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How to safely dispose of expired medicines?

The human and environmental effects of flushing medicine

Over the past few years, I have collected a small stash of expired and even unopened medicines, ointments, sprays and lotions because I just didn’t know what to do with them. I used to bin any dated medicines or flush the liquids and tablets down the drain. Like many, I don’t think I actually considered that this uniformed practice would come full circle or have any harmful effects. The quick and easy disposal, the ‘out of sight, out of mind’ sentiment, was another contributing factor because I didn’t know what else to do and didn’t really question it either.

What is pharmaceutical pollution?

Drug or pharmaceutical pollution is a real thing posing hazardous effects to both humans and all aquatic life and ecosystems. Improperly treated water is able to carry pharmaceutical pollution and reach groundwater, lakes, rivers and the ocean through wastewater. According to a recent Delft Institute Study, drug pollution levels are considerably higher in most of Latin America, Africa and Asia where less than a quarter of wastewater is treated.

According to the Nordic Life Science organisation, a 2017 UNESCO study found that only nine out of 118 assessed pharmaceuticals were removed from wastewater during municipal wastewater treatment processes”. In other words, the medicines we are not discarding properly are finding their way into the water we drink.

Drugs found in untreated or “under-treated” water include anti-inflammatories, antibiotics, anti-convulsants, mood stabilisers, sex hormones and antimicrobial resistance (AMRs). An AMR is a microorganism that has evolved to resist the effects of antibiotics and other drugs, also known as a superbug.

The World Health Organisation has predicted that by 2050, AMRs (the superbugs) will take 10 million people’s lives. [i]

How are pharmaceuticals getting into the waterways?

Pharmaceutical giant, AstraZenca weighs in:

· 88% of pharmaceuticals in the environment can be attributed to patient-use excretion of the drugs (poop and pee)

· 10% from unused medicines that people don’t dispose of properly, and

· 2% attributed to waste from manufacturing


Millions of people around the globe rely on prescriptions every day. The USA is projected to fulfil 4,57 billion prescriptions in the year 2024. [ii] And as we know, the highest contributing factor to leakage into our water system is through patient use and excretion. It is therefore so important to consider how you dispose of the drugs you don’t intend to use. Anything from pain killers like paracetamol, to cough syrups, antifungal creams, anti-inflammatory, sleep sedatives that help with sleep, anxiety and seizures, benzodiazepine to treat depression, stimulants like the amphetamines and pseudoephedrine for decongestion are all common over the counter medicines available without prescription. In addition to all this medical waste is the foil and plastic packaging they come in, only adding to our microplastic crisis.

Water filtration

Even if you have a water filter system at home, do you know if it is effective enough? Most store-bought filters aren’t able to remove trace pharmaceuticals. But of even greater consideration is the millions of people (the majority of people on earth) who don’t have access to purified water.

More on this topic to come in a future blog post!

How to discard medicine safely?

In Singapore, and other places around the world, you can return any medication (prescription and over the counter drugs) to a pharmacy or drug store and they will incinerate. Hospitals don’t reuse or take back any medication, but the hospital pharmacy can safely discard.

It is so important to note that incineration also has its environmental blow. A further step we could take as patients and care givers is to consider if we need all the ‘buffer’ in our first aid home kits.

I hope you will join me in switching up how we dispose our pharmaceutical waste to lessen the load on our water, our air, our landfills, our planet (and all her creatures) as well as our bodies.

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