Millions In Pills - Going Down The Drain

At Nursing Homes, Brand New Medications Flushed Away

(CBS)  It's a ritual at nursing homes across the country that few outsiders ever witness.

Brand new medicine left over from patients whose prescriptions changed, who were discharged or passed away, is methodically punched out of unopened blister packs and, unbelievably, flushed down the toilet, CBS News investigative correspondent Sharyl Attkisson reports.

At St. Anthony's nursing home in New Orleans, the deed is done by a former ER nurse who was stunned when she first saw so many drugs going down the drain.

"I'd see people coming into the ER who are so ill because they haven't been able to afford their medicine. And here I was flushing what they needed down the toilet," said Pam Rowland, director of nursing at St. Anthony's. "It's discouraging."

Federal law has long required nursing homes to destroy leftover drugs to protect against misuse. Turns out the simplest way to get rid of them is flushing. And it's been common practice as long as chief pharmacist Jack Sassone can remember.

"We've got policy-makers that make these policies for us and we have to follow," said Sassone.

Nobody knows just how much perfectly good medicine is being flushed at nursing homes nationwide, but one study puts the value as high as $378 million a year.

And because most older Americans are covered by government prescription drug plans, you are paying for all that waste.

At another nursing home we agreed not to identify, a nurse is also busy punching pills. Each card represents a wasted prescription:

$100 worth of an Alzheimer's drug (Namenda).

A $260 prescription for a memory medicine (Exelon).

$300 worth of blood thinner (Plavix).

The medicine also includes unopened syringes full of medicine to prevent blood clots. One box of ten syringes costs more than $1,000, but won't be helping anybody.

The FDA, which regulates drug disposal, has decided against creating a national program to donate the drugs to the poor, and instead leaves it up to the states.

Without federal direction, they haven't figured out how to do it effectively on a large scale.

Back at St. Anthony's, the owner says he'd rather to see the medicine go to those who can't afford it. But there's no place in New Orleans that takes it.

So the ritual continues. Even after all the pill punching we saw, there's more.

"You'll notice, if you can see, I have four boxes," Rowland said.

Boxes of valuable pills and your tax dollars … flushed.


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by hksanborn April 15, 2008 12:46 AM EDT

I''m so sorry you had the opportunity to not only show the total waste of taxpayer money and valuable medicines, without seeing it through to the end of the story where we are all being poisoned by all these medications which end up in our water. Water treatment plants cannot remove the hormones and many of the compounds in these drugs and to show repeated flushing down the toilet of huge quanitites of pills without a single mention of the danger that practic posese to the environment and all of us, was a real lost opportunity. To make amends, you need to do a story on why NO ONE should be putting them in the toilet and that we need a national program to collect unused drugs from the public and properly manage them.

Reply to this comment

by leslie9540 April 14, 2008 2:51 PM EDT

It''s bad enough that all these meds are being wasted when so many could use them. This is just another example of our very wasteful practices in this country. But this was made worse by the fact that you didn''t even mention the detectability of medications in our drinking water now. Please do a follow-up story on this. There are plenty of experts in this country who could give you the details. Those of us who work in environmental fields are trying to get the word out and you have a golden opportunity to do just that! Good journalism should give the full story.

Reply to this comment

by lisaerx April 14, 2008 9:51 AM EDT

I''m a pharmacist and in my state we can return, credit and reissue all but "controlled" medications. Any left over "non-controlled" medication can be donated to clinics or hospice. "Controlled" medications are regulated by the DEA, and those medications must be flushed. There are national pharmacy organizations and pharmacist which have been trying for years to change the DEA''s mind, but so far nothing has changed, and those medications are being flushed.

Reply to this comment

by welchrob April 13, 2008 10:13 PM EDT

What about the fact that these pharmaceuticals are showing up in our drinking water?

