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Question of the Week: What do you do with unused over-the-counter or prescription drugs?

2008 December 8

Each week we ask a question related to the environment. Please let us know your thoughts as comments. Feel free to respond to earlier comments or post new ideas. Previous questions.

Drugs and pharmaceutical products include powerful chemicals that have saved or improved countless lives. But even small amounts of drugs need to be disposed of carefully so they don’t pollute the environment or harm human health and wildlife. In early 2007 the government set guidelines for proper disposal of prescription drugs.

What do you do with unused over-the-counter or prescription drugs?

Editor's Note: The opinions expressed here are those of the author. They do not reflect EPA policy, endorsement, or action, and EPA does not verify the accuracy or science of the contents of the blog.

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115 Responses leave one →
  1. Eileen permalink
    December 9, 2008

    I do not use prescription or OTC drugs, so I don’t encounter this problem. We use a combination of various healing foods, herbs and homeopathic remedies to prevent and treat all illnesses. I’m in my mid 40’s and still look & feel great without any of those dangerous drugs. My last illness was a cold (this includes headaches and indigestion too) and occurred in April of 2005. Health is not the absence of illness, but so much more.

  2. Pat permalink
    December 9, 2008

    My Dad recently passed away and we have left over medicines. Before I knew it my brother had, done what he thought was appropriate, and flushed many of them. But other medicines I caught in the nick of time and was searching to find somewhere to donate them. I found a place on the internet. I haven’t sent the medicine yet, put it looks to be a reputible place with a very worthwhile cause. ….They only take unexpired meds, and they send them to other countries to folks in need. Check out info at:

    I also found info on disposal at several websites, including:

  3. Peter Durham permalink
    December 9, 2008

    For non-narcotic medications, a charity organization, Red Cross for example, could possibly receive and re-distribute to third world countries or to local patients of free clinics. Collection could be possible through local pharmacies, hospitals and clinics.

  4. Sarah S permalink
    December 9, 2008

    Far more pharmaceuticals are excreted, unmetabolized than are flushed down the drain. This presents an unique challenge, to say the least, to those of us trying to limit the amount of pharmaceuticals reaching WWTPs and beyond.

  5. Eileen Mahoney permalink
    December 9, 2008

    I often mix them in with the cat litter when I change my cats’ boxes. The litter absorbs liquid, and renders it really gross, so no-one can use them; this all goes to the normal garbage landfill. A pharmacist recommended putting any pills in a snack-size zip-lock baggie and adding a good squirt of dishwashing liquid, mushing them around and putting with the “wet garbage”.
    SOMETIMES if you have a leftover very expensive medication, there are clinics who can take donations for patients in very tight financial straits…

  6. Mark O'Neil permalink
    December 9, 2008

    I dispose of them in my trash which goes to the local landfill (which will become a future superfund site in the future).

    Federal or state laws need to be passed requiring that prescription medicines be returned to the local pharmacies or hospitals for proper disposal. Prescription medicines and over-the-counter medicines should be labeled with their proper disposal method and or whether the medicine should be returned to a pharmacy or hospital for proper disposal.

    Hazard assessments should be done on each medication whether prescription or over-the-counter for potential risk to the environment (i.e. potable water), and then proper disposal reccomendations labeled on the containers and packaging as required by a law.

    Fast track procedures should be in place for medicines that need to be release to the public quickly for the public good/health and for which a full risk assessment could not be completed with labeling that unused medicine should be returned to the pharmacy or hospital for proper disposal or even recycling.

    This should be a high priority issue.

  7. Marcele Starr, RN permalink
    December 9, 2008

    Recycle through qualified pharmacies from first owners prescription bottles

  8. Jim Mullowney permalink
    December 9, 2008

    Tell me I’m wrong

    One man’s theory of the destruction of humanity, a theoretical account of the cause of cancer and autism.

    I have been in the environmental disposal field for 20 years, starting out from college as a chemist for a waste disposal firm. I was out of the environmental field for almost 5 years, when I returned to the field in April of 2007, I was confronted with some new questions on how to dispose of some non regulated wastes from hospitals. The waste was mostly un-used pharmaceuticals.

