The lack of regulatory direction for wasting controlled substances has been a source of significant confusion in pharmacy and has resulted in a variety of waste practices being undertaken. While the DEA requires controlled substances to be rendered unrecoverable, they do not specify the methods to meet this definition. Historically, many facilities have taken the path of least resistance and wasted these products via the sewer. However, before sewering any pharmaceutical waste, you must first contact your water treatment facility and determine whether they will permit these products to be drain disposed.

Of course, preventing waste in the first place through strategic purchasing planning is the best approach. For example, if anesthesiology is generally using 3 mg vials of morphine sulfate, avoid ordering a larger size and creating waste. The cost to manage pharmaceutical waste should be included as part of any purchasing decision, thus making the purchase of smaller vials, which result in less waste the most cost-efficient choice over the long-term.

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Morphine Sulfate Waste Disposal Methods
Over the past year there has been a change in disposal methods for morphine sulfate waste practices. Fewer facilities are using the regular trash, red sharps bins, or yellow chemotherapy-hazardous bins to dispose of this waste. Use of RCRA-hazardous containers and the sewer are increasing, however. RCRA-hazardous containers are used by 14% of facilities, up from 11% last year. The most common disposal method is the sewer at 44% of facilities, up from 39% a year ago. The red sharps bin is the second most common disposal method.

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Chloral Hydrate Waste Disposal Methods
Disposal trends are similar for chloral hydrate waste. Fewer facilities are using the regular trash, red sharps bin, or yellow chemotherapy-hazardous bin to dispose of this waste. Rather, more facilities are moving toward disposing of this waste in RCRA-hazardous containers; currently 35% of facilities take this approach versus 21% a year ago. Disposal via the sewer is also increasingly common; 23% of facilities are now taking this approach versus 19% in the previous year.

Because chloral hydrate is U-listed and a controlled substance there has been some confusion surrounding waste practices for this product. The best approach is to only dispense chloral hydrate in patient-specific oral syringes, rather than in cups, thus reducing the amount of waste to be managed.

Deanne Halvorsen is the editorial director for Pharmacy Purchasing & Products.