Reply to this comment

by Anne West April 12, 2008 5:44 PM EDT

It is not only a waste of good medications but think of the thousands of poor people who cannot afford their medicines who could be helped if only these meds could be recycled.
Secondly, most of municipal water treatment plants have no way of removing these meds from the water they are flushed in. No wonder we are all developing allergies and drug resistent problems. How much of these are coming back into our drinking water?? How many of our health problems are resulting from meds leaching into the water and soil??

Reply to this comment

by sophie2u April 12, 2008 5:34 PM EDT

Are we all CRAZY? Didn''t we learn less than a month ago that trace amounts of medications are now found in our drinking water? DUH! Dumping pills in the toilet is insane. But we''re used to doing things in an insane manner: Thank you Bush and The Evil Cheany who want socialism for corporations and can''t help the small guy! They promote fear to help their like.

Reply to this comment

by glassactly April 12, 2008 5:01 PM EDT

This story enrages me. For years this very subject has been on the top of my list of peeves. As a Nurse aide in Louisiana in the 70''s I watched as the nursing home where I worked had to convert its system from dispensing pills in a bottle to the "unit dose system". This meant that medications were going to be packaged in a way where only one pill or dose would be dispensed,thereby preventing the contamination of the other pills & eliminate waste. The nursing home had to then switch services to a pharmacy which could package and dispense the medications ordered by physicians to the indivigual patients and they were charged an extra amount for this service. It was mandated that it had to be done this way if you were a resident of the nursing home. It was a medicaid facility as well as private pay. For a while any medicine that was not used could be returned to the pharmacy for a refund to the patients account or recycled. Of course this process required there be even more quality assurance and manpower on the part of the pharmacy, and how was this refund process working out? They were not happy and eventually begain to refuse to accept returns, and probably didn''t make many refunds, and what the patients and taxpayers had to pay more for, was never truely delivered.
As a nurse I''ve seen so many wasted drugs and its a tremendous amount nationwide I''m sure. Its outrageous!
Something should have been done about it 25 years ago.

Reply to this comment

by atwor-2009 April 12, 2008 4:33 PM EDT

To sblake63: The meds are NOT owned by the nursing homes, the patients are charged for them. It was necessary for me to put my father in a facility a year ago. I took his meds-only 2 that he was prescribed-when he checked in. He died less than 24 hours after he arrived. Imagine my surprise when sent a bill for $600 in prescriptions 2 months later!! The home never could prove why these were prescribed for him, which I thought very strange, especially since they would not even sign the death cert. After filing these with his insurance co. & proving to the pharmacy they were not going to pay, they cancelled the charges. As far as I''m concerned, the nursing home tried to rip us off!!! Now I worry that these have been flushed, as well.

Reply to this comment

by sblake63 April 12, 2008 3:12 PM EDT

The medication has been purchased and is OWNED by the nursing homes in question. Leave it to some heart wrenching liberal to dig up this story lol. If they want to toss it, it''s THEIR BUSINESS. Doesnt matter how they got it or who provided it. Washington has NO say in this matter.

Liberals want more laws to regulate everything. Guns, health care, where your kids go to school, what you eat. It never stops. They use buzz words such as "it''s for the children" or "the poor". The founding fathers would turn in their graves if they knew of the nonsense we are up to these days.

Look at Obama''s remarks. A typical socialist. His statement saying small town people cling to gun rights and religion because the goverment isnt doing its job? So what he''s saying is the "normal" condition of a person''s beliefs is somebody who looks to the goverment to improve their lives and when all is "well", there''s no need to own guns or have a strong belief in god or moral values.

This thinking is dangerous. The class envy against the rich, wanting to take arms away from the people, all social services ran by Washington. You know this was tried before, it was called the USSR. Look at what happened to them!

Reply to this comment

by glock4me April 12, 2008 3:05 PM EDT

Is this why kids are able to get high from decomposing feces?

