Critical Control: Proper Disposal Systems Protect People And The Environment

One of the most pressing needs of hospitals, nursing homes, and other medical facilities around the U.S. is proper disposal of pharmaceutical waste.

Throughout the course of a busy day for doctors, nurses, and anesthesiologists, countless scenarios lead to leftover or unused portions of controlled substances: patients choosing to use fewer painkiller patches in recovery from surgery, anesthesiologists using less sedatives than initially anticipated, or nurses administering smaller doses of treatment than the vial contains.

But what happens to the leftover and unused controlled substances that aren't needed during surgery, treatment, or a different medical procedure? Medical facilities have controls and protocols in place, but during the course of a fast-paced and stressful day, are they sufficient and are they followed thoroughly each time?

After administering controlled substances, medical professionals need accountable and secure places to efficiently dispose of unused drugs where they can no longer be accessed nor contaminate the environment. But in many reputable medical facilities, outdated and inefficient physical controls don’t provide medical professionals a good option to quickly and safely dispose of the drugs.

Often, liquid substances and leftover pills are squirted down sinks or flushed down toilets, while partially filled syringes and painkiller patches are dropped in red sharps containers or thrown in the trash.

The chief reason to have proper disposal systems in place is for the health and safety of hospital staff and their patients. Improperly discarded pharmaceutical waste can quickly become a primary target for drug diversion, the unauthorized repurposing of controlled substances from their intended use.

Our nation’s rising prescription drug addiction epidemic has fueled a surge in the demand for illicit substances, causing medical facilities to become targets to supply this demand through drug diversion. The most vulnerable opportunity for this diversion is after disposal because the substance is no longer tracked. Tightening up loose controls, however, dramatically increases prevention and decreases opportunities for diversion.The first to benefit from improved pharmaceutical waste systems are medical professionals.

Even with thorough knowledge of controlled substances and their hazards, healthcare workers are not immune to substance abuse. An estimated 10-15 percent of medical professionals suffer from substance abuse disorders, a number significantly higher than the 8-10 percent of the general population.

A variety of factors contribute to this disparity, but a major cause is the widespread access that medical professionals have to controlled substances coupled with obsolete controls and protocols. Those who most routinely follow the disposal protocol are those best suited to know of its weaknesses.

Drug diversion happens at alarming rates in a vast array of forms, from the nurse who squirts leftover injectable drugs in a water bottle to the night custodian who secretly reclaims partially filled syringes from the red sharps container. When drugs are not properly discarded, they can always be accessed at a later time.

Hospitals and other medical facilities can provide a safer work environment for their employees by introducing proper physical controls that tighten up gaps in the disposal of controlled substances that actually promote efficiency and simplify their jobs.

Preventing drug diversion in medical facilities not only improves the health and well-being of hospital staff but also protects patients from receiving the diminished care of impaired providers. Medical professionals under the influence of controlled substances are not able to provide the same quality of care.

At its worst, substance abuse in the medical community has left a dreadful trail of patients whose prescription drugs have been secretly swapped out for placebo treatments or other dangerous drugs.

Any solution to protect medical professionals and their patients from the impact of drug diversion will require a multifactorial response, but an important part of the solution is prevention. Systems and controls that increase staff accountability and minimize diversion accessibility go a long way.

Along with decreasing the flow of drug diversion in healthcare, it is imperative to stop the current of pharmaceutical waste being added to our environment, which frequently occurs through flushing: squirting unused liquid substances down the sink or flushing leftover pills down the toilet. While flushing keeps controlled substances out of the hands of substance abusers, it puts toxic waste directly into our lakes, rivers, and groundwater.

Trace pharmaceuticals have been found in the drinking water supplies for over 41 million Americans, including antibiotics and mood stabilizers. Flushing isn’t disposal, it’s contamination.

Stopping the flow of controlled substances from medical facilities entering the environment may not be the entire solution, but it can play a critical role. Improved disposal systems help keep hospitals green and minimize their environmental footprint, protecting both our drinking water and the species who call those environments their home.

Innovative physical controls that neutralize controlled substances can greatly prevent both drug diversion and harmful effects on the environment.

At Stryker, we manufacture the Cactus Smart Sink to match this need: a secure controlled substance waste management system that renders partially administered drugs unusable and non-retrievable. Engineered specifically for hospitals and other medical facilities, the system is small enough to attach to a wall or cabinet in high-risk areas of hospitals but also large enough to secure both liquid and solid pharmaceutical waste.

To streamline accountable disposal protocols, the Smart Sink facilitates two-person witnessed-wasting to ensure the waste ends up in the right place and regulations are followed in a compliant manner.

The overall solution for preventing drug diversion and the flow of pharmaceutical waste into the environment will require a combination of coalescing efforts. However, enhanced controlled substances disposal systems can play an immediate and dramatic role in improving the health of medical professionals, their patients, and the environment.