Why you should stop throwing out your old drugs

How many times have you been hectored and hounded to discard and replace “expired,” expensive prescription drugs?

Is it really necessary?

Probably not, according to new research published in the Archives of Internal Medicine.

The myth about discarding “expired” drugs stems from concerns that they lose their potency, or even convert to toxic metabolic byproducts or poisons over time. (As if most of them aren’t poison enough to begin with.) And big pharma promotes this myth to bilk almost an extra billion dollars out of consumers every year.

National Public Radio recently delved into the myth of expired drugs. And they interviewed Lee Cantrell, a toxicologist who runs the California Poison Control Systems. The story began when Cantrell found a cache of expired prescription drugs from the 1960s in the back closet of a retail pharmacy.

Cantrell saw it as an opportunity to test the drugs’ shelf life. He contacted Roy Gerona, a researcher at the University of California who grew up in the Philippines. In the Philippines, they can’t afford to just throw out unused prescriptions. They often take expired drugs, which appear to work fine and help lead to recovery.

Cantrell and Gerona ran tests on 14 different drugs — including antihistamines, pain relievers, and stimulants  — all still in their original sealed containers.

Twelve of the 14 drugs were still as potent as they were when they were first manufactured 50 to 60 years ago.

Turns out, the dates on drug labels, which typically range from two to three years after the drug is manufactured, are simply the point up to which the Food and Drug Administration and pharmaceutical companies guarantee the drugs’ effectiveness. But the dates don’t necessarily mean they’re ineffective immediately after they “expire.”

In fact, the FDA knows the vast majority of drugs remain viable well past the expiration date. The government — including the CDC, Department of Defense, and Department of Veterans Affairs — actually stockpiles massive amounts of medications and vaccines to provide a first-line defense in the event of a national emergency.

The Department of Defense alone has $13.6 billion in “expired” drugs. In fact, even though government agencies require private medical facilities to toss drugs after three years, the government itself has been storing and testing the potency of their own drugs for over 30 years.

Throwing out perfectly good prescription drugs contributes to the waste in our healthcare system. According to the most conservative estimates, one-quarter of healthcare expenditure stems from waste, fraud, and abuse. That waste comes to about $800 million per year. And that figure doesn’t include the costs of expired drugs at long-term-care and retail pharmacies and in consumer medicine cabinets.

After Cantrell and Gerona published their findings in Archives of Internal Medicine in 2012, some industry leaders accused them of being irresponsible and advising patients that it was OK to take expired drugs. Cantrell says they weren’t recommending the use of expired medication, just reviewing the arbitrary way the dates are set. And refining the process could save billions.

The system is rigged to work against you

Until a few years ago, my brother worked for a start-up biotech company that developed and manufactured a drug for resistant bacterial infections. (The start-up was based in the historic town of Lexington, Massachusetts, where we both grew up, once upon a time.)

The drug worked well against resistant infections when given immediately upon diagnosis. And hospitals always kept it on stock.

But here’s the catch: The drug “expired” after only a short period of time.

So — hospitals had to keep fresh supplies on hand at all times, whether they used them or not. And they had to throw out unused supplies (which were probably still perfectly good) and buy new supplies several times a year.

The start-up drug developers congratulated themselves on their genius product. It had virtually guaranteed profits.

In many ways, as I often warn, big pharma rigs the system to work against you. Indeed, as you may recall, earlier this year I reported that you don’t really need to take antibiotics as long as prescribed. In fact, research shows a two-week prescription works in about one week, and a 10-day prescription works in about five days.
In other words, when you feel better, you are better. There’s no real reason to keep taking antibiotics until they’re all used up. Plus, when you stop taking the antibiotic as soon as you feel better, you’re also protecting your microbiome (the healthy bacteria) in your gut.

When scientists first developed antibiotics, they really were a miracle cure for deadly infectious diseases. And doctors had good intentions. But there was no real data on how long patients should take them.

This latest research on “expired drugs” suggests you also can keep the extra antibiotic pills on hand for if and when you need them again. And then, you won’t have to wait to get and fill a prescription.

I know many people routinely pour “expired” or unused drugs down the drain or flush them down the toilet. But this ritual ultimately fouls our natural water system and poisons the aquatic environment. It also drugs wildlife in their water supply.

Instead, take them into your pharmacy where they can safely dispose of them. You can also search for a participating facility in your area by visiting diposemymeds.org or call 703-638-8200. Or better yet, leave them in your cabinet. Chances are, they’ll still work when you need them next!


“That Drug Expiration Date May Be More Myth Than Fact,” NPR (www.npr.org) 7/18/2017