The discussion of old prescriptions is a departure from the normal discussions in this blog around Health and Life Sciences Architecture, but related enough for me to ask you (gentle reader) the question: What do you do with your old prescriptions?

A few days ago, my wife and I were cleaning out old prescription bottles, the kinds with a couple pills left from things like root canals, sinus infections, strained muscles, etc.  

As we were going through them, the question became: what to do with them? 

The SMARxT Disposal website has some good instructions – but they only go so far:

1. DO NOT FLUSH unused medications and DO NOT POUR them down a sink or drain.  Note: you can flush ones that explicitly say so on the label.
2. Be Proactive and Dispose of Unused Medication In Household Trash. When discarding unused medications, ensure you protect children and pets from potentially negative effects:
   1. Pour medication into a sealable plastic bag. If medication is a solid (pill, liquid capsule, etc.), add water to dissolve it.
   2. Add kitty litter, sawdust, coffee grounds (or any material that mixes with the medication and makes it less appealing for pets and children to eat) to the plastic bag.
   3. Seal the plastic bag and put it in the trash.
3. Remove and destroy ALL identifying personal information (prescription label) from all medication containers before recycling them or throwing them away.

Good instructions for disposing of the pills.  But their instructions to “destroy” the prescription label doesn’t give enough guidance or information.

Think about it: how exactly do you remove personal information from a pill bottle?  Have you ever tried to remove one of those labels?  That can be done with enough effort, but what about those pill bottles that have the information directly printed bottle itself, how do you handle those? 

Because it just too hard, too much effort to remove the label, most people don’t do anything and just throw away the bottle, trusting our trash system!

Consider the implications:

• The information on the bottle: Your name, prescription number, drug name, prescribing doctor, doctor’s phone number, pharmacist, pharmacy address and pharmacy phone number are all on the label of prescription bottle. 
• Who can get your pill bottle: A family member, a visitor or friend of your teen or young adult, someone working in your house, anyone who has access to your bathroom (where most meds are kept), the person picking up your recycling (if you recycle the bottles), “treasure hunters” picking through the trash at the dump (if you throw the bottles away).  All of them have varying degrees of access to your prescription bottles.
• What they can do with your pill bottle: This is frightening.  Call the pharmacy’s “automated refill line”, punch in the prescription number into the phone, 30 minutes later drive up to the pharmacy drive-thru window, ask for the prescription by YOUR name and (usually with no identity check other than “are you still living at….”) drive away with a full 30 day supply of the drug in question.

Scary, huh?  Worse yet, you call for your next prescription refill and find that it has already been filled.  By someone else.  And you are stuck.

And that isn’t to mention the other prescription theft possibilities.  If they have your doctor’s phone number and your pharmacy’s phone number, the person with the information can call your doctor’s “refill line” or even a call for another new prescription.  Pretty easy.

A few years ago I was embarking on a long overseas trip.  Given that I was taking a few red-eye flights during the trip, I called my physician for some Ambien.  After explaining the situation to the physician’s assistant for a few minutes, she asked for my name and date of birth (easy enough to get or know), asked where (what pharmacy) I wanted the prescription sent and 15 minutes later I went down and picked it up.  Other than name and DOB, there were no questions asked by anyone from the doctor’s office to the pharmacy to verify my identity.

Worse yet, perhaps, personally, is the privacy implications.  Those pill bottle labels imply every medical condition my family has had since we last cleaned the medicine cabinet.  Do we really want that information in someone else’s hands?

Still, I’ve never protected the information on those pill bottle labels.  Just threw them away.  Until this last time. 

I saw the recycling symbol on the bottle, thought “I should recycle that”, and was putting it in the recycling bin when I looked at the information on the label.  The privacy implications of that label struck a chord.  Thus, this blog is more an exploration of “how-to” than “do-this”.

So – what should I do with our old prescription bottles?  I Bing the possibilities and find a few options:

• Peel the label / Soak the label – For most pill bottles, if the label doesn’t peel off directly, soaking the label off works quite nicely.
• Shred the label – Don’t just throw the (dried) label away, treat it like other sensitive information.  Shred it!
• Use permanent marker – A method of last resort, this works on bottles that have the prescription printed directly on the bottle or have labels that are tough to get off.
• Shred the bottle – Some pharmacies have bottle return policies, where they will shred the bottle for you (ask your pharmacist if you can return the old one when you get a refill).  There are also data shredding services that shred pill bottles.

At the end of the day what do you have once the label is removed?  A bottle that can – and should – be recycled or reused.  Of course, there are lots of ways to reuse old pill bottles… but we’ll let others handle that topic.