2nd Quarter 2017 Benefits Corner

When thoughts turn to Spring many items appear on our TO DO list--spring cleaning, planting, putting winter items away, clearing out the garage, and changing over our wardrobe.  However, there is one activity that should be a priority for a number of reasons: (1) our own health (2) for the safety of toddlers, children, and pets, and (3) to reduce an accumulation that often causes confusion on what is/is not needed or effective within our medications and first aid supplies.

The objective of this quarter’s Benefits Corner is assisting with the sorting process, identifying medications and supplies that are no longer viable, assessing prescriptions that require refills, over-the-counter medications and supplies that require replacement, and determining the appropriate disposal options.

Now, let’s get started …

Because the purpose of medications is treatment of conditions and diseases, it’s essential that they are as effective as possible.  As such, review each prescription bottle, package, or tube, for the expiration date (the packaging may include a “dispose by date”).  What exactly does the expiration date mean?  Required in the U.S. since 1979, law requires manufacturers to guarantee that their drugs have at least 90% of the original potency at the date of expiration, when stored under proper conditions. 

Some medications have greater longevity and stability, while others are reported to more quickly lose potency, and could potentially have consequences after their expiration date.  There may be others including newer medications that should also be included on the warning list below.  Consequently, you should always check with your physician if you have a question on medications past their expiration date.  The best course is always, “Better safe than sorry!” 

Anticonvulsants
Contraceptives (Oral)
Dilantin
Digoxin
Epinephrine
Eye Drops
Insulin
Nitroglycerine
Paraldehyde
Procan Sustained Release Procainamide
Tetracycline
Theophylline
Thyroid Preparations
Warfarin

While there’s considerable debate about medications and effectiveness past the expiration date, the fact is there are also a number of factors that impact the potency and potential life of medications:

1. The environment, including climate, heat, moisture, oxygen, and light.Keep in mind that many medications are stored in the bathroom where they may be subjected to additional heat and moisture from repeated showers/baths.
2. The form of the medication; i.e. solid or liquid/creams.A solid pill, capsule, or powder is typically more stable than a liquid/cream form.
3. Packaging and the closure.Sealed packaging (i.e. bubble-packs) can be more effective than opened bottles where contents have been compromised, thus diminishing the life

Now that you have the background and better understanding of medication complexities, you’re ready to begin the process of sorting and disposing of your medications:

1. Identify all prescription medications that you either no longer take or are past their expiration dates, then:
   1. Empty the prescription bottle or package into zip-lock/sealable bag, or margarine tub, or can with lid that will prevent leaking in the trash; and
   2. Scratch through your personal information to make it unreadable on the pill bottle or prescription packaging, including prescription number, before placing the bottle/packaging in the trash.
2. Identify all over-the-counter medications that you no longer take or are past their expiration dates, then:
   1. Empty the contents of the bottle or package into a zip-lock/sealable bag, margarine tub, or can with lid that will prevent leaking in the trash. Then place empty bottle(s) or packaging in the trash.
   2. Review all other supplies in your medicine cabinet or the first aid kit in your home and car for expiration dates, to ensure you’re using only those supplies that are still viable for use on wounds.

Once medications are sorted, it’s time for the next steps:

1. Review current prescription medications to determine if any refills are required.
   1. Make a list of medications that require refills:Include the Pharmacy, Prescription Number, Pharmacy Telephone Number, Medication Name, MG, quantity, number per day.
   2. Contact your physician to request refills or make follow-up appointments, if required.
2. Review over-the-counter medications and first aid supplies.
   1. Make a list of those medications and first aid supplies required for purchase.

The final step is responsibly disposing of unused and expired medications.  Below are options to consider, though some medications, or delivery mechanisms (needles/syringes/inhalers/patches), have explicit instructions or limitations) on disposal: 

