National Prescription Drug Take-back Day is this Saturday. This is one of those curious events that comes around once a year and sounds vaguely like a good idea. It seldom actually motivates very many people to act.
But, should it?
When non-medical persons think about old meds, they are worried about poisoning. The Medical Letter is a very well-respected authority on medications, and looked at tablets and capsules stored in the original container at average room temperatures. No medications turned to poison, and medications five years out of date were still at virtually original strength. 
Old medications will not poison you.
The big concern is the law of unintended consequences. If you are taking the medication for something other than it was prescribed for, you can get a very bad result.
Antibiotics as a class are one of the safest medications made. It is difficult to take too much, which is more often wasteful than dangerous. It is dangerous to take too little. The reason is that any infection is made up of many germs that are easy to kill (99%), and a few that are resistant and quite hard to kill. Almost all of the easy germs are killed in the first several days of treatment. The remaining ones take seven to 10 days to kill. Therefore, taking only a few days of leftover antibiotics acts to select the strongest (most resistant) germs to create a superinfection. Survival of the fittest – germs, not you.
Pain medications that are left over from an injury present several possible disaster modes. Opiate medications are quite addicting. They often find their way out of the medicine cabinet by family or friends. Do you really want to give your kids a taste for opiates? Seems like a really bad idea.
Pain medications also are quite effective after you have a diagnosis. The pain is telling you something! Get it examined/X-rayed and treated. If you skip the figure-it-out part, you may be walking on a broken leg and making it much worse. Or you may take old pain pills for chest pain, which will not stop a heart attack. Or for abdominal pain, which can delay care for acute appendicitis, causing your appendix to rupture. Now we are talking ICU, not arthroscopic appendectomy same-day release.
For many reasons, you are safest if you get rid of all those old pill bottles with a couple of stray tablets. They don’t belong in the dump. Take them to a collection facility and they will red-bag it, and safely make it go away.
Take care,
Dr. B
Donald Bucklin, MD (Dr. B) is a Regional Medical Director for U.S. HealthWorks and has been practicing clinical occupational medicine for more than 25 years. Dr. B. works in our Scottsdale, Arizona clinic.
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