There's an interesting kerfuffle on disposal of unused medications, from and article by our friends at Cleaning & Maintenance Management.
On the one hand, "The U.S. Environmental Protection Agency strongly discourages the pouring or flushing of pharmaceutical drugs into the sewer system and has issued a new rule banning this practice for hazardous waste pharmaceuticals at health care facilities. Makes sense. There have been many indications that even small doses of medications turning up downstream can impact various critters, and municipal sewage treatment systems are not designed to remove such contaminates.
On the other hand, "The U.S. Food and Drug Administration, in contrast, has advised individuals to dispose of narcotics and other controlled substances down the drain or toilet in order to prevent animals and children from coming in contact with them."
You can't win.
Perhaps the best solution might be to put the stuff in the red Hazcom trash cans that most health care facilities use, for bodily fluid contaminated material, sharps, and so on. That trash is picked up by a specialized vendor and taken out to be (generally) incinerated. Perhaps a third of our commercial cleaning involves healthcare facilities; they all use the Hazcom containers, and are generally pretty careful about keeping dangerous materials out of the regular trash.
But I could tell stories about a string of dialysis facilities we cleaned years back; we'd often find rather large pools of blood under the dialysis chairs, and used sharps (needles) siting on the counter, point outward. They wound up with a "major reorganization" involving liability from a patient bleeding out during dialysis. Some clients you don't much mind losing.
None of the above addresses what individuals ought do at home, with unused or outdated medications. Most folks I know don't have Hazcom receptacles available. And, for me, I don't much want miscellaneous medications to get to my dogs.
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