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Friday, November 7, 2008

Tell me about your extra drugs!

Earlier this year, the Associated Press did a big investigation of the levels of pharmaceuticals in our drinking and ground water. A lot of the drugs get into the water after passing through people's bodies, but some end up there because patients are following the traditional instructions for disposal of unused medications--flush 'em.

I'm working on a story, as part of our Medicine and the Environment series, about what physicians can do to help fix this problem. Obviously, if you have a drug takeback program in your area, that's great. But if you don't, what should you be telling patients to do with their leftover meds?

I found one article that details the laborious process (involving kitty litter and unmarked containers) recommended by the federal government, but I highly doubt that's getting a lot of play in offices or homes around the country. So, has anyone ever asked you what to do with their unused medications? What do you tell them? If it were a relatively simple process, would you be willing to collect the meds?

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4 Comments:

Anonymous InteractMD.com said...

This is an interesting issue--especially since it came out two months ago that hospitals are flushing millions of pounds of drugs per year.
http://www.truthout.org/article/health-facilities-flush-estimated-250-million-pounds-drugs-a-year

Medicine is not a very "green" industry in general--it's surprising the general media has not picked up on this much. We agonize over how much petroleum it takes to ship a banana from Chile to LA, but we never hear how much diesel it takes to move a Band-Aid from China to Peoria!

I usually tell patients to bring in their unwanted drugs, and we can usually find a way to use them. Should a patient throw away a prescription if it cost them $1,000? The pharmacies will not take stuff back, of course.

November 10, 2008 12:50 AM  
Blogger Stacey Butterfield said...

Thanks for the link. I hadn't even realized that entire hospitals are flushing their drugs. Using the unwanted meds sounds like the ideal solution. What kinds of uses do you find for the pills that are brought in?

November 10, 2008 10:20 AM  
Blogger BEP said...

THANK YOU for initiating this discussion, I had a patient just ask me about this yesterday as I prescribed amoxicillin liquid to his daughter (that we often give "extra" of for spills/etc..) I had no answer for him. Found this post searching on the web.

So...what ARE providers telling their patients, what do you recommend I start telling my clients and when/where will the article be published?

April 13, 2009 10:06 AM  
Blogger Stacey Butterfield said...

BEP, here's a link to article: http://www.acpinternist.org/archives/2009/02/drugs.htm I'm afraid I didn't find much in the way of disposal options other than takeback programs or the government recommendations. Concerns about contamination, expiration and liability seem to prevent reuse of meds in most places.

April 14, 2009 11:25 AM  

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Members of the American College of Physicians contribute posts from their own sites to ACP Internist and ACP Hospitalist. Contributors include:

Albert Fuchs, MD
Albert Fuchs, MD, FACP, graduated from the University of California, Los Angeles School of Medicine, where he also did his internal medicine training. Certified by the American Board of Internal Medicine, Dr. Fuchs spent three years as a full-time faculty member at UCLA School of Medicine before opening his private practice in Beverly Hills in 2000.

David Katz, MD
David L. Katz, MD, MPH, FACP, is an internationally renowned authority on nutrition, weight management, and the prevention of chronic disease, and an internationally recognized leader in integrative medicine and patient-centered care.

DrDialogue
Juliet K. Mavromatis, MD, FACP, provides a conversation about health topics for patients and health professionals.

Dr. Mintz' Blog
Matthew Mintz, MD, FACP, has practiced internal medicine for more than a decade and is an Associate Professor of Medicine at an academic medical center on the East Coast. His time is split between teaching medical students and residents, and caring for patients.

Everything Health
Toni Brayer, MD, FACP, blogs about the rapid changes in science, medicine, health and healing in the 21st century.

FutureDocs
Vineet Arora, MD, FACP, is Associate Program Director for the Internal Medicine Residency and Assistant Dean of Scholarship & Discovery at the Pritzker School of Medicine for the University of Chicago. Her education and research focus is on resident duty hours, patient handoffs, medical professionalism, and quality of hospital care. She is also an academic hospitalist.

Glass Hospital
John H. Schumann, MD, FACP, provides transparency on the workings of medical practice and the complexities of hospital care, illuminates the emotional and cognitive aspects of caregiving and decision-making from the perspective of an active primary care physician, and offers behind-the-scenes portraits of hospital sanctums and the people who inhabit them.

Gut Check
Ryan Madanick, MD, ACP Member, is a gastroenterologist at the University of North Carolina School of Medicine, and the Program Director for the GI & Hepatology Fellowship Program. He specializes in diseases of the esophagus, with a strong interest in the diagnosis and treatment of patients who have difficult-to-manage esophageal problems such as refractory GERD, heartburn, and chest pain.

I'm dok
ACP Member Mike Aref, MD, PhD, ACP Member, is an academic hospitalist with an interest in basic and clinical science and education, with interests in noninvasive monitoring and diagnostic testing using novel bedside imaging modalities, diagnostic reasoning, medical informatics, new medical education modalities, pre-code/code management, palliative care, patient-physician communication, quality improvement, and quantitative biomedical imaging.

Just Oncology
Richard Just, MD, ACP Member, has 36 years in clinical practice of hematology and medical oncology. His blog is a joint publication with Gregg Masters, MPH.

KevinMD
Kevin Pho, MD, ACP Member, offers one of the Web's definitive sites for influential health commentary.

MD Whistleblower
Michael Kirsch, MD, FACP, addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.

Medical Lessons
Elaine Schattner, MD, ACP Member, shares her ideas on education, ethics in medicine, health care news and culture. Her views on medicine are informed by her past experiences in caring for patients, as a researcher in cancer immunology, and as a patient who's had breast cancer.

Prescriptions
David M. Sack, MD, FACP, practices general gastroenterology at a small community hospital in Connecticut. His blog is a series of musings on medicine, medical care, the health care system and medical ethics, in no particular order.

Reflections of a Grady Doctor
Kimberly Manning, MD, FACP, reflects on the personal side of being a doctor in a community hospital in Atlanta.

Technology in (Medical) Education
Neil Mehta, MBBS, MS, FACP, is interested in use of technology in education, social media and networking, practice management and evidence-based medicine tools, personal information and knowledge management.

White Coat Underground
Peter A. Lipson, MD, ACP Member, is a practicing internist and teaching physician in Southeast Michigan. The blog, which has been around in various forms since 2007, offers musings on the intersection of science, medicine, and culture.

ACP Internist and ACP Hospitalist also contribute to and draw upon content from Get Better Health, a network created by Val Jones, MD, to support and promote health care professional bloggers, provide insightful and trustworthy health commentary, and help to inform health policy makers about the clinician's point of view on health care reform, science, research and patient care.

Other blogs of note:

American Journal of Medicine
Also known as the Green Journal, the American Journal of Medicine publishes original clinical articles of interest to physicians in internal medicine and its subspecialities, both in academia and community-based practice.

Clinical Correlations
A collaborative medical blog started by Neil Shapiro, MD, ACP Member, associate program director at New York University Medical Center's internal medicine residency program. Faculty, residents and students contribute case studies, mystery quizzes, news, commentary and more.

db's Medical Rants
Robert M. Centor, MD, FACP, contributes short essays contemplating medicine and the health care system.

Interact MD
Michael Benjamin, MD, ACP member, doesn't accept industry money so he can create an independent, clinician-reviewed space on the Internet for physicians to report and comment on the medical news of the day.

PLoS Blog
The Public Library of Science's open access materials include a blog.

White Coat Rants
One of the most popular anonymous blogs written by an emergency room physician.

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