Blog Post by Terry Matlen, ADD Consults

This post was developed in collaboration with Adlon Therapeutics L.P, a subsidiary of Purdue Pharma L.P. Personal opinions expressed within this post are my own.

In my work with people who have ADHD, I’m often asked what ADHD medications are best to take. Since I’m not a physician (I’m a clinical social worker/psychotherapist), I’m not trained, licensed, nor ethically able to answer that particular question. Besides, that’s a topic you need to address with your primary care physician or whoever is prescribing your ADHD medications.

But I can talk about a few important related topics in the ADHD literature: how to store and dispose of your stimulant medications safely.

A key healthcare professional who can help you with these decisions is your local pharmacist. They are trained to answer such questions, yet sadly, few of us reach out to seek their professional guidance and recommendations. We tend, instead, to come up with our own solutions and many, if not most, are not safe for us, for those around us, or for our environment.

Let’s take a step back to see how this all starts and then, what you can do about it.

How it all Starts

In working with your healthcare provider, it can take a while to sort out which ADHD medication works best for you or your child. That means, you may have various old containers of prescribed pills around the house that you tried but weren’t right for you. These can add up quickly and lead to potentially dangerous situations.

I recall, years ago, when my daughter was prescribed a new ADHD medication. Her psychiatrist had started her on various trials of different stimulant medications to determine which helped with her symptoms most effectively with a minimum of side effects. It took months- yes, months- of trial and error to find the right medication, including figuring out the proper dosage and the best time of the day to take it. That meant I was left with nearly full bottles of unused pills she’d never need again. Not only was that rough on my pocketbook, but it also created a problem for me: what do I do with all these unused bottles of tablets and capsules? It seemed a shame to waste them- to just toss them in the garbage. Over the weeks and months, and yes…even years, the bottles multiplied; I had a whole stash.

Concerned that I (or later, my daughter) might accidentally grab the wrong bottle and take the wrong pill, I stored these unused bottles on the top shelf of the cabinet, just above the shelf of the medications she was currently taking.

More than once, there was confusion and I’m not proud to admit that it could have had dangerous consequences.

I ended up placing all the unused bottles in an upstairs closet- still, not a great solution, but one that would work for the time being.

As time passed, those shelves began to bulge with bottles and bottles of medications no longer needed. To add to my embarrassment, I must admit that many had expired years earlier. They were useless, but more importantly, potentially dangerous.

With ADHD comes difficulties organizing and often times feelings of overwhelm.[1] I have ADHD as well as my daughter, and I simply didn’t take care of the situation until many years later when I decided to finally clear out and organize that closet.

But I didn’t know what to do with all of those unused, unneeded medications. Do I flush them down the toilet? Toss them in the garbage? What I decided to do was keep them stored in that upstairs closet “for now.” Bad decision.

Danger, Danger!

If you have children, teens, or young adults in your home, you may or may not realize just how dangerous it can be to keep ADHD (and other) medications around with easy access to innocent – and not so innocent- curious hands. Young children love to explore, and those bottles of colorful little tablets and capsules could look like candy.[2] Need I say more?

Children and teens might be curious to see what it feels like to take their siblings’ prescribed stimulant medications. You can see one such scenario here (https://adlontherapeutics.com/supporting-responsible-stimulant-use/morgan/).

We need to understand and accept- and be proactive- that there are teens and young adults who might realize that they could sell prescription drugs for money. Some college students, unfortunately, are searching for performance-enhancing pills to pull all-nighters to study for upcoming exams or to get homework assignments completed in time.

However, prescription stimulants will not help someone succeed academically if they don’t have ADHD.[3] Some colleges and universities even consider misuse of prescription stimulant medication a

violation of the school’s academic honor code or other policies, which could result in penalties such as academic probation, suspension or even expulsion.

And then there could be the casual explorer in the house, searching for a pill to eradicate a bad headache, reaching for pills not meant to be used for that purpose.

Sharing or selling prescription stimulant medications is illegal. Some of the above behaviors could lead to major consequences, including a serious medical reaction, or even accidental overdose and death.[4].5

Remember: prescribed medications should only be taken by the person it was prescribed for – the person whose name is on the bottle.[5]

The Safest Ways to Store your Medications

The safest and best way to store your ADHD medications is by lock and key in a dry, safe, place.2 Did you know that bathrooms are one of the worst places to store your pills? The humidity can create an environment that makes medications lose their potency, which means, you could be taking your prescribed dosage but not getting adequate amounts of active ingredients into your system.[6]

Direct sunlight and moisture can also degrade the quality of your medications, so it’s best to keep them out of those kinds of environments. And don’t forget to keep your pills in their original containers! This keeps the pills safe from environmental factors but also eliminates confusion as to just what pills you’re taking. Storing them in, say, plastic baggies, is just not a good idea (note to self: no more pills in baggies for outings (i.e., picnics, concerts, etc.).6

Here’s a great resource to learn more about how to properly store your ADHD medications: (https://rx-stimulant-safety.everfi-next.net/student/dashboard/prescription-stimulants-safety/adlon-caregivers/2447?locale=en#module-3/module-3-activity/page-4)

How to Dispose of Medications Properly

When I finally got around to de-cluttering that closet, I took all of the unused, unneeded, and expired pills and threw them in an old shopping bag and tossed it in the garbage for pickup. Bad decision! I didn’t realize at the time that someone could be searching through garbage for prescription medications to use or sell illegally.

It wasn’t until I read an article years ago that there are far better and safer ways to dispose of unused medications:

  • Bring the bottles to a DEA “take back” or authorized collection site for this purpose. You can learn more about this at https://takebackday.dea.gov/.[7]
  • Remove the medication from the original container and mix it with something undesirable, like kitty litter or coffee grinds and place the mixture in something you can close (i.e., ziploc baggie, empty can or other container) and throw the container in the trash.
  • Talk to your local pharmacist. Some pharmacies have a mail-back program or disposal kiosk for unused medications.

Remember: we all have to be responsible for our and our children’s prescription medications. Throwing caution to the wind can cause severe physical illness or even death.

To learn more about how to keep your medications safe, check out the excellent information at https://rx-stimulant-safety.everfi-next.net/student/dashboard/prescription-stimulants-safety/adlon-caregivers/2447?locale=en#module-3/module-3-activity/page-1 .

[1] Children and Adults with Attention-Deficit/Hyperactivity Disorder. Diagnosis of ADHD in Adults. https://chadd.org/for-adults/diagnosis-of-adhd-in-adults/

[2] Put Your Medicines Up and Away and Out of Sight | Features | CDC. Centers for Disease Control and Prevention. https://www.cdc.gov/patientsafety/features/medication-storage.html. Published June 17,

2019

[3] US National Library of Medicine, Do college students improve their grades by using prescription stimulants nonmedically?, Accessed January 3, 2020, Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5140739/

[4] NCBI, Prescription Stimulant Misuse, “Where Are We and Where Do We Go From Here?”, Accessed Dec 15, 2018. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5113141/

[5] Prescription for Disaster: How Teens Abuse Medicine.; 2018. https://www.dea.gov/sites/default/files/2018-11/DEA_PrescriptionForDisaster-2018ed_508.pdf. 

[6] National Institute of Health: MedlinePlus. Storing Your Medicines. https://medlineplus.gov/ency/patientinstructions/000534.htm#:~:text=Store%20your%20medicines%20in%20a,medicine%20in%20a%20bathroom%20cabinet.

[7] How to Dispose of Unused Medicines. U.S. Food and Drug Administration.  https://www.fda.gov/consumers/consumer-updates/where-and-how-dispose-unused-medicines.