    Upon looking at the MSDS (Material Safety Data Sheets) for these materials I was troubled. Over my 20 years in the environmental business I have researched a lot of chemicals for their toxicology and what I discovered this past year terrifies me. An example is a common chemotherapy chemical (drug) Mustargen made by MERCK. On page one of the MSDS it states as a warning:
    May cause cancer
    May cause heritable genetic damage
    May cause harm to the unborn child
    Well at least they can’t say they didn’t tell us.

    I hope that I am wrong and someone smarter than me can disprove my theory, however here it is.:

    Over the last few months I have learned how chemotherapy drugs work, they are chemicals that have one job, they mutate genes, Hence the term, “mutagenic”. Effective because they get into the cells and mutating the DNA to kill the cancer; these drugs are non-dose dependent, which means that the amount you give a patient does not matter, I read that in an article in the August 20th 2007 Chemical and Engineering News.

    These chemicals are administered to the patient in pico gram per liter concentrations. That translates into part per trillion, levels that are given to the patient; they work magnitudes less in the body, at a cellular level. This means that when a gene is mutated and the cell splits in two, the two new cells are mutated also, a.k.a, genetic engineering.

    This is the problem I have: the chemical (drug) is administered to the patient at a level so low that the only way to measure it is by a series of dilutions. What happens to the rest of the chemical? It goes down the drain, into the sewer and septic systems. The waste water treatment plant does not remove the chemical, it cannot kill the chemical, because it is not alive, it is a chemical, a chemical with a job to mutate the human DNA.

    What does this drug do when it enters the water supply? It is not selective, it does not discriminate. It does what it is designed to do which is to mutate genes. In goes into the water system and does its job. It mutates the genes of frogs so they have 5 legs, three eyes, no genitals, there have been many studies on the mutation of lower level planet dwellers what about humans?
    I am not saying that Chemotherapy Chemicals are the only Mutagenic Chemicals, many chemicals have a side effect of being possible Teratogen, or mutagen. I am saying Chemotherapy Chemicals ( Drugs) have only one job and that job is to mutate the genes of humans.

    The disposal of unused drugs is only the tip of the problem. The absorption rate of most drugs is less than 10% and some less than 3% some even lower, so if you are taking chemotherapy most of the drug will pass thru your system and into the toilet, the saliva out of your mouth, or excreted thru your skin or out through your breath.
    Alcohol Breath smells like alcohol, Gasoline smells like Gas, Look up “Chemo Breath” on the internet

    What is happening to the septic systems? Why is the good bacteria, (and bad bacteria), missing? Why are septic maintenance companies finding dead systems? What do they need to do to make them functional again? In August 2007, I was in Concord NH talking to a person that is a regulator of septic systems. I mentioned my theory and he made a disturbing comment. He said that the septic pump maintenance businesses are complaining that some of the systems are being destroyed by the human waste from a chemotherapy patient. The systems need to be rinsed and cleaned out before they will work again. What happens to the Chemo when the septic system fails, you guessed it, right into the well and the ground water.

    Once again the genetically engineered drugs are doing their job.

    Did I mention that these cancer curing drugs are also carcinogens, yes that means they cause cancer, and they are administered to the patient in pico gram per liter quantities. That means very small. (If you stack dollar bills like a deck of cards a trillion of them would reach from Boston to Ohio). That means one of those dollars between Boston and Ohio is a part per trillion. Did I mention these chemicals are non dose dependant. That means it does not matter how much or how little you are exposed to — you are exposed. I found that that information also in Chemical and Engineering News.

    This is where I get very scary.

    In 2002 the US geological survey looked for Pharmaceuticals in ground water; in 80% of the places they looked they found what they were looking for. Granted the levels were low, parts per trillion, pico gram per liter. Do you follow me yet? Part per trillion in ground water, part per trillion administered to cancer patient, mutagenic drug.

    Ok this is the part that will get me knocked off by a Big Pharma lobbyist.

    In November 2007 a study was announced that stated that Autism is a genetic disorder that is not hereditary.

    How do you get a genetic disorder that is not hereditary?

    You mutate the genes.

    How do you mutate genes?

    Chemotherapy Chemicals doing their job.

    We cracked the human genome 10 years ago; we started genetic engineering using designer chemicals to cure diseases, chemicals that are effective at a molecular level. The waste from manufacturing these mutagenic, and teratogenic drugs sent down the drain (mutagenic affects you when you are alive, teratogenic affects you before you are alive, in the womb)

    Autism has increased 10 times in the last 10 years. It now affects 1 in 150 children. I read an article that it affects 1 in 60 in Northern New Jersey. Northern NJ also has the greatest concentration of Pharmaceutical Manufacturers in the world.

