Kokua Line

By June Watanabe

Sunday, March 16, 2003

Use empty Clorox bottle
to dissolve old medicine

Question: Is there a collection agency or something similar to that for unused medicine? My father recently passed away and has a lot of unused medication, such as Darvocet and cough medicine with codeine. It seems so shameful to just throw them away.

Answer: There is no effort to collect medicine from individuals because it's considered too risky -- there's no way to know under what conditions they have been kept.

"It really is hard for a health-care professional to take a product back from a person who had it stored under their own control and not under professional control, just because you don't know what the temperature, humidity and light conditions were," said John Fleming, an inspector with the state Food & Drug Branch in Honolulu. "You don't know if they've handled the medications properly or not."

There are also questions regarding sanitation and purity.

Those questions may also be raised about unused medications from institutions, where they are supposed to be kept under supervised professional control.

"You would be really hard pressed, given the current climate, to get anybody to take (medications) back," Fleming said. "For a while there, we were even having a hard time getting pharmacies to take things back that they actually dispensed in error because of the appearance of impropriety and potential allegations of fraud."

About two years ago, IPC Pharmacy in Honolulu was convicted of fraud for repackaging returned unused medication. Medicaid law prohibits returning unused medication to a pharmacy.

Fleming also noted there are provisions in the state pharmacy act that deal with returns and, in more general terms, federal provisions "that speak to the issue."

"Basically, anything that doesn't have a known history for storage has by definition been held under conditions which may have included potential for adulteration," he explained.

As for just tossing the unused medications into the trash, Fleming warned that people should "handle prescription vials as being very confidential pieces of information."

"You don't just want to throw the vials in the garbage unless you are comfortable with other people potentially seeing that you're taking different medications."

He added: "That's always an issue we have with facilities and pharmacies -- we make sure that labels are destroyed so nobody can gain information about that person's individual health information."

The other concern is the potential for abuse, so officials recommend rendering any medication, especially narcotics, unusable before discarding them.

One recommendation is to dissolve tablets in an empty Clorox container, Fleming said.

Although some people recommend just flushing medications down the toilet, Fleming and his group cringe at that.

"We have to go back constantly and tell facilities and nursing homes that we really don't want (them) flushing this down the toilet," he said. "It's always hard when you have contradictory information out there."

Meanwhile, his branch is working with the Medicine Bank and Aloha Medical Mission to help reduce waste from nursing homes and intensive-care facilities.

Q: I know that a service animal doesn't have to be certified and that you can train your own dog for your disability, but what if some close friend or family member has a disability and you want to train it for her so she doesn't have to pay thousands of dollars? And what disabilities can a dog help with?

A: The federal rule on service dogs allows for self-trained and/or nonprofessionally trained dogs.

That means basically anyone can train a dog to help a disabled person, whether for a friend or family member.

A service dog has "to be trained, but they don't have to trained through a national establishment," said Francine Wai, executive director of the state Disability and Communication Access Board.

Although guidelines from the federal Americans with Disability Act are very generous in this regard, Wai cautioned that the "dog has to be trained to compensate for the limitations of the (disabled) person."

It can't be just a pet that provides companionship or comfort, she emphasized.

The ADA describes service dogs as "any guide dog, signal dog or other animal individually trained to provide assistance to an individual with a disability."

The most familiar service dogs are "seeing-eye dogs," which are used by the blind. Service dogs also include those that alert people with hearing problems to sounds; pull wheelchairs or carry and pick up things for people with mobility impairments; and assist people with mobility impairments with their balance.


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