1. Take-back programs safely dispose of most types of medicines.This program is confidential, with no questions asked.Keep in mind that needles, sharps, asthma inhalers, and illicit drugs are NOT accepted at the drop box.
   1. The U.S. Drug Enforcement Administration (DEA) periodically hosts the National Prescription Drug Take-Back event where collection sites are set up in communities nationwide for safe disposal of prescription drugs.In 2016, the DEA set up 5,400 DEA sites across the United States.For 2017, their nationwide event is scheduled for April 29, 2017.
   2. Consumers can visit the DEA’s website at https://www.deadiversion.usdoj.gov/drug_disposal/takeback for more information about drug disposal, National Prescription Drug Take-Back Day events and to locate a DEA-authorized collector in their area.They may also call the DEA Office of Diversion Control’s Registration Call Center at 1-800-882-9539 to find an authorized collector in their community.
2. Local law enforcement agencies also sponsor medicine take-back programs in your communities, such as “Dispose-a-Med.”They typically establish dates and times at well-known locations, and distribute cards or flyers for consumers to pick up at local pharmacies or retail stores showing these dates and times.The events provide flexibility and advance notice that allow consumers to be prepared.
3. Local waste management authorities can also be contacted about disposal guidelines in each geographic area.
4. Pharmacies have envelopes for consumer purchase that can be used to send in unwanted medications for disposal.
5. Prescription drug labeling or patient information that accompanies the medicine may include specific disposal instructions.Otherwise, it is not recommended to flush medicines down the sink or toilet unless the label information specifically instructs you to do so.
   1. The rationale for flushing is due to the potential harm (i.e. including fatality) that could occur if used by anyone other than by the one for whom they are prescribed.To avoid accidental exposure by others, including children or pets, it’s recommended that they are either disposed of quickly through take-back programs or that they are flushed down the sink or toilet as soon as no longer needed.
   2. While flushing may be a concern, the fact is the primary source of drugs entering the water system is through passing through human bodies, as drugs are not completely absorbed or metabolized.These drugs are still present even when processed through wastewater treatment systems.
6. There is another disposal option; i.e. placing medications in the trash.Below is information on this approach:
   1. Mix medications (do not crush tablets or capsules; they will typically be absorbed by these materials) with a substance such as dirt, kitty litter, or used coffee grounds;
   2. Place the mixture into a zip-lock/sealable bag, margarine tub or can with lid that will prevent leaking in the trash;
   3. Throw the container in your household trash; and
   4. Scratch out all personal information, including the prescription number, on the prescription label of your empty pill bottle or empty medicine packaging to make it unreadable, then dispose of the container.

Cautions:

1. Toddlers and young children – In 2011, over 60,000 toddlers and young children were taken to the emergency room for accidental poisoning from taking pills or drinking medicinal fluids while their parent, grandparent, or caretaker weren’t looking.These medications were located in a medicine cabinet, a suitcase, or handbag.While these statistics are older, it provides a measure of the senseless tragedy that could have been avoided with more focus on medicinal security.When very young, everything goes in their mouth!
2. Teenagers – With teenagers, taking and using someone else’s medications is often intended, though the outcome has unintended consequences.Visitors to your home, or home of another, may include teenage relatives and their friends, perhaps during celebrations or reunions. Keep in mind that you cannot be everywhere every moment when you’re busy acting as host/hostess or guest.At that age, teenagers can wander, and become extremely “creative” in mixing whatever they find, including narcotics.As such, ensure that your medications are secure, since the contents of your medicine cabinet, suitcase, or handbag, may hold drugs that inspire experimentation that could become deadly.
3. Pets – Our pets are part of our family.Our medications, if consumed by pets, can cause seizures, kidney failure, and even death from a single pill.Consequently, care is necessary when taking our medications, or transferring medications from bottles/packages to pill boxes or weekly organizers, to ensure we don’t accidentally drop pills.If taking a pill, or transferring a volume of pills, consider doing so over the sink with the drain closed.You can imagine your pet leaping into action at the sight of a rolling pill, chasing and swallowing it in an instant.Even if you don’t notice dropping it, the “find” will lead to great pain for them and extreme sorrow for you.Worse, it can also be found by a toddler or young child, leading to tragedy.With toddlers especially, everything goes in their mouth!Leaving any type of medication on the counter is dangerous, whether it’s in sealed packaging or in plastic bottles.Pets can quickly chew through these.Over-the-counter medications can be just as harmful as prescription drugs.Having your medications on counter also make them accessible to anyone else who is unexpectedly in your home.
4. Guests – Inform guests that are visiting where to put their handbags or suitcases, so that they are safely out-of-the-way to prevent medication access by others or pets.Let them know of your concern, so they can also be careful andwatchful along with you.
5. Friends – While we all want to help our friends, giving them our medications should NOT be one of the areas where we “share” with anyone.Medications are prescribed for us only, based on our family history, medical conditions, and current symptoms.They are potentially dangerous for anyone else.If no longer required or past the expiration date, they should be disposed of accordingly.
6. Again, when in doubt about whether to use a medication past its expiration date, always check with your physician.If he/she is not available ask your local pharmacist.
7. If there’s a question about proper drug disposal, ask your local pharmacist.

The CRA Benefits Committee hopes you’ll take this opportunity to review your medications as well as first aid supplies.  You will not only have medications necessary for your current health conditions, but also first aid supplies will be up-to-date and on hand should you need them. 

ConsumerMedSafety.Org, WebMD Magazine, U.S. Environmental Protection Agency, Rx List, EMedExpert, U.S. Department of Health and Human Services, Food and Drug Administration (FDA), and U.S. Department of Justice, Drug Enforcement Administration (DEA

Lezley Barth, Benefits Chair:
Phone: 816-506-0026
Email: lezleykbarth@gmail.com