    Genetic engineering has been growing ten fold and so has Autism, those pesky little chemicals are doing their job, changing DNA to cure cancer. As well as changing the DNA of our Children and our Future.

    Are you scared yet?

    I am

    Ask everyone you know who has an autistic child if someone close to them has had chemotherapy, I have two friends with autistic children, and both had family members undergo chemotherapy before their child was born.

    This is one Chemists Theory

    Jim Mullowney
    38 Pelham St.
    Newport, RI 02840
    March 7th 2008

  9. Sharon permalink
    December 9, 2008

    I have been pealing the label off and just throwing them away in the trash can.

  10. Jed permalink
    December 9, 2008

    My local health department in Michigan collects outdated and unused meds (including over-the-counter) during their monthly Household Hazardous Waste (HHW) collections. I can also take them directly to the health dept as part of the HHW program. The meds are then incinerated. The meds cannot have any info that would identify the patient. They also have teamed up the Sheriff’s dept and offer a couple days a year when you can drop off your prescription narcotics. Encourage your local HHW program to do the same.

  11. December 9, 2008

    I take my expired meds to household hazardous waste (HHW) events sponsored by my city

  12. J.D. Smith permalink
    December 9, 2008

    Why would you have leftover meds? I take all I can get ahold of. If it is something that could harm me, like that Avandia, I just give it to the kids to play with. They are much less likely to get the heart attacks if they go ahead and swallow a few. It’s just not a big deal!

  13. Kathy permalink
    December 9, 2008

    As a caregiver for an individual who took close to 16 pills per day, I encountered this fantastic situation head on. What should I do with old prescriptions?
    I explored this with my pharmacist. I was told that the pharmacist doesn’t throw out (via trash) the pharmaceutical waste; rather he flushes everything down the toilet.
    The story doesn’t stop there. As a small business owner, this pharmacist weighed:
    1) the cost of having a medical waste service pick-up his pharmaceutical waste ( passing the cost along to his customers / with the irony being: the pharmaceutical waste would simply be put in the trash via the service )
    2) his business’ trash container being a target for would-be addicts.
    — Sadly, this pharmacist has the account with several nursing homes in the area. You can imagine the volume being flushed.
    Having learned of this small business professional’s quandary, you can exponentially assume the predicament of how much pharmaceutical waste IS GOING DOWN THE DRAINS of America.
    Isn’t it the responsibility to create reverse-distribution from the Pharmaceutical companies to pick-up their product and not leave a pharmaceutical footprint in the local communities?

    I learned of a state university researching the question of how much pharmaceutical waste doesn’t break down in our local landfills. Admirable research, no?
    However, severe budget cuts may cut the Hinkley Institute at the University of Gainesville, Florida and results of this research may not be known.

    So, the question of the week shouldn’t be a simple census drive.
    We have a real problem with our water resources being one big cocktail of Medicine.

  14. robert Ressl permalink
    December 9, 2008

    What does the household hazardous waste drop-off do with the medications?

  15. Bob Ressl permalink
    December 10, 2008

    Why not dissolve pills in a cup of vinegar to probably destroy most of their drug function or may use a solution of baking soda or maybe lye or drain cleaner?

  16. Tiffany permalink
    December 10, 2008

    Check it out!

    The SMARXT DISPOSAL campaign is designed to raise awareness about the potential environmental impact from improperly disposed of medications and to provide proactive guidance through proper disposal alternatives.

    A video clip shows you how to dispose of your unused or expired medications.

  17. Heinz Braun permalink
    December 10, 2008

    I flush them quite often. I am aware that this may cause problems with recycling water but what can you do and not have an effect on the world as previously discussed. Landfill them I feel could create the chance that someone takes them, sells them or uses them and could possibly get in the hands of children. Which I feel is far worse then the water issue. I had not heard of the incineration process and if that is the best method then we need to advertise this.

