When you’re administering an estate, leftover prescription drugs and other medicines in the decedent’s home are more than “household clutter.” They can create safety risks (poisoning, accidental ingestion, diversion/misuse) and environmental risks if disposed of improperly. The executor’s goal is to secure the medications, document what was present, and then dispose of them using community-approved channels—ideally through take-back programs—while protecting private health information.

Step 1: Secure, inventory, and separate

As soon as possible, gather all medicines in the home—prescriptions, over-the-counter drugs, liquids, creams, inhalers, patches, and supplements—into one secure area that only the executor (or a trusted agent) controls. Consider a brief inventory (photos + a simple list) to show what existed and what was removed, especially when there are controlled substances. Keep medications in their original containers until disposal to preserve identifying information for your log and to avoid mistakes.

Step 2: Use “take-back” as the first choice

The EPA’s guidance emphasizes drug take-back events/programs as the preferred option for disposing of unwanted prescription and over-the-counter drugs. Specifically, the EPA recommends calling your city or county government’s household trash and recycling service to ask whether a take-back program is available locally; some counties also accept medicines at household hazardous waste collection days for proper disposal.

From an executor’s perspective, this is typically the cleanest solution: you drop the medications at an authorized collection site/event, and the program handles downstream compliance and destruction.

Practical county-level places to start include:

• County solid waste/trash & recycling department (often the “front door” for take-back info)
• Household Hazardous Waste (HHW) program/facility or HHW collection events
• Sheriff’s office / police department drop boxes (common partners for take-back events)

Names will vary by county.  See extended list of suggested resources below: “Common resources, departments at the local level”

Step 3: If take-back isn’t available, follow household disposal steps

If your county confirms there’s no take-back option available, the EPA sheet provides a clear “household disposal” method (sourced to national drug disposal guidelines). The key points are:

• Don’t flush expired or unwanted prescription/OTC drugs unless the label or accompanying patient information specifically instructs flushing.
• Do remove medications from their original containers, mix them with an undesirable substance (e.g., used coffee grounds or cat litter), place the mixture in a sealed disposable container or bag, and then place that sealed container in the trash.
• Before discarding empty pill bottles/packaging, conceal or remove personal information (including Rx numbers) by using permanent marker, duct tape, or by scratching it off.

This approach reduces the likelihood of diversion while also limiting environmental release from drain disposal.

Why the “don’t flush” rule matters for estates

Executors are often tempted to “flush and forget,” especially when dealing with a large volume of medications. The EPA explains why that can be a problem: in homes with septic systems, drugs flushed down the toilet can leach into the ground and seep into groundwater. In homes connected to wastewater treatment plants, drugs poured down the sink or flushed can pass through the treatment system and enter rivers and lakes, potentially flowing downstream into sources of community drinking water. Importantly, the EPA notes that water treatment plants are generally not equipped to routinely remove medicines.

In other words: improper disposal is not just a household risk—it can become a community water quality issue.

Handling sharps and other medical supplies in the home

While the EPA sheet, How to Dispose of Medicines Properly, focuses on medicine disposal, estates often involve needles/syringes, lancets, and other “sharps.” Treat these separately: place sharps in a puncture-resistant container with a tight lid, label it, and follow your county HHW or solid waste guidance for sharps disposal. (Many counties have specific sharps rules distinct from medication drop-off.)

Executor best practices: minimize liability and protect privacy

• Restrict access until disposal is complete (especially controlled substances).
• Document disposal (brief log + photos; keep any receipts from drop sites/events).
• Remove identifying info from packaging you discard (names, Rx numbers, pharmacy info).

Common resources, departments at the local level

The department or resources differ from county to county across the United States.  Here are some possibilities to reference for guidance on disposal of prescription medicine in your county.
Names may differ county to county.

• County Department of Public Health / Public Health Division
        Usually the best first call. They can tell you local rules (trash vs. take-back), identify drop boxes, and point you to approved sharps disposal options.
• County Environmental Health (often within Public Health)
        Handles “household hazardous waste” guidance, medical waste questions, and proper disposal for items like sharps, mercury thermometers, oxygen tanks, and certain chemicals.
• County Solid Waste / Waste Management Department
        Can confirm what’s allowed in curbside trash, where to bring unwanted medicines, and whether the county partners with take-back kiosks or special collection days.
• County Household Hazardous Waste (HHW) Program / HHW Facility
        Many counties run an HHW site or events that accept pharmaceuticals (policies vary). They’ll also explain how to package items for drop-off.
• County Sheriff’s Office (Community Programs Unit) or Local Police Department
        Common host for secure medication drop boxes and National Prescription Drug Take Back Day events; can advise on controlled substances disposal.
• County Aging Services / Office on Aging / Elder Services
        Often has caregiver and executor-facing guides, and can refer you to local take-back locations or home clean-out resources.
• County Medical Examiner / Coroner’s Office (informational guidance)
        Not always involved, but they can sometimes direct you to local protocols when deaths involve controlled substances or when families ask about safe handling.
• County Emergency Management / Local Harm Reduction or Overdose Prevention Programs
        In some counties these teams distribute safe storage/disposal information, and may know where drop boxes and take-back events are scheduled.
• County 311 / Citizen Services Call Center (or county information line)
        If your county has a central help line, it’s a fast way to get routed to the correct department and learn about local drop sites.
• County Social Services / Human Services (general referral)
        May not manage disposal directly, but can connect executors to community partners (public health, law enforcement, senior services) with the right disposal channels.

Reference

United States Environmental Protection Agency (EPA), Office of Water, “How to Dispose of Medicines Properly” (EPA 816-F-11-003, April 2011).

 

See Also:

Unused Medical Supplies and Equipment: National Council on Aging Guide

Guide to Donation of Personal Medical Equipment

Guide to Donation of Prosthetic Equipment