Keeping expired medication around the house greatly increases the risk of unintentional injuries and poisoning, especially among younger children and seniors.

All medications, prescription or over-the-counter, come with information about their proper use; possible side effects and drug interactions; recommended dosage; and an expiration date. However, sometimes people will stop taking their medication part way through treatment because they begin to feel better, they forget, or they have a reaction to the medicine. Unfortunately, this means that some of the medications in our homes may have expired or are no longer being used. The danger is that taking medication for the wrong reasons or taking expired medication can cause severe health complications. Medication can help fight disease and make us feel better, but if it is misused or taken incorrectly, medication can also cause us serious harm.

What are medications?

Medications are substances that help our immune system fight infections, treat and manage diseases, and help keep us healthy. Physicians prescribe medications to treat specific illnesses and conditions. Non-prescription drugs, such as cold and sinus medications can be purchased over-the-counter without a prescription or doctor referral. Natural health products such as some vitamins and minerals, herbal remedies, and other homeopathic medicines are also available to treat a wide variety of health issues.

Most of these products can help make us feel better if used properly, however, they are all potentially dangerous if used improperly or unintentionally.

The dangers of medication…

Medications are a major source of childhood poisoning. Young children learn by interacting with things around them and by exploring their environments through taste and touch. This may cause a young child who sees a parent or guardian taking medication want to imitate them. The danger is that even small amounts of some prescriptions and over-the-counter medications can seriously damage or kill young children.

Research conducted by the Canadian Institute for Health Information shows that medication is responsible for more than two-thirds of unintentional poisonings of children aged O to 14 years, resulting in hospitalization (see diagram below). Also, nearly two-thirds of all poisonings, occur in children aged 1 to 4 years (Safe Kids Canada, 2006).

Medications can also be harmful to seniors. If expired medication is unintentionally used, it may cause severe side effects and may interact dangerously with other medications. The potential side effects include confusion, drowsiness, impaired motor function, disorientation, low blood pressure, or other serious health complications. Some of these side effects can cause loss of judgement or balance which can lead to a fall. Falls are the leading cause of injury among people aged 65 or older (Canadian Institute for Health Information, 2006). In fact, one in three seniors will suffer a fall every year, with about one in four falls resulting in injuries such as sprains, fractures and breaks, and even death (SMARTRISK, 2004).

Unintentional poisoning hospitalizations among Canadian children aged 0-14 years by cause, 1994-2003

Tip

It is recommended that all medications be kept in their original containers with the original label. However, for those taking multiple medications, it may be helpful to use a medicine organizer case marked with the days of the week to ensure you are following your pharmacist’s directions correctly. This may be especially helpful if you are taking medications prescribed for alternating days of the week. Never discard the original instructions. Ask your pharmacist about other ways to organize your medications.

How to properly store medications

• Keep medication, prescription and non-prescription, in a locked container or cabinet and away from children.
• Never mix different medications unless directed by a physician and never remove the original label.
• Store medications in a cool, dry place, and away from direct light. Storing medication in the bathroom is the worst place because it is too damp and warm.
• Do not store medicine with food or household products.
• Ask your pharmacist to put prescription and non-prescription medicine in child resistant containers.

The risk of improper medication disposal

Taking expired medication can be very hazardous to your health, but disposing of medication improperly can have serious consequences as well. When a prescription or over-the-counter drug is discarded in the garbage, or flushed down the toilet, the chemicals end-up in the water supply and soil. These can contaminate the environment and be especially harmful to human health if they end up in drinking water sources.

There is also some concern that improper disposal of medication may be adding to the growing problem of antibiotic resistance. Antibiotic resistance occurs when bacteria develop a resistance to the effects of an antibiotic. For more information on how this occurs, visit http://www.wechealthunit.org/workplace-health/e-bulletins/ts_ht_medcabinet.pdf/view

How to properly dispose of medication

At least once a year, you should look at your medications, remove any that have expired, and take out medications you no longer use. Be sure that you check the expiry dates on non-prescription drugs and remove those that are outdated. In addition, remove medicine that appears discoloured, ointments or liquids that have turned cloudy, and pills that are crumbling. Unlabelled bottles or containers should also be removed. If you are unsure if the medication has expired, check with your pharmacist. When disposing of medications, check to see if your pharmacy has a drug recycling program that disposes of unused or expired drugs in an environmentally safe way.  Most pharmacies provide such services, often called “Pharmacy Disposal Programs”, and many municipalities have Municipal Disposal Programs that incinerate drugs.

For more information on these types of programs speak with your pharmacist.

Always follow the instructions...

All medications should be used as directed by your doctor or pharmacist. In the case of antibiotics, it is important to take the full course of treatment to ensure all the germs are destroyed. Never stop taking a prescription part way through the course of treatment without first discussing it with your doctor, even if you feel better. If you are experiencing unexpected side effects contact your doctor or pharmacist as soon as possible.

If you think you have taken expired medication, contact your local Poison Centre (the phone number is located at the beginning of your phone book) or dial 911.

Key References
Canadian Institute for Health and Information. (2006). National trauma registry 2005 report. Major injury in Canada. Ottawa, ON: Author.

Health Canada. (2004). Proper use and disposal of medication. Retrieved January 15, 2007, from http://www.hc-sc.gc.ca/iyh-vsv/med/disposal-defaire_e.html

Ontario Regional Poison Information Centre. (2006). Poison-proof your home – information for families. Retrieved January 17, 2007, from http://www.sickkids.ca/poisoninformationcentre/custom/poisonproofhome.pdf

Safe Kids Canada. (2006). Child & youth unintentional injury: 10 years in review 1994-2003. Retrieved January 16, 2007, from http://www.sickkids.ca/SKCForPartners/custom/SKW06NationalReportENG.pdf

SmartRisk. (2004). Facts on falls. Retrieved January 16, 2007, from http://www.smartrisk.ca/contentdirector.aspx?cd=297&dd=0&sr=1