Patterns of Usage, Disposal, and Environmental Impact of Expired Medications: A Cross-Sectional Analysis

Abstract

Expired medications, when misused or improperly disposed of, pose significant risks to human health and the environment. This study investigates the storage, usage, and disposal patterns of expired drugs among 122 participants and evaluates the chemical stability and microbiological safety of selected medications beyond their expiration dates. Survey data revealed inadequate awareness of proper disposal methods, with 72.28% of participants discarding expired drugs in regular trash. Laboratory analysis demonstrated significant declines in chemical potency and antimicrobial activity in expired pharmaceuticals, highlighting potential contributions to therapeutic failure and antimicrobial resistance. These findings underscore the urgent need for public education campaigns, pharmaceutical take-back programs, and stricter regulatory frameworks to mitigate health and environmental risks.

Keywords

Introduction

Medications are formulated with a specific shelf life, ensuring their efficacy, safety, and stability within the stated period [1]. However, the misuse and improper disposal of expired medications have emerged as global challenges, particularly in developing countries. Expired medications not only lose their therapeutic value but may also contribute to adverse drug reactions, microbial resistance, and environmental toxicity [2, 3].

The problem is compounded by the lack of public awareness and infrastructure for proper drug disposal. A significant proportion of expired medications end up in landfills, water bodies, or are consumed beyond their expiration date, leading to serious public health and environmental consequences [4].

This study aims to bridge gaps in understanding the behavior surrounding expired medications by:

1.   Assessing storage, usage, and disposal practices among individuals.

2.   Evaluating the chemical stability and microbiological activity of expired medications.

3.   Analyzing environmental implications of improper disposal.

2. Objectives

1.   To assess public awareness and practices related to expired medications.

2.   To evaluate the chemical and microbiological stability of selected expired pharmaceuticals.

3.   To examine the environmental consequences of improper disposal practices.

3. MATERIALS AND METHODS

Study Design:

A cross-sectional study was conducted combining survey data from participants and laboratory analysis of expired medications.

Sample Size and Population:

The survey involved 122 participants from diverse demographic backgrounds. Laboratory testing was performed on widely used drug categories, including NSAIDs, antibiotics, and topical formulations.

Data Collection:

1.   A structured questionnaire was used to gather data on storage, usage, and disposal practices.

2.   Laboratory analyses included accelerated stability testing, UV spectrophotometry, and microbiological assays to evaluate potency and microbial resistance.

Ethical Considerations:

Ethical approval was obtained prior to the study, and informed consent was secured from all participants.

4. Results

4.1 Storage and Usage Patterns

•     16% of participants stored expired medications, primarily citing convenience or lack of awareness.

•     23?mitted to using expired drugs, including NSAIDs (11 cases), antibiotics (4 cases), and topicals (8 cases).

•     Expired medications were used up to 24 months post-expiry.

4.2 Disposal Practices

•     72.28% of participants discarded expired medications in regular trash.

•     12% flushed liquid medications into sinks.

•     16% stored unused expired drugs, often mixing them with active medications.

4.3 Stability and Efficacy of Expired Medications

•     Chemical Potency:

•     NSAIDs like ibuprofen retained 55% potency 12 months post-expiration, but this dropped to negligible levels by 24 months [5].

•     Antibiotics showed reduced antimicrobial activity, with expired ampicillin exhibiting only 30% of its original efficacy.

•     Microbiological Safety:

•     Staphylococcus aureus and Pseudomonas aeruginosa cultures exhibited resistance when treated with expired antibiotics, raising concerns about antimicrobial resistance development [6].

4.4 Environmental Impact

Improper disposal practices contribute to soil and water contamination, as well as toxic effects on flora, fauna, and marine ecosystems [7].

5. DISCUSSION

This study highlights the alarming frequency of improper storage, usage, and disposal of expired medications. Public unawareness, combined with insufficient disposal infrastructure, exacerbates health and environmental risks.

Implications:

1.   Health Risks: Reduced chemical potency of expired drugs can result in therapeutic failure, while improper antibiotic disposal may accelerate antimicrobial resistance [8].

2.   Environmental Consequences: Active pharmaceutical ingredients (APIs) leached into water systems can disrupt aquatic ecosystems and bioaccumulate in organisms [9].

Recommendations:

1.   Public education campaigns should focus on safe drug disposal methods and the risks of expired drug use.

2.   Implementation of pharmaceutical take-back programs and incentivized disposal systems.

3.   Strengthening regulatory frameworks for pharmaceutical waste management.

6. CONCLUSION

Expired medications represent a dual threat to public health and the environment. This study underscores the critical need for public awareness, robust pharmaceutical waste management policies, and further research into the long-term environmental impact of pharmaceutical contaminants.

REFERENCES

1. U.S. Food and Drug Administration. Expiration dating of drugs. FDA Guidelines, 2022.
2. International Journal of Pharmaceutical Sciences Review and Research, Vol. 15, Oct. 2022.
3. Journal of Applied Pharmaceutical Science, Vol. 13.
4. Van Heugten, J. Stability and efficacy studies of expired drugs. Utrecht Institute of Pharmaceutical Science, 2021.
5. Armed Forces Medical Journal, Accelerated stability test results of NSAIDs. PMID: 36147412.
6. Research in Biotechnology, Microbial activity in expired antibiotics. Vol. 10, 2023.
7. International Environmental Health Review, Impacts of improper pharmaceutical disposal. Vol. 7, 2022.
8. World Health Organization. Antimicrobial resistance: A global concern. WHO Report, 2022.
9. Environmental Protection Agency. Pharmaceuticals in the environment. EPA Guidelines, 2021.