Patients receiving palliative care often have a residual supply of opioids and other pharmaceuticals at the time of the patient’s death.
Educating families on proper disposal of medications is an important patient safety measure.

Ideally, medications should be given to a secure medication collection site or disposed of through an official take-back program. Many collected medications are incinerated.

If the patient cannot access a secure collection site, they should be instructed on safe medication disposal in the household trash.

Recommendations:
- Remove medications (liquids, tablets, or capsules) from their original container.
- Mix medications (do not crush tablets or capsules) with unpalatable substances (such as kitty litter or used coffee grounds) and seal in a plastic zip lock bag or empty container and place in the trash.
- Remove identifying information about the patient and medication by covering with permanent marker or scratching off labels.
- Empty pill bottles should be thrown in the trash or recycling.
- If a drop-off program is unavailable, an option is flushing down the toilet medications that can be harmful to unintentional users (opioids, rectal diazepam, and transdermal methylphenidate and buprenorphine).
- Fentanyl patches, transdermal buprenorphine and methylphenidate should be folded in half, sticky sides together, and flushed down the toilet.

This information is from studies in a high-income country, but it may be also useful for countries in other socio economic levels.

See reference for more information.

Adapted from Nathan S, Deamant CD. Medication disposal. Palliative Care Network of Wisconsin. Fast facts and concepts #286. Internet. Accessed on December 27, 2018.