  18. Mark O'Neil permalink
    December 10, 2008

    1) Methods of proper disposal for pharmaceuticals should be funded research at universities. We could be creating derivative toxic compounds by improper disposal methods not to mention the compounds being potentially released into the water supply via toilet or landfill.
    2) Do we even want average citzens on a large scale attempting to dispose of pharmaceuticals via such methods themselves or is it better to collect the pharmaceuticals centrally and have someone who is properly trained dispose of them?

  19. david permalink
    December 10, 2008

    say hi to david cook

  20. Jess permalink
    December 10, 2008

    That’s great! Thanks for sharing!

  21. ScienceCheerleader permalink
    December 11, 2008

    I’d like to post the video on how to properly dispose of drugs, on my website: Can you upload it to YouTube so I may grab it? Thanks for considering! –Darlene

  22. December 11, 2008

    Right now in the US I believe that it is illegal to give unused “regulated controlled substances” to ANYONE, including pharmacists once they leave their hands originally. The Drug laws need to be changed so that groups that want to hold a take back day or pharmacies that want to help by having a return disposal policy can do that without added costs of having law enforcement present at all times to take control of the regulated substances. EPA and DEA should be working harder at trying to come to some compromise or or stiplutaion in the law that allows controlled to be handled by a pharmacist or doctor “after the fact”

  23. suec permalink
    December 11, 2008

    I work in a nursing home and I am disgusted and deeply diturbed by the amount of medication flushed into our sewer/waste water! People have no idea the magnitude of this problem, antibiotics, narcotics and antidepressants…just to name a few. The effects to wildlife, ourselves, and altered organisms. the cost to Medicare. many drugs are ditroyed just because a patient goes from skilled level of care to nursing facility level. Patients don’t take there remaining medications home with them, I have no idea why! The elderly in this country are prescribed far too many drugs….guanity vs quality!? There is no time left for commities, this practice is going on in every nursing home in the country! Something needs to be done now! Is this not every bit as detrimental to our environment as an oil spill!?? It is, you just can’t see it happening!

  24. concernedmother permalink
    December 11, 2008

    Some of the comments on here frighten the hell out of me. If we all do not take responsibility and stop having a I Don’t care attitude we all are in trouble. I personally take all of the perscriptions That I get and try to use them. If I no longer need a certain drug I try to find someone who has been perscribed the same drug. Then I give the left overs to them. Also many organizations accept left overs to give to foreign countries. There is a solution and it starts with being trustworthy. If more people were trustworthy then people would not fear taking recycled meds.

  25. Georges M. permalink
    December 11, 2008

    This response is not only for this subject, but personally, I applaud the EPA for doing all they can to help us make sure things(all things) are disposed of properly, and helping us to make sure we do not mistakenly hurt our environment in small or large ways. As for the criminals that purposefully harm our environment intentionally, I’d like to see them all go to jail, because we only have one planet, and as far as we know,we are also the most advanced civilization our planet has had on it so far. We only get one shot at treating our planet right and personally, I think every rich Oil Baron and Family that has made trillions of dollars on making smog building and ozone killing fuels should be on that list too, but they are untouchable because they own way too many things;things that most people aren’t aware of. I personally know our vehicles could be run without gasoline and just run on a multitude of different clean (green) energy sources,(like compressed air, which the only bi-product of it is…More compressed air) but we still pay trillions of dollars every day to use that same Earth killing fuel. So we are all guilty in some way of killing our planet, and I hope we stop soon. As I said, I applaud the EPA in their efforts to rid our Earth of the evil people who dump toxic waste in our waters and oceans, for they have no idea the future damage they will do..I hope your system catches every one of them and brings them to justice.. Sincerely, G.M.

  26. Tree Hugger permalink
    December 11, 2008

    I try not to take medicine in the first place. I personally wouldn’t put anything leftover down the drain or the toilet, especially after hearing about chemicals showing up in public water supplies. The few times I’ve had to take a prescription, it’s been short term and it has always said to be sure to finish all of this medicine on the bottle. Of course, I always ask whether or not medicine is necessary when I see the doctor. I’m surprised at how often they tell me it will make me feel better but not make me actually better. In which case, I prefer to walk out without a prescription.

