Part of me is just dying to check "D."
Wednesday, December 16, 2015
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Part of me is just dying to check "D."
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Doing some CME (continuing medical education) on Sunday, and saw this question on the post-test.
Part of me is just dying to check "D."
A Blog detailing the insanity of my medical practice and the stupidity of everyday life.
Part of me is just dying to check "D."
Welcome to my whining!
This blog is entirely for entertainment purposes. All posts about patients, or my everyday life, or anything else may be fictional, or be my experience, or were submitted by a reader, or any combination of the above. Factual statements may or may not be accurate. I could be making all this up. I may not even be a doctor. The only true statement on here is that I probably drink more Diet Coke than you do. A lot more.
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Twitter fans- you can follow me @docgrumpy
Cast of Characters:
Annie: My Phenomenal MA
Mary: My Awesome Secretary
Ed: The office fish
Dr. Pissy: The guy I share an office with
Mrs. Grumpy: My Boss (also the world's greatest school nurse)
Frank, Craig, and Marie: The Grumpy Tribe
Garlic and Riley: The Grumpy Dogs
Questions? Comments? Biting sarcasm? Write to: pagingdrgrumpy [at] gmail [dot] com
Note: I do not answer medical questions. If you are having a medical issue, see your own doctor. For all you know I'm really a Mongolian yak herder and have no medical training at all except in issues regarding the care and feeding of Mongolian yaks.
Cast of Characters:
Annie: My Phenomenal MA
Mary: My Awesome Secretary
Ed: The office fish
Dr. Pissy: The guy I share an office with
Mrs. Grumpy: My Boss (also the world's greatest school nurse)
Frank, Craig, and Marie: The Grumpy Tribe
Garlic and Riley: The Grumpy Dogs
Questions? Comments? Biting sarcasm? Write to: pagingdrgrumpy [at] gmail [dot] com
Note: I do not answer medical questions. If you are having a medical issue, see your own doctor. For all you know I'm really a Mongolian yak herder and have no medical training at all except in issues regarding the care and feeding of Mongolian yaks.
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34 comments:
Well, the other methods are somewhat wasteful...
e) stockpile in case of future need
f) sell on craigslist
g) return for refund.
I'd go for e.
They left off e) What are unused OxyContin tablets?
h) Return to pharmacy for proper disposal of dead drugs.
murgatr
Pharm. Tech RDC'06
D would make you more popular and probably get you better gifts for your birthday and holidays. Just sayin'
None of these options are good. Who has the ability to burn their leftover drugs? I second option H.
Quite frankly, none of the choices are all that great??
Just out of curiosity...What would the right answer be? I assumed it would be H (letting pharmacy dispose of it correctly). But when I asked large urban health care system pharmacy (that I also work for) what I should do with my husband's expired Norco from shoulder surgery 3 years ago, they shrugged their shoulders and said "Just flush it. We can't take it."
e) sending them to a PO box in Maryland, near the FDA's headquarters.
H) wouldn't work in my area. I tried taking them to the pharmacies for appropriate destruction and disposal, and was told they weren't legally allowed to accept them. There are "drug drops", usually at the police station. You drop your excess/expired/unused medications into something that looks like a mailbox. Of course, always be sure to remove your personal information from the bottle.
All that being said, I'd much rather take it to the pharmacy. I love my pharmacists and, given their training and expertise, I trust them to handle this task safely.
And yes, the original answers from the survey suck. Who the hell writes this crap?
Conversely, I *do* have almost an entire bottle of Hycodan (from a bad cough) and hydrocodone (from a surgery) that I could sell, so I could make a dent in my student loan payments... ha ha j/k
I tried (a), but the smoke is really harsh and hard to inhale.
Our hospice nurse mixed leftover medications with flour and water and sealed them up in a plastic container for us to place in the trash. Toilets were readily available. They must study from a different book.
Pharmacies don't take bag expired meds. There are kits you can purchase OTC and mail off. If you don't want to do that, mix unused meds with coffee grounds or kitty litter to make unfit for human consumption. Then put in ziploc bags. Do NOT flush down toilet. And don't bring back full sharp's containers. We don't take those either. Signed, your friendly neighborhood pharmacist
So what is the answer they are looking for? I'm guessing C, because A, B and D aren't recommended. But C enables people to get the drugs by rooting through the garbage. I'd say crush the suckers up and put them in coffee grounds, then dispose.
The things I learn here. :D
First, WHAT leftover meds? JK!
As other have said, many pharmacies (at least the ones here) won't help with Option H. This is a shame as others have pointed out they have the expertise to *safely* destroy the medicine.
The toilet IS a quick and tempting option, one that I think I recall some advocating years ago. Don't do it. I remember interviewing a director of Public Works Sewer systems and learned treatment plants cannot remove/degrade/destroy the compounds and the stuff ends up in fish. Or somewhere we don't want it.
Anonymous 10:33 seems to have the best idea, (but what does it do to the landfill?) short of the disposal boxes some police departments have.
I sort of wonder about the worries about flushing. Apparently, most people do not realize that a large percentage of drugs are excreted unchanged in the urine and feces. I would not worry about a few vicodan in the sewage when you consider that all those drugs people take wind up there also.
Going through the medicine cabinet a few years ago, I found a bottle of oxycontin tablets with three still in the bottle. Holding it up to show my adult daughter, I asked her what she thought I could get if I went downtown and stood on a corner and sold them. She said probably three to five....years in prison.
