How Do I Dispose of Expired Prescriptions?

The expiration date of a drug refers to the period of time for which the drug is approved for use, and it indicates the period during which the drug can guarantee quality under prescribed storage conditions. The validity period of a drug is an important indicator of the safety and effectiveness of a drug. Expired drugs have a serious impact on the normal drug market and the health and life of the people. Therefore, recognizing the hazards of expired medicines and taking effective measures to recover expired medicines are the objective requirements to ensure the safety of human medications and safeguard people's health.

Chinese name: Expired medicine

Foreign name: Expired medicine

Expired Drugs I. Definition of Expired Drugs

Drugs that have not been used within the validity period and have potential quality problems.

Expired medicines 2. Status of expired medicines

With the rapid development of China s socio-economic development, people s health awareness and awareness are continuously strengthened. With the implementation of China s over-the-counter management system, consumers can judge, purchase, and use over-the-counter medicines without a doctor s prescription. Many citizens have small medicine boxes at home . Nowadays, more and more pharmacies are opened in various places. In order to attract customers, some pharmacies allow customers to apply for membership cards and discount on certain days every month. Many citizens basically go to pharmacies every month to buy some medicines they want or not, which leads to an increase in expired medicines in their own medicine cabinets. But many people do not have the habit of cleaning up medicines. Even when they have a minor illness, they rarely pay attention to whether their medicines have expired. Regarding the dangers of expired medicines, they said that they did not pay much attention ^[1] .

Expired medicines III. Fate of expired medicines

A survey by the drug regulatory department showed that about 78.6% of households in China have spare medicines, and 52.4% of households have small medicine boxes at home. However, up to 73.6% of families ignored the storage conditions of medicines, and at least 80% of households did not have the habit of regularly cleaning up expired medicines ^[2] .

Ninety percent of the respondents had the experience of discarding expired medicines at will, and this problem is even more serious in rural areas; some people expressed concern that expired medicines would re-enter the market, the packaging would be removed and discarded, or medicines would be flushed into the sewer; Individual elders would sell the drug to "high-priced drug dealers."

Dangers of expired drugs

Expired medicines not only have no value in themselves, but also cause a lot of harm, mainly in the following aspects ^[3] :

1. Initiation of drug safety issues After the drug expires, it may not only lose its original therapeutic effect, but also may cause harmful substances to the human body due to changes in its internal quality and the like. If people use expired medicines, they may delay the timing of treatment, cause other health damage, and even threaten their lives. According to the "Drug Administration Law", drugs that have expired are inferior drugs, and their production and sales are prohibited. Some criminals collect expired medicines at low prices, change the packaging, and sell them to hospitals, pharmacies, and some unlicensed clinics in remote areas through illegal channels, and then flow into consumers again, seriously endangering the public's health and life.

2. Causes environmental pollution problems Improper handling of expired medicines will have certain impact on the environment. On the one hand, discarding expired medicines directly may pollute the environment. Relevant investigations show that most people treat expired medicines the same as ordinary household waste, and do not do anything before discarding them. Dispersion of pharmaceutical ingredients into the environment is likely to cause pollution, and some special properties of drugs, such as strong allergenic and volatile drugs, have a greater degree of pollution to the environment; on the other hand, the destruction of expired drugs may also pollute the environment. Due to the high cost of professional environmental destruction facilities and services, the destruction of expired drugs by relevant departments, units and consumers is often incinerated in the open air at garbage dumps, which is bound to cause harm to the environment.

3. Cause the problem of waste of resources No matter the country or the average consumer, the amount of medical expenses should not be underestimated, and every aspect is trying to reduce medical expenses. A large number of expired medicines not only have no use value, but also need to invest human, material and financial resources to deal with them, resulting in a waste of resources.

Expired medicines V. Recycling policies for expired medicines abroad

1. World Health Organization

The World Health Organization (WHO) classifies expired medicines under the category of unwanted medicines (UMs). UMs also include unused, spilled, contaminated pharmaceutical products, medicines, vaccines, and serum. The WHO believes that UMs should be disposed of as medical waste immediately and cannot be reused. In 1999, the WHO issued the first global guidance document on the safe management of waste generated from health care activities, proposing rules and regulations for waste management, including minimizing waste discharge, recycling, storage, transportation, disposal, and training Employees deal with waste and other content to increase the public's awareness of the reasonable disposal of medical waste.

2.Europe

Article 127b of EU Directive 2004/27 / EC requires all member states to establish recovery mechanisms for unused and expired drugs. In 2007, in order to explore how to implement a drug recycling project, the European Federation of Pharmaceutical Industry Associations conducted a survey of 27 EU member states and Norway, and the results showed that these countries have established their own expired drug recycling programs, which are mainly collected by drug stores. Financial support for recovery of expired medicines varies from country to country, some rely on government financial allocations, and some rely on companies or pharmacies for funding.

