Patients are usually told to read the label on the medications carefully before using them and to take them as prescribed for effective treatment.
But little or no advice is given on how to handle unused medications properly when they are no longer needed. Most people simply toss them in with the household trash or flush them down the drain.
“Neither of these actions are good ideas. Washing pharmaceuticals down the toilet and sending them to landfill can affect the environment,” said Asst Prof Dumrongsak Pekthong, a lecturer at the Faculty of Pharmaceutical Sciences of Naresuan University in Phitsanulok.
He explained that when pharmaceuticals are flushed away, chemical compounds found in the products can contaminate waterways, threatening marine life and humans.
He cited studies indicating that the Chao Phraya River and major canals in Bangkok have been found to be tainted with some prescribed pharmaceuticals.
“Pharmaceuticals and their residues impact aquatic ecosystems. The toxins from the harmful chemicals enter the food chain and potentially harm our health,” he said.
Returning unused medicines program
In effort to encourage people to dispose of unused medicines safely and securely, reduce medication waste and help save the environment, while saving healthcare costs, Naresuan University’s Faculty of Pharmaceutical Sciences initiated the PharmaSea: Saving the Medicines,
Saving the Sea project in 2021. It has also teamed up with the Sunday Cycling Club in Phitsanulok to collect unused and expired medications from members of communities near the university under the “Hero for Zero Contamination Program.”
“During the cycling trips, the club’s members and village health volunteers meet the locals to pick up unused medications from them. They also educate them on the proper disposal of unused medications and the consequences if they are not handled safely and securely,” Dumrongsak said, adding that burning pharmaceuticals in incinerators at high temperatures can restrict their access to the waterways.
Once collected, the donated medications are inspected by the faculty’s student volunteers to check expiry dates and signs of tampering.
They are then separated into unexpired and out-of-date categories. The unexpired are redirected to hospitals in need in remote areas to make the most of them, while the expired are sent to a company providing waste incineration services.
The company’s facility burns pharmaceutical waste at high temperatures and turns it into energy.
“Some of the medications have expired but are still in good shape. I have used them as an educational aid for students in my classes to let them explore how ingredients are combined and mixed to create medicine,” the lecturer said.
According to him, pharmaceuticals people have sent to the faculty vary from household remedies to prescribed medications mostly used to treat non-communicable diseases and over-the-counter medicines.
Dumrongsak explained that leftover drugs are usually the result of a change in treatment, patients’ conditions improving and no longer needing their prescribed medication, when they experience side effects and are put on new medications or, in some cases, if they receive medications from many hospitals and clinics.
He added that the faculty has re-distributed the donated medications to Umphang Hospital, Phop Phra Hospital, Tha Song Yang Hospital and Mae Ramat Hospital, all in Tak province on the Thai-Myanmar border.
The hospitals have patients who are stateless and displaced and need medications. They have limited access to health care services provided by the government.
“We work closely with the hospitals. They send us a list of medications they need. We then fulfill them. This is to make sure that medicines we’ve re-distributed are delivered there,” Dumrongsak said, adding that different hospitals have different needs.
He added that medications the faculty re-dispenses are unused and kept in original sealed containers, that the packaging shows no sign of tampering and that they have a shelf life of at least 6 months before the expiry date.
Since the start of the project, the faculty has gathered more than 6 million tablets and over 100,000 units of medications and supplies (including injectables, liquids, inhalers, patches and pharmaceuticals for external use) that people have donated.
Of these, more than 3 million tablets, worth over 4 million baht, have been re-dispensed to hospitals and community health centers facing medicine shortages.
Thailand’s annual value of imports of medicines and pharmaceuticals is reported to be higher than 100 billion baht, according to an analysis of Thailand’s pharmaceutical outlook by Krungsri Research.
Making zero the hero
Collective efforts are needed to help reduce waste from pharmaceuticals being released into the environment.
“Anyone can be a hero to help save the planet. We can work together and you can all do your part to care for the environment.” Dumrongsak said.
He urged doctors to prescribe the medications patients need in the amount needed for treatment over a set period. Hospital’s pharmacists can help patients count the medications they have left so doctors can prescribe only what is needed until the next appointment.
Hospitals can set up take-back sites on their premises and encourage patients to drop off unused and expired medications. He said the faculty has worked with many hospitals in Phitsanulok province to install drop-off boxes at their hospitals. The faculty’s team then collect them for proper management.
He has also called on pharmaceutical companies to step up efforts to increase manufacturing efficiency to help eliminate waste and educate communities on the safe disposal of unused medicines, and encourages patients to take medications only as prescribed by doctors and dispose of all unused or expired medications responsibly.
“Medicines have pros and the cons. If you have some and no longer use them, don’t throw out your expired or unused medications, return them to our pharmacy,” he said adding that the medicine take back option is the best way to safely dispose of unused and expired prescription and non-prescription medicines.
If you are interested in donating your medications, please send to Naresuan University’s Faculty of Pharmaceutical Sciences at 99 Moo 9, Thapo Sub-district, Muang District, Phitsanulok, Thailand 65000
By Thai PBS World Feature Desk
