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Archive November 2019 XX, No. 11

Smarter Hazardous Waste Disposal

There are safer, more economic ways to get rid of medications, sharps and fluid runoff.

Adam Taylor


Kimberly New, JD, BSN, RN
REMOVING TEMPTATION Medication disposal systems are simple, such as this jug that has a carbon mix in it, but effective, as they render controlled substances inactive and pointless to try to divert.

The surgical nurse had a substance use disorder, went to rehab for treatment and was in long-term recovery. All seemed well, but she was surrounded by temptation when she returned to work in the OR.

“Seeing wide-open medication waste containers with syringes that still had fentanyl in them was too much for her to resist,” says Kimberly New, JD, BSN, RN, founder of Diversion Specialists, a medication security consulting firm in Nashville, Tenn.

The nurse relapsed and ultimately lost her nursing license. Her method of diversion was simple: She went into trash cans and open sharps containers to retrieve discarded syringes that contained a few precious drops of fentanyl.

“People [with drug abuse problems] will go to any lengths to divert,” says Ms. New. “With the kinds of drugs, the quantities of the substances and the pace of the work in a surgical setting, you need to have a disposal device that reduces the risk of diversion close to where staff are working, so they can immediately discard controlled substances.”

Drug disposal devices that prevent diversion are much more common than they were even a couple of years ago. Some of the devices are plugged into a power source, and some need water added to them, but most operate the same way: Armed with a one-way funnel, the devices contain a carbon-based mix that absorbs contents deposited from syringes, vials and IV bags, deactivating the substances and making them non-retrievable for use. Even though the devices render substances unusable, some manufacturers add ipecac syrup to induce vomiting in the event someone breaks into the device and drinks the discarded medications.

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