2.1 United Kingdom In the early 1990s, the Royal Pharmaceutical Society advocated for patients to return expired medicines to pharmacies. In 1996, the "Special Waste Disposal Regulations" stipulated that expired drugs should be disposed of in landfills or be incinerated. Drug use and prescription supervision in the United Kingdom is relatively strict, and households rarely have expired medicines, and they will be punished if they are discarded casually. Expired medicines should be placed in garbage bags labeled with expired medicines and disposed of by pharmacists. Unclassified behaviors will be included in "bad records", affecting personal integrity.

2.2 France France is one of the few countries in the world that clearly has an expired drug recall system. Its environmental department has formulated relevant policies and systems, which are implemented by the "National Drug Recycling Association". In April 1992, the French government promulgated the second "Waste Disposal Law", which requires pharmaceutical companies to take charge of the recycling and disposal of waste packaging of medicines they produce. In order to effectively implement the Waste Disposal Law, the French Pharmaceutical Industry Organization established the National Drug Recycling Association in 1993 to be responsible for matters related to drug recycling. In addition to the drug packaging, the Drug Recycling Association also collects all UMs, including expired and still-expiring drugs. The Association has set up recyclable medicine boxes in pharmacies, and pharmacies voluntarily and freely collect medicines. Nearly 90% of French pharmacies have actively participated in this action. At present, French pharmacies divide UMs into reusable and pending destruction categories. Pharmaceutical companies or wholesalers of medicines go to pharmacies to retrieve the drug waste for more detailed classification: after inspection of well-packaged and unexpired medicines, they will be sent free to domestic or international humanitarian organizations that have a cooperative relationship with the association. These organizations issue to individuals, regions, or countries that lack medical treatment; although expired, some of the components of which are still available will be sent to the relevant departments or laboratories for extraction and utilization; completely useless expired drugs and packaging will be shipped To a waste treatment plant capable of incinerating pharmaceutical products for incineration.

2.3 Germany In 1991, the German "Packaging Management Regulations" stipulated that product packaging entering the circulation field should be recycled by producers and operators; in 1996, the German "Garbage Law" stipulated that all products should be The product is responsible for recycling. Constrained by these two regulations, German drug recycling implements a corporate recycling responsibility system in accordance with the principle of "who produces and pays". Pharmacies are the main agency in Germany for handling expired medicines. All major pharmacies in Germany have outdated drug brochures, and pharmacies are obliged to collect the expired drugs in the hands of residents free of charge and send them to the waste recycling department for high temperature incineration. The environmental protection department also recommends that people hand over expired medicines to nearby pharmacies, and it is best to send the instructions and packaging to the pharmacy at the same time so that the pharmacy understands its hazards. Pharmacies generally do not reuse expired medicines, otherwise it is illegal.

3. United States

The U.S. federal government has not yet established an expired medicines recovery mechanism, and different agencies have different recommendations for dealing with expired medicines (except for specially managed medicines), but they complement each other. Its Environmental Protection Agency (USEPA) encourages every household to participate in local hazardous waste recycling projects, some of which include recycling expired medicines. For specially controlled drugs, according to the "Controlled Substances Act" (CSA) issued by the US Drug Enforcement Administration (DEA), the corresponding law enforcement agencies must be responsible for the recovery of specially controlled drugs. At present, many states in the United States have expired drug recycling programs, mainly led by pharmacies and environmental organizations, setting up collection points at parking facilities, or encouraging people to mail expired drugs to collection points by mail. In 2007, USEPA contributed $ 300,000 and asked the University of Maine's Aging Center, Community and Human Services Resource Center to study drug recycling mechanisms. The aging center mainly collects by mail, and the service resource center mainly sets up collections at chain drug stores; in order to reduce the generation of expired drugs, it also analyzes the main reasons for unused drugs.

4.Canada

Canada does not yet have a national policy for the treatment of expired medicines, and there are corresponding regulations in Alberta and Columbia only. In October 1996, Canada allowed residents of Alberta and Columbia to return UMs to pharmacies. The pharmacies received all prescription drugs, over-the-counter medicines, Chinese medicines, vitamins and mineral supplements, and throat sugar, and the recovered medicines were incinerated. Columbia has a recycling treaty and is the only province that has legal provisions for drug recycling. Alberta, Columbia Pharmacists Association and other agencies (such as government, pharmacy, business) to develop drug recycling plans, such as the Pharmaceutical After Sales Service Organization (PCPSA) set up in Columbia, to publicize through posters, manuals, pharmacist guidance, etc. Publicity and education to encourage consumers to return expired or unused medicines to pharmacies. Recycling projects in Columbia are funded by pharmaceutical companies, while Alberta is co-funded by the government and companies. The National Pharmaceutical Regulatory Association of Canada (NAPRA) particularly emphasizes the role of pharmacists in drug recycling, believing that pharmacists can find out the potential causes of drug waste, and through prescription review systems, dispensing small doses of drugs, and educating residents to prevent drugs Waste; can also work with other relevant groups to develop expired drug treatment plans and recycle expired drugs ^[4] .

