What to Do With Medications After Someone Dies (Hospice Drugs Too)

When someone dies at home, a good first move with their leftover medications is to ask the hospice about its disposal policy, then get opioids to a drug take-back site or the police. Working out what to do with medications after someone dies is one more task landing on you at a hard time, and the first part is simple: keep the medicines together somewhere secure. Federal law lets a hospice's trained staff destroy controlled drugs in the home after a death, but only where state law allows it, so the answer depends on the hospice.1,2

In This Guide

• Key Takeaways
• What to Do With Medications After Someone Dies, Step by Step
• If Your Parent Was on Hospice
• Opioids and Other Controlled Drugs: Who Can Take Them
• How to Find a Drug Take-Back Location
• When There's No Take-Back Option: The FDA Flush List
• Everything Else: How to Throw Medicines Away Safely
• Which Option Fits Which Medicine
• Frequently Asked Questions
• Learn More

What to Do With Medications After Someone Dies, Step by Step

You don't have to sort the whole medicine cabinet today. What matters first is that strong painkillers aren't left where a visitor, a grandchild or a pet could reach them. GAO has reported that hospice patients who die at home often leave behind unused controlled substances that can be diverted and misused by anyone with access to them.2

Here's an order that works for most families:

1. Keep the medicines together and out of sight until you can deal with them, especially anything from a hospice comfort kit or a pain prescription.
2. Call the hospice, if your parent had one. Ask what its written disposal policy says and whether its staff will dispose of the controlled drugs.
3. Set aside the opioid pain medicines (such as morphine, oxycodone or fentanyl patches) and anything else the hospice or pharmacist says is a controlled drug.
4. Take the controlled drugs to a DEA-registered take-back location or to law enforcement, or use a prepaid mail-back envelope.
5. Use a take-back option for the rest, too, if one is handy. If none is, flush only medicines on the FDA flush list and put the rest in the household trash using FDA's method.
6. Scratch out your parent's name and prescription details on every empty bottle and package before it goes in the trash or the recycling.

Steps 4 through 6 follow FDA's household guidance: a drug take-back location or prepaid mail-back envelope first, flushing only for flush-list medicines when take-back isn't available, and the household trash for almost everything else, with personal information scratched off the packaging.3

If Your Parent Was on Hospice

If your parent died on hospice, the hospice was supposed to explain its disposal rules back when it first ordered controlled drugs, a time when a lot else was going on and the details are easy to lose. Under the federal Hospice Conditions of Participation, at section 418.106, a Medicare-certified hospice must have written policies and procedures for managing and disposing of controlled drugs in the patient's home. When controlled drugs are first ordered, the hospice must give a copy of those policies to the patient or representative and the family, discuss them in a language and manner they understand, and note in the clinical record that it did so.1

What hospice staff may do after the death

Since the SUPPORT Act of 2018, federal law (21 U.S.C. 822) allows an employee of a qualified hospice program to dispose of a patient's controlled drugs onsite in the home after the patient dies, as long as the disposal follows all applicable federal, state, tribal and local law. To dispose of a deceased patient's controlled drugs under 21 U.S.C. 822, the hospice employee must be a physician, physician assistant, nurse or other person licensed to provide medical or nursing services where the patient lived, and trained by the hospice in secure disposal. The hospice must record in the clinical record the type of drug, the dosage, route and quantity, and the time, date and manner of disposal.2

Why the nurse may leave the drugs with you

The federal law doesn't stop a state or local government from adding its own controls on hospice disposal. GAO reported on one hospice that hadn't started disposing of patients' drugs because its state health department told it not to until a state law gave hospices that authority. That hospice kept leaving the controlled drugs in the home and teaching family members how to dispose of them.2

So if the nurse who comes after the death doesn't take the morphine or the patches, that doesn't mean anyone did something wrong. It may be the hospice's policy, or your state's rule.

What to ask the hospice

• Can I have another copy of your written policy on disposing of controlled drugs?
• Will your nurse dispose of my parent's controlled drugs during the visit after the death, and will I be there for it?
• If not, how does your policy say the family should dispose of them?
• Which of the medicines in the house are controlled drugs?

Our guide to the Medicare hospice benefit explains what hospice covers while a parent is in its care, and Medicare's own hospice care coverage page has the official details.