Reply to this comment

by pollroller1 April 12, 2008 2:39 PM EDT

To hear a story like this is realy devasting, I have a brother in a rest home,He is getting ss disability,I have been figting a battle for years getting the drugs he needs with the amount of money he draws,because he can''''t pay a $2,400 bill I was told my brother would not get his medication, Then I hear things on the news with all the waste, Right now I can''''t say I''''m happy to be an american.
Posted by ginnylou3 at 10:59 AM : Apr 12, 2008
I am truly sorry to hear about your brother. I wonder if the pharmaceutical companies are behind this so they can make more profits. It wouldn''t surprise me one bit.

Reply to this comment

by ginnylou3 April 12, 2008 1:59 PM EDT

To hear a story like this is realy devasting, I have a brother in a rest home,He is getting ss disability,I have been figting a battle for years getting the drugs he needs with the amount of money he draws,because he can''t pay a $2,400 bill I was told my brother would not get his medication, Then I hear things on the news with all the waste, Right now I can''t say I''m happy to be an american.

Reply to this comment

by hotpaulie April 12, 2008 1:47 PM EDT

God bless America???

Reply to this comment

by pollroller1 April 12, 2008 1:04 PM EDT

Hey y''all, this is America. This is how we do things here in the home of the brave, land of the free. hahahaha

Reply to this comment

by ssakoian April 12, 2008 12:53 PM EDT

Dumping into the water supply certainly is pollution. Burning them, returning them to the manufacturer or pharmacy for destruction? Recycling? Thing is, all this talk about "giving them to the poor" - good intentioned as it is, is a risk as well. If the drugs were to be tampered with prior to distribution, you have another problem, a potential lawsuit. Dumping down the toilet is the easiest way, but the fact is, it has long term hazardous results - pollution and who knows what else for animals, plants, fish, people.

Reply to this comment

by fridak-2009 April 12, 2008 12:43 PM EDT

Out here in the west there are fish that are developing dual *** characteristics because of the high levels of drugs in the water. A lot of this is because of what is excreted in urine, but adding to it by flushing meds does not make sense. There has to be a better way.

Reply to this comment

by antizion April 12, 2008 12:39 PM EDT

Then that toxic *** winds up in our water supply. Where is the EPA when we need them? Putting fluoride in your water to keep you a zombie so you don''t rise up and demand legitimate government. Stalin did the fluoride trick in his labor camps for the same reason.

Reply to this comment

by swwils April 12, 2008 12:39 PM EDT

I will bet the farm,that they aren''t flushing narcotics.Those are either going home or to the dope man.My brother was an inspector for the state,he use to go to theses facilities and check out the patients and how they were being cared for.His team found many bagged up prescription drugs,and needles heading out the door with maintenance workers,nurses,and aides.They even busted a director of one home that was over ordering the medicine,and selling it right out of the facility.

Reply to this comment

by truth-hurts April 12, 2008 11:49 AM EDT

STEP DOWN OBAMA

THE TRUTH IS OUT!!

AND IT''S NOT ABOUT BITTER VOTERS, ITS ABOUT THE WORKING CLASS, SMALL TOWNS, RURAL AMERICA, RELIGION AND GUNS

Reply to this comment

by w0074 April 12, 2008 11:39 AM EDT

Back in the day when I use to be a RCRA inspector (Resource Conservation Recovery Act) for my state, throwing drugs down the drain could constitute potential violations, if the drugs were hazardous. Another aspect of throwing drugs down the drain is the bioaccumulation of drugs in the environment and the potential bioaccumulation of pharmaceutical drugs in drinking water. You good people are possibly looking at a potential violation that is documented in this video. I don%u2019t know what New Orleans state laws would accommodate this as a violation, never less I know that most pharmacy%u2019s and hospitals%u2019 that I have inspected have a program where they return the drugs back to the manufacture (recycling or proper disposal). Hence, the pharmaceuticals companies could redistribute the drugs to the poor and it%u2019s a win, win situation for every one and the environment.

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[hksanborn]

I''m so sorry you had the opportunity to not only show the total waste of taxpayer money and valuable medicines, without seeing it through to the end of the story where we are all being poisoned by all these medications which end up in our water. Water treatment plants cannot remove the hormones and many of the compounds in these drugs and to show repeated flushing down the toilet of huge quanitites of pills without a single mention of the danger that practic posese to the environment and all of us, was a real lost opportunity. To make amends, you need to do a story on why NO ONE should be putting them in the toilet and that we need a national program to collect unused drugs from the public and properly manage them.

