (Soma) and cyclobenzaprine (Flexeril) are prone to misuse, often combined with narcotics and alcohol. This risky combination can lead to severe effects like respiratory depression and coma. Carisoprodol is exceptionally addictive and is sometimes mixed with opiates and benzodiazepines for a euphoric effect known as the "Houston Cocktail." While cyclobenzaprine is mainly prescribed for muscle pain, it also carries a risk of addiction, highlighting the dangers of these medications.

Psychotropics (Psychiatric Meds) - Seroquel, an atypical antipsychotic prescribed for mood disorders and schizophrenia, is often misused, especially by individuals with substance use disorders. Some exploit its sedative effects to ease withdrawal symptoms or enhance the impact of illicit drugs. It's known on the street by names like "Susie Q" and "Squirrel." Misuse practices, such as crushing and inhaling tablets or injecting the solution, significantly increase the risks of adverse reactions and overdose.

Barbiturates - Barbiturates are highly addictive substances commonly used by older adults and often found in home medicine cabinets. Examples include amobarbital, secobarbital, and phenobarbital, as well as combinations such as butalbital, acetaminophen, and caffeine. While they effectively induce sleep and reduce anxiety, barbiturates pose serious risks due to the difficulty in determining safe dosages. Minor overdoses can lead to severe complications, including coma or death, and withdrawal can be life-threatening, making dependency a significant concern.

Gabapentin - Gabapentin, known as Neurontin, is an anticonvulsant available in various forms, used mainly for managing seizure disorders and neuropathic pain, like post-herpetic neuralgia. The extended-release version, Horizant, is used to treat restless leg syndrome (RLS). Recently, overdoses of gabapentin have increased as it is used more frequently in pain management, often as an alternative to opioids. Unlike opioid overdoses, there is no specific antidote for gabapentin toxicity, and its long half-life increases the risk of overdose. Prompt medical intervention is crucial in overdose cases, highlighting the need for awareness among patients and healthcare providers.

Antibiotics - The inappropriate use of antibiotics can lead to significant health issues, including antibiotic resistance, which fosters the development of bacteria that are difficult to treat. Overuse can disrupt the beneficial gut microbiota, potentially leading to diarrhea and yeast infections, and is particularly concerning for the elderly and those with weakened immune systems. Clostridium difficile (C. diff) infections can result in severe diarrhea and dangerous colon inflammation, with a risk of toxic megacolon and sepsis. C. diff is highly contagious, spreading through contaminated surfaces and hands, especially in hospitals and nursing homes.

Expiration and Potency

A significant concern regarding medication storage in residential cabinets is the potential for efficacy to decline over time. While past beliefs suggested that expired drugs lose effectiveness, a 2012 study in the Journal of the American Medical Association found that many medications may retain potency long after their expiration dates. However, this topic remains debated.

This issue is particularly relevant for seniors, who often retain and share unused medications, posing substantial health risks. Many keep prescriptions they no longer need due to the financial burden of acquiring new ones. As health conditions change, the risk of dangerous drug interactions increases, especially if seniors combine medications without professional guidance.

Disposal of Medication

As previously mentioned, this biannual event presents a valuable opportunity for individuals to assess and declutter their medicine cabinets. It is essential to regularly review one’s medications and properly dispose of any that are no longer necessary or have expired. Historically, flushing unused medications down the toilet was considered an acceptable disposal method; however, various municipalities have since prohibited this practice due to increasing environmental concerns and its potential effects on water supplies.

To ensure the safe and environmentally responsible disposal of medications, the following steps are recommended:

Step 1 - Combine the medications (without crushing tablets or capsules) with an undesirable substance, such as soil, cat litter, or used coffee grounds. This mixture effectively minimizes any potential for misuse or diversion of the medications during the disposal process.

Step 2 - Carefully place the mixture into a secure container, such as a zip-top or sealable plastic bag. Ensure that any excess air is removed to prevent leaks. Once properly sealed, please dispose of the bag in the household trash, taking care to place it in a location where it will not be easily accessed.

Step 3 - When discarding the prescription vial, remove the label and completely obliterate any personal information contained on it. This step is vital in safeguarding personal privacy and preventing identity theft, as it removes identifiable information linked to the medications.

To promote the safe and environmentally sustainable disposal of unused or expired medications, it is advisable to utilize pharmacy take-back programs or solid waste management initiatives. Many local pharmacies offer designated days for collecting unwanted medications, making the disposal process convenient and easy. Additionally, various municipalities offer solid waste programs with specific guidelines for disposing of pharmaceutical waste. Participation in these programs not only helps prevent potential misuse of medications but also protects our water supply and ecosystem from contamination. Individuals are encouraged to consult with their local pharmacy or waste management office to explore available options.

To locate a Take Back facility in your vicinity, please click on the logo below and enter your zip code to access relevant information.

A Final Word

"It is essential to acknowledge the health risks associated with the retention of unused medications within households, particularly those with young children, adolescents, and elderly individuals," asserted Attorney Connelly. "Although child-resistant containers are designed to minimize the risk of accidental access, they do not provide a complete barrier against such occurrences, and incidents of unintentional exposure may still arise. Research indicates that 45% of accidental medication exposures in children involve medications stored in these containers. We strongly encourage all families to participate in this Saturday's Prescription Drug Takeback Day."

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