  27. Dana Phillips permalink
    December 11, 2008

    When will the EPA pass a law for all pharmacuticals to be disposed of properly? By inforcing hospitals and pharmacies to dispose of pills properly could save our water. Flushing and tossing the pharmacuticals into the trash is unsafe and dangerous. If communities had companies that could pick up the unused pills in a locked container then dispose of the pills at a near by incinerator, that could be our best bet for keeping these dangerous pharmacuticals out of our drinking water. These companies are already being formed in various states and the incenerating method so far is safe and effective. Without the EPA people will continue to practice unsafe methods. The future is not looking to bright period for our children. If communities do not ban together and figure out ways to stop our future water from being contaiminted completley are water will be doomed.

  28. Yvonika,Filipe permalink
    December 11, 2008

    I follow the instructions of the doctor

  29. Sandy R permalink
    December 12, 2008

    I was looking for a rx disposal program this morning and came across this blog. I am very concerned with the amount of prescription drug’s I have left over from being treated for cancer for the past 10 years. I have numerous expired prescriptions from old antibiotics to anti-depressants, nausea control, ect. I asked my friends what they do with their old drugs and they stated that they dump them in the toilet! I asked them if they were aware that the parts of the drug ended up on our water supply. They did not realize this. I live in florida and am aware of the effects this practice has taken on our water, fish, frogs. ect. The florida department of enviromental affairs suggest that you keep the drugs in the original container, black out your name and rx #, place them in a plastic container with a lid ( like a old detergent bottle). Duct tape it closed and throw it in the garbage.(not the recycle bin).Now I ask myself, how is this safe?. How am I being a good servant by throwing the plastic containers in the garbage to be taken to the landfill? There must be a better solution. I will continue my research until I can find or come up with an environmentally safe solution.Sandy R.,Sarasota Florida

  30. Tony permalink
    December 12, 2008

    I feed them to my dog. I figure someone should get some use out of the old pills.

  31. mcastle permalink
    December 13, 2008

    Yvonika,Filipe Says,if we all follow the instructions of the doctor,the question would be solved.

  32. Larry Robles permalink
    December 14, 2008

    That is a very good question. I dissolve them with very hot water. I have a Tankless Water Heater which provides endless hot water. So, I use the Tankless water heater and dissolve them in hot water. It works everytime. Then, I throw all plastic containers in the appropriate recycle container.

  33. kelly F permalink
    December 14, 2008

    I bring any unused prescriptions to the hospital pharmacy for disposal.

  34. Kathryn Lammers permalink
    December 14, 2008

    I believe we are not doing enough to divert any medication from getting into the water system. We have indications that small amounts can cause changes to frogs, alligators, and fish. The pharmaceuticals in the water can be prevented by holding health care professionals accountable to use community take back the pill programs.

    In my town La Crosse County Waste Management has a drop off site for almost every day and has successfully included businesses to divert medications from disposal in landfills and water. In one year we have diverted about 5 million pills.This highly effective method should be a prototype for other areas.

    We need to have nurses problem solve the disposal of meds in the work site into appropriate containers rather than the sink or trash.

    We need more research into the effects of water pollution on humans.

    We a multidisciplinary approach to this problem of water pollution.

    The amount of medication usage is growing rapidly each year. We need to act now to strengthen the laws to prevent pollution.

    Kathryn Lammers RN PhDc
    Assistant Professor of Nursing
    Winona State University
    member of the Wisconsin Nurses Association

  35. Betsey permalink
    December 14, 2008

    I try to use natural products when possible, but I confess, I have flushed RX’s down the comode and into my septic system. Maybe that is why the geese are acting frisky!

  36. Betsey permalink
    December 14, 2008

    I like that idea, very funny. LOL

  37. michele lemieux permalink
    December 14, 2008

    Before enrolling in a class in college, entitled “Wastewater Management”, I never really thought about this subject. My mother had always flushed outdated pills and other medications down the toilet. After learning about how our wastewater is processed, I have changed my way of thinking, as well as my mothers. It is still difficult however, to determine the best way to dispose of these items. I think that it would help the environment very much if the pharmacies educated people in each Town as to how to properly dispose of these harmful drugs. I don’t think people realize that these prescriptions are getting back into our drinking water as contaminants.

