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The Problem with Unused Medicines

The Problem with Unused Medicines

How much medicine goes unused?

30 percent of the medicines we purchase go unused for various reasons according to common estimates based on scientific studies using a variety of methodologies. Examples of relevant survey results include:

  • A survey of 238 California residents found that 2 out of 3 prescription medicines were reported unused. Common reasons were:  disease/condition improved (40.4 percent), forgetfulness (10.6 percent), and side effects (8.0 percent). Law et al. “Taking stock of medication wastage: Unused medications in US household”. 2015. Research in Social and Administrative Pharmacy 11; 571-578.
  • An Los Angeles County Department of Public Health survey of 1,062 residents found:
  • Similarly, a 2009 survey of WA residents found:
    • Over half of respondents had six or more medication containers in the home, and 39 percent of those people had at least one container that had expired or would not be used for some other reason.
    • 25 percent of respondents said there were unused narcotics or other medications following a death or major illness of somebody they knew.
    • 72 percent of respondents said that they or a household member would either drop-off unused or expired medicines at a free, convenient location or use a free mailer. “Medication Disposal: 2009 Survey of Attitudes and Preferences Among Oregon and Washington State Residents”. The Gilmore Research Group. December 2009.

Why are so many medicines unused?

Prescription and over-the-counter medicines go unused for many reasons. Changes in prescribing and dispensing practices coupled with changes in consumer demand could reduce some wasted prescriptions. However, even when the health care system and patients do everything right, some medicines are leftover and need secure disposal.  Reasons for leftover medicines include:

  • Lots of medicines are needed during a serious illness, but when the individual recovers there are leftovers.
  • Lots of medicines, including strong pain relievers, are needed for end-of-life care and are leftover for family members to deal with when the patient dies.
  • Medicine is not finished if the patient has an allergic reaction, can’t tolerate the drug, or other side effects develop.
  • Different medications are prescribed in the search for the right treatment. This is particularly common in treatment for depression and other common psychological conditions.
  • Medicines expire before they are fully used.  This is common with prescription drugs that patients take only “as needed” for a recurring condition, and with over-the-counter medicines that consumers purchase to have on hand if needed.
  • Drugs are overprescribed in some situations.  There is increasing awareness in the medical community about the problem of overprescribing, especially for pain pills. WA has adopted strong opioid prescribing and pain management guidelines.  This is a complex issue. Responsible practitioners must balance limiting the size of a prescription with a patient’s legitimate need for appropriate pain management or other treatment.
  • Consumers buy more over-the-counter medicines than they will need. This is encouraged by advertising that prompts consumers to “stock up” their medicine cabinets.
  • Sometimes people stop taking their prescription medicines before they should, sometimes because they feel better. While physicians stress the importance of medication adherence to patients, this is an ongoing area of emphasis to ensure patients complete drug treatments.

Survey responses from 2,041 Maine residents who returned unwanted medicines in a pilot mail-back program found the following reasons why medicines were returned:

  • 47.4 percent medicine expired
  • 31.1 percent doctor said to stop taking it
  • 27.3 percent doctor ordered a new medicine
  • 24.2 percent other reason
  • 18.0 percent felt better
  • 12.2 percent side effects
  • 11.9 percent negative reaction or allergy
  • 7.2 percent didn’t want to take it

Respondents could select multiple reasons.

Source: Kaye, Crittenden, Gressitt, Sorg, LaBrie and Chase. Safe Medicine Disposal for ME: A Handbook and Summary Report April 2010. Page 47. Available online from this site: