How to Safely Dispose of Expired Medications: FDA Take-Back Guidelines and Best Practices

Every year, millions of unused or expired pills sit in medicine cabinets across the U.S.-some for years, some just a few months. You might think tossing them in the trash or flushing them down the toilet is harmless. But it’s not. The FDA says improper disposal contributes to accidental poisonings, drug abuse, and even environmental damage. The good news? There’s a clear, safe way to get rid of them-and it’s easier than you think.

What the FDA Says About Disposing of Medications

The FDA’s official stance is simple: take-back programs are the best and safest option for nearly every medication you have. In 2024, the agency updated its guidelines to make this even clearer. Out of the 5.8 billion prescriptions filled in the U.S. last year, an estimated 15-20% went unused. That’s hundreds of millions of pills. And if even a small fraction ends up in the wrong hands or in waterways, the consequences can be serious.

The FDA’s Drug Disposal: Questions and Answers document (updated October 2024) states that take-back programs are the only method proven to safely remove medications from circulation. These programs collect drugs at secure locations-like pharmacies, hospitals, or police stations-and destroy them under federal oversight. There’s no risk of theft, no chance of contamination, and no environmental harm.

Three Ways to Dispose of Medications (Ranked by Safety)

There are three approved methods for getting rid of expired or unwanted meds. But not all are created equal.

1. Use a Drug Take-Back Location (Best Option)

This is the #1 recommended method by the FDA, DEA, and EPA. As of January 2025, there are over 14,352 DEA-authorized collection sites across the U.S.-mostly at pharmacies like CVS, Walgreens, and Walmart. Nearly 70% of U.S. counties have at least one permanent drop-off point. You don’t need a prescription or ID. Just bring your meds in their original bottles (no need to remove labels yet), and staff will handle the rest.

Take-back programs collected over 1 million pounds of medication during the October 2024 National Take-Back Day alone. That’s more than 28% higher than the year before. And the success rate? Nearly 99.8% of medications collected are properly destroyed. No chance of reuse. No risk of pollution.

Walmart now has take-back kiosks in all 4,700 of its U.S. pharmacies. CVS has invested $15 million into mail-back and kiosk programs. These aren’t just marketing gimmicks-they’re part of a national effort to cut down on opioid misuse, which contributed to over 13,000 overdose deaths in 2022.

2. Use a Mail-Back Envelope (Great Alternative)

If there’s no take-back site nearby, prepaid mail-back envelopes are the next best option. These are available through pharmacies, insurance providers, or companies like DisposeRx and Sharps Compliance. You fill the envelope with your meds, seal it, and drop it in any mailbox. The company handles everything-shipping, destruction, compliance.

These envelopes cost between $2.15 and $4.75, but many insurers (like Express Scripts) offer them for free to members. In a 2024 survey of 287,000 users, 94.2% said they found the service easy and reliable. Military families using VA-provided mail-back kits showed an 89.2% compliance rate-far higher than those trying to dispose on their own.

Important: The envelope must meet USPS Domestic Mail Manual Section 604.8.0 standards. Not all “pharmaceutical disposal” envelopes do. Check the packaging for compliance labels.

3. Home Disposal (Only If No Other Option)

If you can’t get to a take-back site or mail-back envelope, and the medication isn’t on the FDA Flush List, you can dispose of it at home. But you must do it right.

The FDA’s 5-step home disposal process:

1. Remove personal info. Scratch out your name, prescription number, and pharmacy details with a permanent marker or use an alcohol swab. Don’t just peel off the label-some ink can be recovered.
2. Mix with unpalatable stuff. Use an equal amount (1:1 ratio) of coffee grounds, cat litter, dirt, or even used paper towels. This makes the pills disgusting to animals or people who might dig through the trash.
3. Seal it tightly. Put the mixture in a sealed plastic bag or container. The FDA recommends plastic at least 0.5mm thick. A resealable bag from the grocery store works fine.
4. Put it in the trash. Not the recycling bin. Trash goes to landfills. Recycling plants can’t handle meds.
5. Recycle the empty bottle. Once you’ve removed all personal info, you can recycle the bottle. Most plastic prescription bottles are #1 or #2 plastic and accepted in curbside programs.