Expired drugs

At present, China's laws and regulations do not regulate the recovery of expired drugs, let alone the main body of drug recovery. Although the "People's Republic of China Solid Waste Pollution Control Law", "Regulations on the Management of Medical Waste" and "Measures for the Management of Medical Waste in Medical and Health Institutions" clearly stipulate the disposal methods of medical waste, expired drugs are not included in the scope of medical waste. The Drug Administration Law of the People's Republic of China treats expired drugs as inferior drugs, but does not specify how to recycle and dispose of them ^[4] .

Expired medicines

1. National legislation The state should adopt legislation to regulate drug production and operation units to establish and improve the system for the recovery and disposal of expired drugs, and to make timely, non-toxic and harmless treatment of expired drugs through technical means.

2. Manufacturer's Recycling Each pharmaceutical manufacturer should promptly recycle and dispose of expired and ineffective drugs produced by the factory.

3. Add the contents of the drug instruction sheet The following shall be added to the drug instruction sheet: a mark that prohibits the use of the expired drug; the possible harm caused by the use of the expired drug; and the disposal method of the expired drug.

4. Establish a recycling agency. Governments at or above the county level should set up specialized agencies responsible for recycling expired drugs. Expired drugs that cannot be returned to the drug manufacturing enterprise shall be regularly organized and handled by the agency.

5. Increase the corresponding clauses of international trade In the duties of quality attorneys, increase the corresponding clauses of international trade to meet the needs of international trade.

6. To clarify the legal responsibilities of quality attorneys, it is necessary to formulate the provisions on legal responsibilities of the attorneys to bear the quality management issues of enterprises, and to resolve local regulations and the when an enterprise has a product, In the case of quality problems, the legal representative of the enterprise shall bear the legal liability other than civil liability. It is necessary to clarify the specific provisions of accountability of attorneys according to law, and legally clarify the legal responsibilities of quality attorneys.

7. Strengthen the assessment of quality attorneys At least once a year, a comprehensive assessment of the performance of the quality attorneys, and rewards and punishments based on the results of the assessment.

8. Formulate national regulations on the quality attorney system. At present, the quality attorney system has been piloted in many provinces and cities throughout the country. The pilot situation should be summarized nationwide, and a nationally applicable management method should be formulated as soon as possible to authorize quality. The qualifications, duties, legal responsibilities, etc. of a person are specified in detail.

9. To give full play to the role of pharmacists in guiding the use of medicines, we should learn from advanced foreign experience, fully understand the important position and social value of pharmacists in promoting rational use of medicines and safeguarding the health rights of the people. Advantages: review prescriptions, dispense small-dose medicines, and interview doctors who prescribe drugs unreasonably in a timely manner, eliminate "big prescriptions" and "big inspections" and prevent drug abuse and abuse. When a pharmacy collects expired medicines, the pharmacy pharmacist must actively educate the public, emphasize the harm of expired medicines to the environment and human health, and guide the reasonable disposal of expired medicines ^[5] .

Expired medicines 8. Specific treatment methods for expired medicines

Treatment of expired medicines Expired medicines become "harmful medicines", which is also manifested in throwing into the garbage bin with domestic garbage without any treatment, which will not only induce diseases to endanger human health and pollute the environment. Once they fall into the hands of criminals, The adverse consequences of flowing to rural markets or returning to pharmacies are even more conceivable.

It can be seen that cleaning up expired drugs does not mean just discarding them randomly.

1. For household expired drugs, it should be included in a special collection and destruction system like recycling used batteries.

2. Tablets, pills, and capsules should be wrapped in paper before being discarded in a sealed paper tube.

3. Liquid medicines such as eye drops, topical liquids, oral liquids, etc. should be poured into the sewers without being mixed with each other;

4. For ointment preparations, the ointment should be squeezed out of the container, collected in an envelope, and sealed after discarding;

5. The spray medicine should be completely vented in a place with good outdoor air circulation, and avoid exposure to open flames;

6. Do not open injections and liquid injection drugs without authorization, and put them in a closed paper tube together with their complete packaging and discard them.

Expired drugs

With the development of China's society and economy, the material and cultural life is constantly enriched, the health awareness of the people is increasing, and consumers are paying more and more attention to the quality of medicines. In particular, China's current drug safety, effectiveness, rational application, and recovery of expired drugs are still not in line with the people's expectations and needs for medicine in the new era. Raising the people's awareness of the recovery of expired medicines, strengthening the construction of the system for the recovery of expired medicines, and effectively implementing the recycling work are the objective requirements to ensure the health needs of the people and the prosperity of the pharmaceutical industry.