[leslie9540]

It''s bad enough that all these meds are being wasted when so many could use them. This is just another example of our very wasteful practices in this country. But this was made worse by the fact that you didn''t even mention the detectability of medications in our drinking water now. Please do a follow-up story on this. There are plenty of experts in this country who could give you the details. Those of us who work in environmental fields are trying to get the word out and you have a golden opportunity to do just that! Good journalism should give the full story.

[lisaerx]

I''m a pharmacist and in my state we can return, credit and reissue all but "controlled" medications. Any left over "non-controlled" medication can be donated to clinics or hospice. "Controlled" medications are regulated by the DEA, and those medications must be flushed. There are national pharmacy organizations and pharmacist which have been trying for years to change the DEA''s mind, but so far nothing has changed, and those medications are being flushed.

[welchrob]

What about the fact that these pharmaceuticals are showing up in our drinking water?

[Anne West]

It is not only a waste of good medications but think of the thousands of poor people who cannot afford their medicines who could be helped if only these meds could be recycled.
Secondly, most of municipal water treatment plants have no way of removing these meds from the water they are flushed in. No wonder we are all developing allergies and drug resistent problems. How much of these are coming back into our drinking water?? How many of our health problems are resulting from meds leaching into the water and soil??

[sophie2u]

Are we all CRAZY? Didn''t we learn less than a month ago that trace amounts of medications are now found in our drinking water? DUH! Dumping pills in the toilet is insane. But we''re used to doing things in an insane manner: Thank you Bush and The Evil Cheany who want socialism for corporations and can''t help the small guy! They promote fear to help their like.

[glassactly]

This story enrages me. For years this very subject has been on the top of my list of peeves. As a Nurse aide in Louisiana in the 70''s I watched as the nursing home where I worked had to convert its system from dispensing pills in a bottle to the "unit dose system". This meant that medications were going to be packaged in a way where only one pill or dose would be dispensed,thereby preventing the contamination of the other pills & eliminate waste. The nursing home had to then switch services to a pharmacy which could package and dispense the medications ordered by physicians to the indivigual patients and they were charged an extra amount for this service. It was mandated that it had to be done this way if you were a resident of the nursing home. It was a medicaid facility as well as private pay. For a while any medicine that was not used could be returned to the pharmacy for a refund to the patients account or recycled. Of course this process required there be even more quality assurance and manpower on the part of the pharmacy, and how was this refund process working out? They were not happy and eventually begain to refuse to accept returns, and probably didn''t make many refunds, and what the patients and taxpayers had to pay more for, was never truely delivered.
As a nurse I''ve seen so many wasted drugs and its a tremendous amount nationwide I''m sure. Its outrageous!
Something should have been done about it 25 years ago.

[atwor-2009]

To sblake63: The meds are NOT owned by the nursing homes, the patients are charged for them. It was necessary for me to put my father in a facility a year ago. I took his meds-only 2 that he was prescribed-when he checked in. He died less than 24 hours after he arrived. Imagine my surprise when sent a bill for $600 in prescriptions 2 months later!! The home never could prove why these were prescribed for him, which I thought very strange, especially since they would not even sign the death cert. After filing these with his insurance co. & proving to the pharmacy they were not going to pay, they cancelled the charges. As far as I''m concerned, the nursing home tried to rip us off!!! Now I worry that these have been flushed, as well.

[sblake63]

The medication has been purchased and is OWNED by the nursing homes in question. Leave it to some heart wrenching liberal to dig up this story lol. If they want to toss it, it''s THEIR BUSINESS. Doesnt matter how they got it or who provided it. Washington has NO say in this matter.

Liberals want more laws to regulate everything. Guns, health care, where your kids go to school, what you eat. It never stops. They use buzz words such as "it''s for the children" or "the poor". The founding fathers would turn in their graves if they knew of the nonsense we are up to these days.

