Mother Blogger

So Sorry to Hear About Your Loss

Did They Leave You Any Good Drugs?

 When my husband's father passed away at home last October, there was solemnity and quiet throughout the house.  He had been under hospice care, and they had attended to his every need, both before and after death.  When my father in law began the process of dying, having trouble with his breathing and becoming a little panicky, the nurses provided strong medications to ease his pain and fear.  Hospice believes in relieving the suffering associated with death, so they are not stingy with the drugs.  We watched him sleep for hours, his fingers slowly becoming blue, his organs shutting down one by one.  

When the moment came, it was peaceful and quiet.   At that point there are many things that need doing, and hospice was very helpful with that.  One of the most unusual things they did, was having an official looking woman come in, looking almost police-like in attire.  She performed the drug disposal before our eyes.

The recommended approach for an in-home hospice nurse to dispose of medicine at the home is as follows (with the exception of drugs noted on the attached list, which, by recommendation of the Food and Drug Administration (FDA), should be flushed down a toilet):

The nurse should perform the drug disposal in the presence of a family member or in the  presence of a second health care clinician to avoid the opportunity for or accusation of drug diversion. The witness to the disposal should sign a document indicating their witnessing of the disposal.

Render the medicine unusable and place in sealable plastic bags or in single plastic container with a screwtop lid and discard in the trash after completing the following:
· Liquids: Add kitty litter, flour or used coffee grounds to the container and recap.
· Tablets and Capsules: Add water to the container followed by kitty litter, flour or used coffee grounds and recap.
· Suppositories: Unwrap and place in container before adding kitty litter, flour or used coffee grounds.
· Transdermal Patches: Using disposable gloves remove patches from the packing and cut the patch in half carefully handing it by the edges. Place the pieces in a container, add kitty litter, flour or used coffee grounds and recap.
· Medicated Ointments/Creams: Squeeze/scoop medication into a container and mix with kitty litter, flour or used coffee grounds before recapping.
· IV/SC/IM cassettes or vials: The nurse is responsible for removing the controlled drugs from the cassettes and vials and verifying their disposal (see liquids above).

 

But when it comes to the following drugs, the FDA still recommends flushing down the toilet, even though environmentalists strongly discourage it, because of  the quantity of medicine that may require disposal and ability of the public to track deaths in media publications. 

Actiq, oral transmucosal lozenge Fentanyl Citrate

Avinza, capsules (extended release) Morphine Sulfate
Daytrana, transdermal patch system Methylphenidate
Demerol, tablets * Meperidine Hydrochloride
Demerol, oral solution * Meperidine Hydrochloride
Diastat/Diastat AcuDial, rectal gel Diazepam
Dilaudid, tablets * Hydromorphone Hydrochloride
Dilaudid, oral liquid * Hydromorphone Hydrochloride
Dolophine Hydrochloride, tablets * Methadone Hydrochloride
Duragesic, patch (extended release) * Fentanyl
Embeda, capsules (extended release) Morphine Sulfate; Naltrexone Hydrochloride
Fentora, tablets (buccal) Fentanyl Citrate
Kadian, capsules (extended release) Morphine Sulfate
Methadone Hydrochloride, oral solution * Methadone Hydrochloride
Methadose, tablets * Methadone Hydrochloride
Morphine Sulfate, tablets (immediate release) * Morphine Sulfate
Morphine Sulfate, oral solution * Morphine Sulfate
MS Contin, tablets (extended release) * Morphine Sulfate
Onsolis, soluble film (buccal) Fentanyl Citrate
Opana, tablets (immediate release) Oxymorphone Hydrochloride
Opana ER, tablets (extended release) Oxymorphone Hydrochloride
Oramorph SR, tablets (sustained release) Morphine Sulfate
Oxycontin, tablets (extended release) * Oxycodone Hydrochloride
Percocet, tablets * Acetaminophen; Oxycodone Hydrochloride
Percodan, tablets * Aspirin; Oxycodone Hydrochloride
Xyrem, oral solution Sodium Oxybate

We were surprised to realize that my father in law had been on several of the above mentioned narcotics.  And it made me wonder.  If there is a Heaven, and a God you meet when you get there, how are you going to know if it is real or just a drug induced hallucination.  I mean, you've gotta be feeling pretty good about the time you get there, right?