Healthcare facilities are required to manage their pharmaceuticals properly.
Many facilities use a Reverse Distributor to manage their unused and outdated pharmaceuticals.
Those pharmaceuticals that cannot be managed through a reverse distributor
program, such as outdated (but not returnable for credit), used in compounding or IV preparation,
spilled, no longer useable for its intended purpose and any
items used in spill cleanup (vermiculite, paper towels and the like) must be
characterized as either hazardous or non-hazardous waste and managed properly.
North Dakota Pharmaceutical Waste Guidance can assist you in determining
if your waste pharmaceuticals are hazardous waste or not.
Following are links to various sites regarding disposal of
medication/pharmaceuticals from healthcare facilities:
North Dakota Board Of Pharmacy
Pollution Control Agency - Health Care Industry
Healthcare Environmental Resource Center
Great Lakes Regional Pollution Prevention Roundtable Sector Resource: Managing
Establishing Compliant And Cost-Effective Procedures To Manage Pharmaceutical
Florida Department Of Environmental Protection - List of Pharmaceuticals That
Are Potentially Hazardous Wastes When Discarded
Of National Drug Control Policy -
Proper Disposal Of Prescription Drugs
US Fish and Wildlife Service - Improper Disposal Of Unused Medication
Sparks Creation Of New Awareness Program
Pollution Control Agency - Pharmaceutical Waste: Disposing of Unwanted
Household wastes also contain medications that, in the past, have been disposed
of by flushing them down the toilet. In response to increasing concentrations of
pharmaceuticals, hormones and other organic wastewater contaminates found in the
rivers and streams across the nation, various agencies (the Office of National
Drug Control policy, the Department of Health and Human Services, the
Environmental Protection Agency, Fish & Wildlife Service and the American
Pharmacists Association and this Department) no longer encourage this practice.
Under a law in North Dakota, consumers can return their unused
prescription drugs to pharmacists or clinics so they can be given to someone
else who can use them. A drug donated under the program must be in the
original, unopened package, except drugs packaged in single-unit doses, or punch
cards, which may be accepted and dispensed if the outside packaging has been
opened and the single-unit dose package is unopened. A nominal fee may be
charged. Check with your local pharmacist or the
Dakota Board of Pharmacy to see who is participating in this program.
Take Back Program - Prescription Drugs
Dipose My Meds
If you have medications that cannot be returned, we now recommend they be
disposed of in the trash. Here are the disposal methods for unused medications:
1. Do not flush most medications*
2. Remove the label or scratch your name off the label
3. Make the drugs unusable or undesirable by:
- If liquid, mix with coffee grounds, kitty litter, salt, flour or
- If solid, add a small amount of water or vinegar to partially
4. Place the unusable medication in a leak-proof, non-descript container (empty
coffee can, detergent bottle, or sealable bag) and tape shut.
5. Place in the garbage.
6. If the medications are in a blister pack, wrap the blister packages together
in multiple layers of duct tape or other tape, then place in the garbage.
* The Food And Drug Administration advises that the following drugs be flushed down the toilet instead of
thrown in the trash:
Actiq (fentanyl citrate)
Daytrana Transdermal Patch (methylphenidate)
Duragesic Transdermal System (fentanyl)
OxyContin Tablets (oxycodone)
Avinza Capsules (morphine sulfate)
Baraclude Tablets (entecavir)
Reyataz Capsules (atazanavir sulfate)
Tequin Tablets (gatifloxacin)
Zerit for Oral Solution (stavudine)
Meperidine HCl Tablets
Percocet (Oxycodone and Acetaminophen)
Xyrem (Sodium Oxybate)
Fentora (fentanyl buccal tablet)
If you have further questions contact, by e-mail,
Christine Roob, or telephone 701.499.5207.