Returning Unwanted Medicine To Pharmacies – Monash University Malaysia

The majority of unwanted or expired medicines are disposed of via household wastes, and only a minority are returned to pharmacies.

When was the last time you sorted through your medicine cabinet? Chances are you’ll fi wid a collection of medications you no longer use or that have expired.

From antidiarrheal tablets you bought just in case you got sick on a trip to the leftover cough syrup to fever medications you didn’t use up to those old painkiller tablets.

If this is the case, don’t pour them down the sink, flush them, or bin them along with your household waste, as pharmaceutical residues may end up in landfill and can contaminate waterways, causing environmental damage, with animals and plants being impacted.

Pharmaceutical products have long been used to treat and prevent diseases in humans and animals. However, the majority of unwanted or expired medicines are disposed of via household wastes, and only a minority are returned to pharmacies.

To make matters worse, pharmaceutical residues are now among the emerging pollutants in the environment with recent studies in Malaysia citing widespread occurrence of active pharmaceutical ingredients with wastewater effluents, surface water, and tap water samples due to improper disposal of unused and expired medications.

Efforts to minimise the undesirable environmental and economic burden through medication waste prevention strategies are thus required.

Against this backdrop, the International Pharmaceutical Federation (FIP) is imploring pharmacists to serve as environmental stewards of safe medication disposal and increase awareness about the negative effects of medications on the environment.

This movement by the pharmaceutical society has sparked a collaborative effort between Alpro Foundation, Monash University Malaysia and the International Medical University with hopes of implementing educational training and promotional activities for proper medication and pharmaceutical disposal. 

This initiative, co-hosted by Monash University Malaysia, the Alpro Foundation and International Medical University, aims to encourage people to properly and easily dispose of their pharmaceutical wastes.

This is a free service for anyone to walk in and dispose their unwanted medications in the Unwanted Medication Disposal bins at any of their outlets.

This project addresses multiple targets of the United Nations’ Sustainable Development Goals (SDGs), primarily to ensure availability and sustainable management of water and sanitation, thus promoting healthy lives and well-being of the community. 

Saw Pui San, a lecturer from the School of Pharmacy, Monash University Malaysia, accentuates that the damaging consequences that medicines currently exert on the environment is worrying — from “feminisation” of male fish exposed to contraceptive pills to global spread of antibiotic resistance.

“Climate crisis is a health crisis, and we need to act now for a systemic change,” she said.

Expanding The Reach Of Medication Disposal Programmes

A recent World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) joint assessment found that only 58 per cent of sampled facilities from 24 countries had adequate systems in place for the safe disposal of health care waste.

On the home front, the Ministry of Health has implemented the Return Your Medicines Program in 2010. Through this programme, the patients can return their unused or expired medicines for safe disposal in public hospitals and clinics.

That said, awareness of the programme could be promoted more effectively by extending it to include community pharmacists.

According to Dr Ali Qais Blebil, a lecturer from the School of Pharmacy, Monash University Malaysia who ran the interviews with the pharmacists, there are various reasons why people may obtain a medicine but not use all of it.

“Medicines often require dose adjustments, a medicine may not work well, or it may cause an adverse effect and needs to be stopped. Sometimes medications are only prescribed to be used when necessary, such as for pain or nausea and vomiting. People may keep spare medicines, such as a salbutamol inhaler at their work, which expire before they are fully used,” said Dr Ali. 

Recently, he led a study to examine the challenges faced by pharmacists when implementing medication disposal programmes in their practice locations. The pharmacists surveyed agreed that there is a lack of clear guidelines and adequate instructions on the medication disposal practices.

Moreover, there is also limited space in the pharmacies for collecting and storing the returned medications. Nevertheless, the pharmacists emphasised the significance of being trained as environmental stewards, even as early in the university years of pharmacy education. 

Online training modules such as this self-paced course have since been developed by International Medical University lecturer Dr Hii Ling Wei and her team in collaboration with Alpro Academy. The objective of the course was to provide a fundamental understanding of pharmaceutical waste management and promote good practice for pharmaceutical waste disposal and reduction. 

“It is time for all health care facilities, professionals, and community to be aware of their responsibilities for proper healthcare waste disposal, especially the healthcare wastes which are hazardous and requiring special attention”, said Dr Hii. 

“The sewage system in Malaysia is not designed to filter medications from it. Before it actually passed onto our water reserves, it flows into other water sources, which affects marine life and ultimately our drinking water,” explained Ostwin Paw, CEO of Alpro Foundation.

It is everyone’s responsibility to reduce medicine waste, and together with Alpro Pharmacy as a prominent prescription pharmacy, consumers will now have easier access to safely dispose of their unwanted medications the right way.

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