Here’s the catch: A 2023 FDA study found that 12.7% of home disposal attempts failed. Why? Most people didn’t mix the meds properly (43.8% of failures) or didn’t seal the container well (37.2%). Liquid medications are especially risky-never pour them down the drain or toss them in the trash without mixing them with absorbent material first.

What Medications Can You Flush?

There’s one exception to the “never flush” rule: the FDA Flush List. This list includes 13 high-risk medications-mostly powerful opioids-that can cause fatal overdoses if found by children, pets, or others.

As of October 2024, the Flush List includes:

• Fentanyl (patches and injections)
• Oxycodone (OxyContin, Percocet)
• Hydrocodone (Vicodin)
• Buprenorphine (Suboxone)
• Meperidine (Demerol)
• Methadone
• Hydromorphone (Dilaudid)
• Tapentadol (Nucynta)
• Alprazolam (Xanax)
• Clonazepam (Klonopin)
• Remifentanil
• Levorphanol
• Phenazepam

Flushing is only recommended if you can’t access a take-back site within 15 miles or 30 minutes. The FDA says flushing these specific drugs prevents immediate harm-even if it causes minimal environmental impact. The EPA still discourages flushing in general, but acknowledges the life-saving benefit for these high-risk drugs.

Important: If your medication isn’t on this list, DO NOT flush it. Flushing non-Flush List meds is illegal for healthcare facilities and contributes to water contamination. The U.S. Geological Survey found pharmaceuticals in 80% of streams tested-but the amount from household flushing is tiny (0.0001% of total contamination). Still, it’s avoidable.

What Not to Do

Here are the most common-and dangerous-mistakes people make:

• Don’t pour liquids down the sink. Even cough syrup or liquid antibiotics can seep into groundwater. Mix them with coffee grounds or cat litter first.
• Don’t just throw pills in the trash. Someone-maybe a child, a pet, or someone looking for drugs-can dig them out.
• Don’t rely on pharmacy leaflets. A 2024 Consumer Reports review found only 72% of pharmacy disposal instructions were accurate. Always check FDA.gov for the latest guidelines.
• Don’t assume “expired” means safe to keep. Many meds lose potency over time, but others (like insulin or epinephrine) can become dangerous. If you’re unsure, ask your pharmacist.

Why This Matters Beyond Your Medicine Cabinet

Proper disposal isn’t just about cleaning out your cabinet. It’s about public safety. A 2024 study in JAMA Internal Medicine found that communities with three or more take-back locations per 100,000 residents saw an 11.2% drop in adolescent opioid misuse. Why? Because fewer pills were sitting around homes.

The DEA found that 42.7% of medications collected in take-back programs were opioids or benzodiazepines-drugs commonly misused. Every pill turned in is one less that could end up in the wrong place.

And environmentally? While flushing contributes minimally to water pollution, the plastic waste from millions of empty bottles and improper disposal containers is growing. The EPA’s 2025 Emerging Contaminants Watch List now includes microplastics from medication packaging. Recycling bottles and using mail-back envelopes reduces that burden.

What’s Changing in 2025

The system is getting better. The DEA plans to expand take-back locations to 20,000 sites by the end of 2025. The EPA has proposed a $37.5 million grant program to help rural areas set up collection points. Walmart and CVS are rolling out more kiosks. And the FDA aims to get 90% of Americans using take-back programs by 2030-up from just 35.7% today.

Meanwhile, mail-back companies like DisposeRx are dominating the market, holding 48% of the share in 2024. They’re making it easier for people in remote areas to participate.

What to Do Right Now

Here’s your action plan:

1. Check your medicine cabinet. Pull out all expired, unused, or unneeded meds.
2. Identify the Flush List drugs. Look for fentanyl, oxycodone, hydrocodone, buprenorphine, etc. If you find any, flush them only if no take-back site is nearby.
3. Find your nearest take-back location. Go to deas takeback site or text your ZIP code to 1-800-882-9539.
4. Use a mail-back envelope if needed. Ask your pharmacy or insurer if they offer one.
5. Dispose of the rest at home, correctly. Mix, seal, trash, recycle the bottle.

It takes less than 10 minutes. And it could save a life.