Don't bother donating expired drugs

Until recently, my practice donated expired drug samples to the headquarters of International Aid, a Christian relief and development agency based in our area. As the medications expired, we'd box them up, and then Carol, a patient of mine who was an IA volunteer, would pick up the boxes and deliver them to the agency. After each of her trips, I received a warm thank you from the agency's director, who described the good our donations were doing.

The idea for the project had grown out of an article I'd read in The Medical Letter on Drugs and Therapeutics, a nonprofit, peer-reviewed publication that offers critical evaluations of prescription drugs. In response to reader queries about the safety of using medications past their expiration dates, The Medical Letter article argued that most prescription drugs could be used as long as five years after their expiration dates if they'd been properly stored. Many of these medications retain at least 90 percent of their potency for 60 months after they've officially expired. (Among the major exceptions are syrups and suspensions, which tend to break down after their expiration.)

From a potential liability standpoint, I hadn't felt comfortable giving out expired samples to most of my patients, although some especially cash-strapped ones gratefully accepted them. But I did feel justified giving the samples to International Aid. Indeed, why waste all that perfectly good medicine?

But wasn't International Aid gratefully accepting my donations? I asked my office nurse to call the agency to find out what was going on.

After a few days and repeated tries, a reluctant staffer finally told her that IA had been discarding our donations. "And why didn't you tell us the drugs were of no use to you?" my nurse asked. "We didn't want to hurt your feelings," the IA staffer had sheepishly replied.

I felt ridiculous. After donating to IA, I'd felt justified for the first time in accepting all kinds of samples from drug reps, including ones I seldom prescribed. If they expired, I knew they wouldn't end up as an expensive heap of trash-they'd be put to good use.

Now I know better. And if you've read this far, so do you.