Features  |   April 2018
Disposal and Treatment of Controlled Substances From the O.R.
Author Affiliations
  • Diane Gordon, M.D.
    ASA Task Force on Environmental Sustainability
  • Sean Michael McGarry, M.D.
    ASA Task Force on Environmental Sustainability
Article Information
Central and Peripheral Nervous Systems / Infectious Disease / Pain Medicine / Patient Safety / Pediatric Anesthesia / Pharmacology / Technology / Equipment / Monitoring / Features
Features   |   April 2018
Disposal and Treatment of Controlled Substances From the O.R.
ASA Monitor 4 2018, Vol.82, 18-21.
ASA Monitor 4 2018, Vol.82, 18-21.
Environmental contamination by pharmaceuticals is well-documented worldwide.16 The environmental burden of apharmaceutical generally correlates with the amount that isdispensed, and therefore the most commonly utilized medications (birth control, antihypertensives, antibiotics, antiepileptics, mood stabilizers and over-the-counter analgesics) are those most frequently found in the environment.3  Propofol is the medication most frequently wasted in the O.R. by volume,7  and although it is not currently regulated by the Drug Enforcement Administration (DEA), it was recommended by the DEA in 2010 to be added as a schedule IV drug like fospropofol.8  Propofol has been treated as a controlled substance in Alabama, Georgia and North Dakota as well as by certain health care systems. Midazolam, acetaminophen-codeine and fentanyl contributed nearly 90 percent by weight to the total controlled drug waste from two hospitals in one study.9  Proper disposal of controlled substances, including propofol, would prevent both environmental contamination as well as unlawful diversion.
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