The hoarding then in case ya need them option sounds great and all until the date on the bottle passes and, for whatever reason, yer house gets searched and they turn up, now yer well and truly screwed.
A pharmacy must obtain a DEA "takeback" license in order to be able to accept them. The only drop off I know of that is licensed is at the Sherriff's station. I usually go with the recommendation on the FDA website to combine with used coffee grounds or kitty litter to discourage consumption by others. It is not recommended to flush as it contaminates the water supply, although many drugs are eliminated in the urine and also enter the water supply.
Hey, option C should also have mix in with used kitty litter!
Options I have used:
R: Save for future use. Just wait until you come down with a toothache in the middle of the night on Saturday.
S: Give them to a friend who's in pain. My good friend who hurts so bad he can't sleep, for instance. At least he got a few nights rest.
T: Take one for general body aches and pains when you could get along without it. Yeah, I know. It's not right, I shouldn't do it, yada yada yada. It's a luxury item. Sue me.
Pain pills are tough to get these days, but they're double tough for law abiding citizens who need them and MDs who will prescribe them. We're perpetually losing the war on drugs, but that doesn't stop the idiots in government from trying.
Your honor, my client had merely FOUND these drugs and was on his way to the police station to turn them in.
Mail them to me @Joe Citizen, 11211 Main street, Anytown, USA
I will make sure to "dispose" of them for you!
Frankly, when my husband broke his thumb and had the surgery and the physical therapy, and the the physical therapist told him to get his prescription filled so that the therapy could commence without due injury (to the therapist), my husband filled his prescription for one tablet. You don't have to get an entire prescription filled, if you think you might not use it.
One son had two dental extractions and he used ibuprofen only, because he said he has 'friends' that might want to 'help' themselves. I suspect that a fifth of fermented potato mash was in the mix, but then he's the kid that cussed the school nurse (sorry Mrs. Grumpy) for not calling his parents soon enough after a greenstick fracture on the school basketball court, but refused to take any medications. So, there's that.
When I first moved to the midwest, the hospital pharmacy where I worked had a retail license. I'd always worked hospital, so was a little thrilled to fill for actual walk-in patients, look over their history (the pharmacy I filled as an intern in the school setting had little green cards handwritten with patient name and we kept track of fills and refills in ink!), counsel the patient, etc.. I was rather excited, then, to pick up a pill bottle on a walk onces and see my name, but the emotion quickly turned to a sick-feeling in the pit of my stomach, when I realized I was picking up an empty bottle of Vicodin on school grounds.
At a state convention on the drug problem here in the 'heartland', we learned that 'take-back' programs are employed all over the state, and special agencies are in force for disposal of drugs.
Hospital pharmacies don't get involved because there are usually facility policies for use of special 'Cactus' disposal technology for drug waste within the hospital (any medication can be reduced to a smidgeon, not just opiates). It would be very, very expensive for the hospital to employ this patented technology on Granny's old lumbago meds.
In general, at this time, no pharmacy can 'take-back' drugs without a special license, after removing any trace of patient identification. If this is not possible, call your local pharmacy to talk with the pharmacist for disposal recommendations. Accidental ingestion of drugs by toddlers is still a significant cause of morbidity, including sweet-tasting, or colorful products, drug patches, and other dosage forms.
Our pharmacy does not accept meds. I was told the Sheriff's Dept two counties away does. That trip is not worth it.
I was also told to use Chlorine bleach for the pills. Mix the pills with bleach in a ziploc bag or some container, and toss in the trash. I think it because 1. Bleach residue would prevent anyone from ingesting the material; and 2. Hypochlorite breaks down organic material like drugs.
I'm amazed that flushing down the toilet or putting them into the waste is considered! Here in Canada all pharmacies will accept expired and unused medications and take care of their safe disposal.
http://healthycanadians.gc.ca/drugs-products-medicaments-produits/buying-using-achat-utilisation/disposal-defaire-eng.php
When my father had some pills leftover his doctor suggested he sell them on the street. He was serious.
Maybe I'm a bit of a goody two shoes, but giving your prescription pain meds (or any prescription meds, for that matter) is a huge no-no.
Imagine you give your friend your leftover opioids. They take too many of them and an adverse event or addiction occurs. Are you willing to be held responsible for what happens? Could you legally be held responsible for what happens?
Furthermore, you may have no idea about the individual's health history, past medical history, other medications they may be taking. Unless you've had training as a pharmacist/MD/PA, it's really not your place to decide who gets to take opioids. Depending on the type of drug and the situation, "just one" could be very problematic for the individual. Very dangerous and irresponsible but then again I'm kind of a pedant/killjoy when it comes to stuff like this.
My license isn't worth it.
Sell them and get cash to buy something from the Grumpy Gift Guide. It's a win-win
In the UK you're asked to take them to a local pharmacy - we have one in our doctors surgery, which is common.
I'm a little surprised that the US doesn't have it as standard.
We have a monthly household hazardous waste drop off in my city. They accept unused medications and sharps. Very convenient-- it's a free drive-thru drop off. It accepts pretty much everything, though probably not explosives!
Doctors without boarders
Australia has what's called the RUM project. No it's not where you get free alcohol, it's where you Return Unwanted Medications to your local pharmacy and they dispose of them free of charge.
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