A New Use For Puppy Litter

Q:  What’s the best way to dispose of my old medicines? My neighbor says to just flush them down the toilet but if I do that, won’t they end up in the water supply?
– Afraid to Flush

Given enough time, pills get crumbly and liquids and capsules lose their potency. It’s a good idea to sort through your medicine cabinet and remove any unused or expired prescriptions. Family members and intruders will often check your bathroom medicine cabinets, looking for medicines they can use or sell. The best way to remove medicines from your home AND protect the environment is to take them to a take-back event or medication disposal site in your community. If you can’t find one nearby, you can also dispose of them at home with just a couple of extra steps before you put them in the trash.

There’s a big take-back event coming up soon: the 8th National Prescription Drug Take-Back Day will be taking place in communities across the nation on Saturday, April 26, 2014 from 10 am to 2 pm.  It’s a partnership between the federal Drug Enforcement Administration (DEA) and local law enforcement agencies with  participating sites all across the country willing to accept your medicines for disposal, with no fees or questions asked.

The DEA launched its first Take-Back event in September 2010 for two main reasons: to give Americans a more environmentally responsible way to dispose of their old medicines than flushing them down the toilet into the water supply, and to provide a more secure way to discard prescription drugs besides just pitching them into the trash.
The last National Prescription Drug Take-Back event in October 2013 collected 647,211 pounds (324 tons) of expired and unwanted medications at 5,683 take-back sites for disposal. In Washington State alone, people turned in 14,508 lb of prescriptions at 86 sites. When added together, the past seven National Prescription Drug Take-Back events have removed over 3.4 million pounds (1,733 tons) of unwanted medicines from medicine cabinets, bedside tables and kitchen drawers.

Prescription drug take-back events are so popular that some communities host local events several times during the year. Some pharmacies also offer year-round disposal of expired or outdated prescriptions.

Potent pain medicines like hydrocodone, oxycodone, OxyContin®, methadone, and fentanyl (Duragesic®) pain patches are a special concern. They should NEVER, ever be placed in your trash. In fact, the Federal Drug Administration advises that if you cannot find a take-back or secure disposal site in your community, you should remove these potent pills and patches from their original containers and then flush them down the toilet. Please be careful when disposing of them. Because they’re so potent, just one dose, one pill or even just sucking on a pain patch can be deadly to a pet or small child.

Here’s How to Safely Dispose of Your Unwanted or Expired Medicine:

1.  Take Your Expired or Unwanted Medicines to a Take-Back Event or Location.
Take your old medicines to collection site in your community during a prescription drug take-back day, such as the upcoming 8th National Prescription Drug Take-Back Day on Saturday, April 26 from 10 am to 2 pm. To find out where the nearest participating location is, go to http://www.deadiversion.usdoj.gov/drug_disposal/takeback. You can also call 1-800-882-9539. As an alternative, check with your local community pharmacy for other drug disposal sites and services.

2. Go Ahead and Flush the Dangerous Ones.
Although the FDA recommends that most prescription medicines should NOT be flushed down the toilet, they make an exception for potent pain medicines like hydrocodone, oxycodone, hydromorphone and fentanyl. First, remove them from their original containers and then flush them down the toilet. After peeling off a pain patch, carefully close it up by folding the sticky sides together to prevent a child or animal from danger should they touch it or put it in their mouth.

3. If You Must Put Them in the Trash, Do This FIRST:
Open your prescription bottles and dump out the pills, mixing them in with kitty litter or used coffee grounds in a container with a secure lid before placing them in your trash.  At my house we call it “puppy litter” because our puppy Clancy uses a litter box.

4. Protect Your Personal Information.
To protect your privacy, use a black marker such as a Sharpie® to mark out any identifying information such as your name, prescription number and the drug name before putting your empty used prescription bottles into the trash.

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Bag Balm® For Your Tongue?

Dear Dr. Louise,

I am suffering from an ulcer on my tongue due to a temporary crown.  It probably would have healed by now but for having an extraction on the other side of my mouth, so I keep chewing on the side of the ulcer. I’ve tried several products without much success and I wondered if it was safe to put Bag Balm® on my tongue, which means I will inevitably swallow some of it. I know folks put it on their lips, but that isn’t quite the same of course. If Bag Balm® isn’t a good choice, what would you suggest? –Hole In My Tongue

Dear Hole In My Tongue:

There are several non-prescription remedies that can help protect the bitten area of your tongue and give it a chance to heal up. If you have already tried one of these and your tongue still has the ulcer 2 weeks later, that’s NOT normal. Please go back to your dentist or doctor and have them take a look at it.

Most of the time, having ulcers in your mouth is annoying and very uncomfortable but not serious. We don’t really know exactly why some people suffer from mouth ulcers, especially those unfortunate souls who have them frequently. Called canker sores or apthous ulcers, they show up as small but painful craters creating discomfort or a burning sensation when you eat or drink hot or spicy foods and liquids. Apthous ulcers can be caused by stress or provoked by injury, like biting the inside of your cheek, wearing braces that rub or poke, or getting carried away with enthusiasm when brushing your teeth.

The main goal of treating apthous ulcers is to protect that tender spot of raw tissue from poking at it with your tongue or bumping it while brushing or flossing your teeth, so you can eat and drink without experiencing excruciating pain. Several years ago I had several ulcers on the roof of my mouth, and whenever I took a sip of water or tried to eat anything, the result was pain that triggered a flood of tears. I not only had second thoughts about eating or drinking, I had fourth, even fifth thoughts:  “Do I REALLY want that sip of water? Is it worth the pain?”

About using Bag Balm® on your tongue, well, it won’t hurt you, but it probably won’t do much to protect that raw spot from the abrasion of chewing or the irritation of having hot foods or liquids in your mouth.

There are products you can use to just want to numb that spot, some that will protect it by covering it, and some that will both numb and protect it at the same time. Which you use depends on what you want to do.

To numb it, the best choice is benzocaine, an effective local anesthetic that is available as both 10% and 20% concentrations. Camphor, menthol and phenol can also help decrease the discomfort, but are not as effective as benzocaine. To protect the ulcer, there are pastes and sticky films that coat the ulcerated spot. If you accidently bite it, though, THAT will still hurt!

The 2 top pharmacist-recommended products for canker sores are ones I have used personally: Orajel® Mouth Sore Gel, a pleasant flavored gel that numbs quickly, and Colgate OraBase® 20% Benzocaine, a sticky paste that numbs and protects.

Orajel® Mouth Sore Gel has 20% benzocaine for pain relief. It doesn’t taste bad; it numbs the area pretty well and doesn’t get washed away by your saliva as quickly as a liquid.

If you accidently bite the inside of your cheek and create a painful hole, I recommend using Colgate OraBase® 20% Benzocaine. You dab the thick paste on the ulcer or sore spot, and it works as a bandage to protect it while also numbing it.  Be careful to dab in on; if you swirl it, it changes to a gritty texture that feels weird.

If you are allergic to benzocaine you can try Campho-Phenique®, which contains camphor and phenol, or a plain version of Colgate OraBase® that doesn’t contain benzocaine. Whichever product you choose, if your ulcer doesn’t go away within 2 weeks see your dentist or doctor to get it looked at. Two years ago I had a canker sore that did NOT go away in 2 weeks. Instead, it ended up being the first sign of something more serious. I’m really glad I got it checked out!

You can find more non-prescription products recommended by pharmacists at www.otcguide.net.

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