Opioids and Other Controlled Drugs: Who Can Take Them

It can feel wasteful, even wrong, to hand a nearly full bottle of pain medicine to a police officer when you know someone else who takes the same pills. But for opioids and other controlled drugs, federal rules leave you a short list of places they can go, and a friend or relative isn't on it. Many opioid pain medicines are federally controlled drugs. Under 21 CFR 1308.12, Schedule II of the federal controlled substances list includes morphine, oxycodone, hydrocodone, hydromorphone, oxymorphone, fentanyl, methadone and tapentadol, and DEA describes Schedule II drugs as having a high potential for abuse.4

Under 21 U.S.C. 822(g)(4), if a person dies while lawfully holding a controlled substance for personal use, anyone lawfully entitled to dispose of the deceased person's property may deliver it to another person for disposal. DEA's regulation, 21 CFR 1317.30, lets anyone lawfully entitled to dispose of a deceased person's property transfer a Schedule II, III, IV or V controlled substance for disposal only to a DEA registrant authorized as a collector, or to federal, state, tribal or local law enforcement acting in its official duties.2

In plain terms, if you're the one sorting out your parent's things, you can hand the opioids over for disposal only to one of those two, never to a friend or relative. In practice, that means a pharmacy or other site with a DEA-registered take-back kiosk, a mail-back program run by a collector, or a police department. If your parent's estate has an executor or administrator, let that person know what you're doing with the medicines. Our guide to what happens to a power of attorney after death explains who handles a parent's affairs next.

How to Find a Drug Take-Back Location

FDA calls medicine take-back options the best way to safely dispose of unused or expired prescription and over-the-counter medicines, and says that all medicines dropped off at take-back locations will be destroyed. Some facilities and businesses are registered with the DEA to collect unused or expired medicines, including those that contain controlled substances. In your community, these authorized take-back locations may be retail, hospital or clinic pharmacies and law enforcement facilities, and they may offer on-site kiosks or drop-off boxes, mail-back programs, or other in-home disposal methods.5

Ways to find one:

• Ask your parent's pharmacy whether it has a take-back kiosk or offers mail-back envelopes. Under 21 CFR 1317.40, retail pharmacies and hospitals or clinics with an on-site pharmacy are among the DEA registrants that may become authorized collectors, so call ahead and ask.
• Search the DEA's collection-site locator on its Take Back Day page by zip code, county, city or state. The DEA also periodically hosts National Prescription Drug Take Back events with temporary collection sites.
• Call the DEA Diversion Control Division Registration Call Center at 1-800-882-9539, which FDA lists for more information about take-back locations.5
• Use a prepaid mail-back envelope. FDA says these can be bought from some retail pharmacies or online, and some pharmacies may offer them at no cost.5

When There's No Take-Back Option: The FDA Flush List

If you can't get to a take-back location and can't get a mail-back envelope, check the FDA flush list. FDA puts a medicine on it when the medicine is sought after for misuse or abuse and can cause death from one dose if taken inappropriately. FDA is clear that you shouldn't flush a medicine unless it's on the list, and that if a doctor or pharmacist gave you specific disposal instructions for a medicine, you should follow those instructions.6

The flush list's opioid entries cover any drug that contains:

• buprenorphine
• fentanyl
• hydrocodone or benzhydrocodone
• hydromorphone
• meperidine
• methadone
• morphine
• oxycodone
• oxymorphone
• tapentadol

The list also names three non-opioid medicines: drugs containing sodium oxybate, diazepam rectal gel, and the methylphenidate transdermal system (a skin patch).6

So yes, morphine is on the flush list, but only as the fallback when no take-back option is available. GAO likewise reported in 2019 that, when collection sites, take-back events or mail-back programs aren't feasible, FDA recommends flushing the most dangerous prescription opioids, such as hydrocodone and fentanyl, and that federal agencies recommend the trash, mixed with something like cat litter, for all other prescription opioids.6

Fentanyl patches need extra care

A fentanyl patch is easy to overlook in a drawer or a wastebasket. FDA notes that even after a fentanyl patch is used, a lot of the medicine remains, which is why fentanyl patches come with instructions to flush used or leftover patches. Check the patch's own instructions before you dispose of it.3

Everything Else: How to Throw Medicines Away Safely

Most of what's left in the cabinet, such as blood pressure pills, vitamins or antacids, can go in the household trash when there's no take-back option nearby. FDA and the Environmental Protection Agency (EPA) both describe the same method:3

1. Take the medicines out of their original containers.
2. Mix them with something unappealing, such as used coffee grounds or cat litter.
3. Put the mixture in something you can close, like a sealable bag or an empty container with a lid.
4. Remove or cover the personal information on the empty bottles and packages, then throw it all away.

EPA's guidance is not to flush unwanted drugs unless no take-back option is available and the label or patient information specifically tells you to.3 For keeping track of medicines while a parent is still living, see our guide to managing an aging parent's medications.

Which Option Fits Which Medicine

Losing a parent you cared for brings a long list of tasks. Our checklist for what to do when a parent dies walks through the rest, and our guide to caregiver grief is there for the part no checklist covers.

Learn More

Find personalized help sorting out a parent's medicines and affairs after a death at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.