Look at Obama''s remarks. A typical socialist. His statement saying small town people cling to gun rights and religion because the goverment isnt doing its job? So what he''s saying is the "normal" condition of a person''s beliefs is somebody who looks to the goverment to improve their lives and when all is "well", there''s no need to own guns or have a strong belief in god or moral values.

This thinking is dangerous. The class envy against the rich, wanting to take arms away from the people, all social services ran by Washington. You know this was tried before, it was called the USSR. Look at what happened to them!

[glock4me]

Is this why kids are able to get high from decomposing feces?

[pollroller1]

To hear a story like this is realy devasting, I have a brother in a rest home,He is getting ss disability,I have been figting a battle for years getting the drugs he needs with the amount of money he draws,because he can''''t pay a $2,400 bill I was told my brother would not get his medication, Then I hear things on the news with all the waste, Right now I can''''t say I''''m happy to be an american.
Posted by ginnylou3 at 10:59 AM : Apr 12, 2008
I am truly sorry to hear about your brother. I wonder if the pharmaceutical companies are behind this so they can make more profits. It wouldn''t surprise me one bit.

[ginnylou3]

To hear a story like this is realy devasting, I have a brother in a rest home,He is getting ss disability,I have been figting a battle for years getting the drugs he needs with the amount of money he draws,because he can''t pay a $2,400 bill I was told my brother would not get his medication, Then I hear things on the news with all the waste, Right now I can''t say I''m happy to be an american.

[hotpaulie]

God bless America???

[pollroller1]

Hey y''all, this is America. This is how we do things here in the home of the brave, land of the free. hahahaha

[ssakoian]

Dumping into the water supply certainly is pollution. Burning them, returning them to the manufacturer or pharmacy for destruction? Recycling? Thing is, all this talk about "giving them to the poor" - good intentioned as it is, is a risk as well. If the drugs were to be tampered with prior to distribution, you have another problem, a potential lawsuit. Dumping down the toilet is the easiest way, but the fact is, it has long term hazardous results - pollution and who knows what else for animals, plants, fish, people.

[fridak-2009]

Out here in the west there are fish that are developing dual *** characteristics because of the high levels of drugs in the water. A lot of this is because of what is excreted in urine, but adding to it by flushing meds does not make sense. There has to be a better way.

[antizion]

Then that toxic *** winds up in our water supply. Where is the EPA when we need them? Putting fluoride in your water to keep you a zombie so you don''t rise up and demand legitimate government. Stalin did the fluoride trick in his labor camps for the same reason.

[swwils]

I will bet the farm,that they aren''t flushing narcotics.Those are either going home or to the dope man.My brother was an inspector for the state,he use to go to theses facilities and check out the patients and how they were being cared for.His team found many bagged up prescription drugs,and needles heading out the door with maintenance workers,nurses,and aides.They even busted a director of one home that was over ordering the medicine,and selling it right out of the facility.

[truth-hurts]

STEP DOWN OBAMA

THE TRUTH IS OUT!!

AND IT''S NOT ABOUT BITTER VOTERS, ITS ABOUT THE WORKING CLASS, SMALL TOWNS, RURAL AMERICA, RELIGION AND GUNS

[w0074]

Back in the day when I use to be a RCRA inspector (Resource Conservation Recovery Act) for my state, throwing drugs down the drain could constitute potential violations, if the drugs were hazardous. Another aspect of throwing drugs down the drain is the bioaccumulation of drugs in the environment and the potential bioaccumulation of pharmaceutical drugs in drinking water. You good people are possibly looking at a potential violation that is documented in this video. I don%u2019t know what New Orleans state laws would accommodate this as a violation, never less I know that most pharmacy%u2019s and hospitals%u2019 that I have inspected have a program where they return the drugs back to the manufacture (recycling or proper disposal). Hence, the pharmaceuticals companies could redistribute the drugs to the poor and it%u2019s a win, win situation for every one and the environment.