Common sense (or lack of ) on expired medication

(Last June 23, the British people voted to leave the European Union after being a member for more than 40 years, which is historic and has implications in the world politically, economically and socio-culturally. The 2016 Euro Football is on and the excitement will surely go beyond the finals on July 10. Ten percent of Island’s population of about 330,000 are currently in France cheering for their national team. However, neither is the subject of my July article).

There were more rainy than sunny days in my region last month. As in previous spring months, I took the pleasure organising not only my wardrobe but cabinets and cupboards. I was heartbroken putting outdated medicines in a paper bag. I thought of bringing these to the chemist (UK)/pharmacy (US) on my way to work, but the queue was half a kilometre long and my bus was about 5 minutes from departing, so I ended up bringing this with me to a nearby country (where I work) that does not legally obliged chemists to take unwanted or expired medicines.

Arriving in the classroom, the first thing I did was to ask my students if they knew of the nearby chemist that accept expired drugs. Co-incidentally, one of them actually took an expired aspirin that morning and she said that she had done this before and it was effective in getting rid of her headache.
The other two students asked me if we can still consume drugs after their use-by date. The Harvard Medical School has reported Psychopharmacology Today’s advice that a drug is absolutely 100% effective even when the expiration date has passed a few years.

According to Psychopharmacology Today, most of what is known about drug expiration dates comes from a study conducted by the US Food and Drug Administration for the military, and this study found that 90% of more than 100 drugs (both prescription and over-the-counter) were perfectly good to use even after 15 years of its expiration date (except nitro-glycerine, insulin and liquid antibiotics), and placing a medication in a cool place (such as a refrigerator) will help drugs remain potent for many years.

(Do you wonder about the role of manufacturers and those in the market chain regarding the use-by or expiration date?)

Experts maintain that use-by or expiration date is an easiest and most conservative way of ensuring the safest way of selling and consuming medicines and food. Generally, current informed opinion is that most drugs are classified as out-of-dated two years after their manufacture and this expiration date is only valid for unopened product. There are ample write-ups on this topic, such as the one published in http://www.emedexpert.com/tips/expired-meds.shtml that says contrary to common belief, there is little scientific evidence that expired drugs are toxic. “There are virtually no reports of toxicity from degradation products of outdated drugs.”

It’s in developed countries that reimburse medication as part of their social security and health systems where unused and expired medicines are in abundance. In the Third World, where treatment is not subsidised or/and reimbursed by the State and quite expensive, medicines are bought only when in dire need and on limited quantity.

This is what I said to my students: “I’d take expired medication for a minor ill-health, like hay fever (which I’ve at the moment) or headache. However, I’ll definitely not take it for a chronic and potentially life-threatening disease, e.g. seizure or heart problems.”

If expired drugs are safe for human consumption, why not donate these to charities at home and abroad? It’s not that simple. The World Health Organisation (WHO) and some individuals and associations are against the donation of expired medicines because they believe that there shouldn’t be a double standard when it comes to donation, i.e. if the quality of an item is unacceptable in the donour country, it is also unacceptable in the receiving nation as outlined in the Guidelines for Medicine Donations Revised 2010. (http://www.who.int/hac/techguidance/guidelines_for_drug_donations).

If in doubt, just bring your expired drugs and medicines to your local chemist/pharmacy. If your local chemist doesn’t accept this, ask him/her if s/he knows one that does this (i.e. sorts and stores them in specific boxes to donate to charities and NGOs, and/or deposits unsuitable drugs on sites with approved incinerator where these are burned at 1200°C to avoid the risk of pollution or reuse).

We should never throw expired medicines in a bin at home (as I was about to do due to laziness), sink, toilet or elsewhere because traces of these will likely to end up in our groundwater and agricultural fields endangering our environment and health.