  38. michele lemieux permalink
    December 14, 2008


    Sorry, you are not wrong. I just finished a college course entitled “Wastewater Management” and discovered the same information regarding these presciptions for cancer treatment. Did you know that out of 286 contaminants that are in drinking water, only 85 of them are tested for in our supplies? The list of contaminants found in our water supplies grows with every year, as the list of prescription drugs grows. Sad, truly sad. My dad is a senior scientist at Pfizer, and he is very disturbed about this. I don’t understand why pharmacies don’t educate people as to how to dispose of these medications. Towns and their pharmacies should get together and send out flyers to every residence to get the word across as to how to dispose of these medications properly.

  39. Dennis permalink
    December 20, 2008

    I can understand where EPA has the authority to regulate medications that are considered hazardous wastes. I don’t see where EPA has the authority to regulate medications that are not. From my understanding of the Universal Waste regulations, the materials to be regulated must first be a hazardous waste first.

    I do agree that keeping medications out of the environment is important. I just think EPA & FDA needs to obtain authority from congress.

    A medications return program should work like returning lead acid batteries, to the place of purchase. This program has worked for years.

  40. fondgule permalink
    December 20, 2008

    Why do you have left over prescription drugs? *occasionally* you might stop taking the drugs if your dr. says so but, that should be a rare occasion. Stupid people get all upset about flushing a couple of tablets? When they may have been taking the drugs for 20 years and passing them through their bowels. If flushing them is a problem then expelling them through your rectum is also a problem. Goes to the same place, yes?

    Empty them out of the bottle into your trash. They are less likely to fall into the hands of stupid people who will take them to see just what they do.

  41. fondgule permalink
    December 20, 2008

    that’s really funny. In most states when you separate the narcotic drugs from the legitimate label you are committing a crime, then transporting them in that condition is also a crime.

  42. fondgule permalink
    December 20, 2008

    the best thing to do is to form a new government agency to handle this problem. It shouldn’t cost more than 50 billion a year.

  43. fondgule permalink
    December 20, 2008

    good idea. Station a nurse in every work site and public facility to pour pills into a big container. We could call that the full employment for nurses in perpetuity program.

    In fact, we could do even better. We could send a nurse to the home of every person taking Rx meds to collect their feces every day. The nurses could then take the feces to a big incinerator facility to make sure all organic remnents of the pills were broken down. Then all we would have to worry about is the air pollution from the incinerator…and the fossil fuels to power it.

    Wow. What would we ever do without academia.

  44. fondgule permalink
    December 20, 2008

    You shouldn’t have any left over antibiotics. You need to take them ALL to be effective in 99% of the time. Best idea, ask you Dr. if you really do need an antibiotic? Antibiotics won’t cure you if you are suffering from virus. Then you wont have anything to throw away.

  45. fondgule permalink
    December 20, 2008

    Those companies that incinerate drugs are phenominally expensive. Not to mention all the fuel consumed (air pollution, anyone) in the collection route.

  46. fondgule permalink
    December 20, 2008

    good idea gM.
    Round up all those wealthy people and confiscate their wealth, take their property and in fact, imprison them. After all, it worked for the Bolshieviks. I am sure Lord Obama is working on something like that right now.

    You are right about the cars too. I developed plans for a Chevy Surburban that was made entirely of recyclable rice paper and ran on Fescue grass clippings and produce zero emissions. Texaco gave me a 100 million dollars for the rights and then they destroyed the formula so they could still sell gasoline.

    Keep up the good work GM, you are on the right track.

  47. fondgule permalink
    December 20, 2008

    They don’t take them because your effin head nurse confiscates them if they are d/c’ed. Never mind that the Dr. *might* restart the medication for that same patient a few days later.

  48. fondgule permalink
    December 20, 2008

    this is correct.

  49. fondgule permalink
    December 20, 2008

    hmmm. and every time you defecate into the toilet you are releasing those compounds any way. Because the ones that don’t break down in the sewage probably don’t break down in your intestine either.

    Having thought about it, I prefer the landfill. I am guessing that by the time the pill leeches into the ground water it is more likely to be degraded by natural forces because, flushing them puts them into effluent sooner?

  50. Sally G permalink
    December 22, 2008

    Good question, but I recently stopped my parents from disposing of old prescriptions by EPA-approved methods because I thought they were too dangerous to the environment. A sad statement, that. I suggested the local hazardous waste disposal day, and now question that. Just because they collect something, doesn’t mean that they necessarily dispose of it properly, does it? And our waste day doesn’t advertise accepting outdated medications. I’ll have to rethink this one. . . .

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