Pharmaceuticals- Defense Centers for Public Health

Pharmaceutical Waste Management Training

This live virtual training course provides an overview of the requirements to manage pharmaceutical wastes in a pharmacy, medical treatment facility, or veterinary clinic setting. Topics include identification of hazardous waste pharmaceuticals, categories of hazardous drugs requiring special handling, and controlled substances. The course will cover the proper storage, labelling, transport, and disposal options for different types of waste pharmaceuticals, including waste containers and loose pills. For more information and to enroll go here: https://phc.amedd.army.mil/Pages/CourseDetails.aspx?CourseID=157

Pharmaceutical Formulary Review

Pharmaceutical disposal can be more than a bit confusing due to the different Federal and state laws. Utilizing a reverse distributor handles most pharmaceuticals. However, this process is not a one size fits all solution. The Military Item Disposal Instruction (MIDI) Team can help by:

An in depth review of all of the items in your formulary to determine disposal method.
You will receive an easy to use spread sheet with disposal information.
Onsite visit if necessary, to inventory all drugs in the formulary.

Free of charge for all DOD units.

Fact Sheets and Technical Information Papers

Waste Management Branch specialists prepare Fact Sheets and Information Papers based on customer requests and assistance visit trends analysis.

For Consumers

Disposal of U.S. Household Waste Pharmaceuticals: Provides disposal options for unneeded or expired medications generated in the home.

For Retail Facilities

CONUS Management of Pharmaceutical Wastage Containers: Provides healthcare facilities with information on commercially available container systems for collecting their pharmaceutical wastage – partial amounts of controlled substances remaining after having been dispensed to a patient.

For Healthcare and Research Facilities

Hazardous Waste Turn-ins from Off-Post Clinics: Provides basic information on regulatory requirements for turning in hazardous waste from clinics not located on military installations.
Management of Acute (P-Listed) Pharmaceutical Containers: Summarizes the hazardous waste (HW) standards for management of empty containers that held an acute HW (P-listed) pharmaceutical, to include any remaining residues. Standards vary depending on whether a state adopted the EPA HW Pharmaceuticals Rule (40 CFR 266 Subpart P).
Controlled Substances Disposal at Veterinary Treatment Facilities: Provides disposal guidance on U.S. Drug Enforcement Administration controlled substances generated at military Veterinary Treatment Facilities.
New Management Standards for Hazardous Waste Pharmaceuticals: Provides extensive information on the 2019 EPA rule for managing hazardous waste pharmaceuticals such as collecting, labeling, storing, reverse distribution and permissible returns, waste residues, and prohibited sewer disposal.
Waste Management of Hazardous Drugs: Disposal guidance for NIOSH listed Hazardous Drugs (HDs) used in military healthcare and research facilities.
Management of Pharmaceutical Wastage: Disposal guidance for DEA-controlled substances wastage – the amounts remaining after having been dispensed to a patient in a healthcare facility.
Management of Used and Unused Insulin: Disposal guidance for containers of used and unused insulin (pens, syringes, vials, IV bags and tubing) at a healthcare facility, which may be D024 hazardous wastes due to the preservative m-cresol.
Waste Characterization of Used Silver Nitrate Applicator Sticks: Provides hazardous waste and medical waste disposal guidance for used silver nitrate sticks generated from healthcare/veterinary facilities.
Medicinal Nitroglycerin Management: Provides disposal guidance for medicinal nitroglycerin generated at healthcare facilities, including its exemption as a federal hazardous waste and where state disposal guidance may differ.
Silver Nitrate Applicator Disposal: Provides details and disposal guidance to healthcare/veterinary facilities on the use, composition, and waste classification of used and unused silver nitrate sticks.
Safe Handling of Hazardous Drugs Hazard Communication: Guidance for the safe handling of NIOSH Hazardous Drugs in health care settings.
Procedures for Cleaning up Hazardous Drug Spills and Leaks: Provides instructions for cleaning up spills and leaks of NIOSH hazardous drugs at healthcare facilities.
Hazardous Waste Characterization of Dietary Supplements: Provides military healthcare facilities, commissaries, exchanges, and other on-post retailers with information for determining whether dietary supplements contain heavy metals (e.g., chromium and selenium) in elevated concentrations that meet hazardous waste criteria when disposed.
CONUS Management of Pharmaceutical Wastage Containers: Provides healthcare facilities with information on commercially available container systems for collecting their pharmaceutical wastage – partial amounts of controlled substances remaining after having been dispensed to a patient.

Additional Resources

Consumer Information

For Consumers Only: How to Dispose of Unused Medicines FDA guidance on disposing of unused medications generated in the home. Not applicable to medications generated in healthcare facilities.

DOD Resource

Military Health System - Beneficiary Drug take Back Program Describes the Military Health System Drug Take Back program pharmacies are required to implement to help beneficiaries properly dispose of their prescriptions and over-the-counter medications.

Federal Regulatory Resources

DEA Controlled Substance Public Disposal Locations DEA search tool to find local authorized collectors who provide year round drop off locations to the public to dispose of unwanted pharmaceuticals. Search by zip code or city/state.
Title 21 Code of Federal Regulations, Part 1317, Controlled Substances Disposal DEA regulations on disposal of controlled substances.
FDA Home Pharmaceutical Disposal Guidance FDA guidance to the public on disposal options for unused medications generated in the home. This guidance does not apply to medications generated in healthcare facilities.
Map of where the new EPA Management Standards for Hazardous Waste Pharmaceuticals are in Effect Maps and tables tracking state adoptions of the EPA Hazardous Waste Pharmaceuticals Rule and the Amendment to the P075 Listing for Nicotine, including links to each state’s hazardous waste laws.
EPA Letter to Law Enforcement: Management of Household Pharmaceuticals Collected by Law Enforcement during Take-Back Events and Programs The 2018 EPA letter supporting law enforcement efforts to collect unwanted household drugs during take-back events and from collection points. Details options to manage and dispose of the collected pharmaceuticals safely.
DOT Special Permit 20255 for Commercial Transportation of MEDSAFE Liners The 2019 DOT special permit allowing military healthcare facilities to ship the contents of MedSafe pharmaceutical collection containers by a contract carrier for disposal. The permit guidelines include packaging and marking requirements, and the need to maintain a copy of the permit on-site.
DOT Special Permit 20255 for Sharps Compliance, Inc. The DOT special permit authorization renewal, valid through 2024, specifically for the company that sells and manages the MedSafe medication disposal system.

Pharmaceuticals

​​​​​​​​​​Pharmaceutical Waste Management Training

​Pharmaceutical Formulary Review

Fact Sheets and Technical Information Papers

For Consumers​​

For Retail Facilities​

​For Healthcare and Research Facilities