Treasure in the medicine cabinet


Did you know that the incidence of poisoning of children has risen in the past few years?  This is not deliberate poisoning by someone with evil intent, but “accidental” poisoning where small children (toddlers especially) are poisoned by taking something dangerous they have found in the home.

The concept of ‘child-proof tops’ has been about for many years, but I am sure you have found that the majority of medications still have simple closures.  And where do the majority of these medications reside in your household?  Probably in the bathroom cabinet or in the fridge.  Yes, your bathroom cabinet!

To show just how unfinished medicines can accumulate in your household (even though you are supposed to take the complete course), one of the patients brought me a present a couple of years ago.  A very large package which weighed 1.44 kg.  If this had been just before Xmas, it could have been all sorts of goodies.  (Miss Hillary in this section would have thought all her Xmases had come at once!  Chocolates at least!)

In fact it did contain all sorts of goodies.  There were capsules, tablets and lozenges and in all kinds of wonderful colors.  These would have been a toddler’s delight.  And all potentially lethal.

The package was the result of the patient’s cleaning out of his bathroom cupboard of outdated, or no longer needed, or even ‘unknown’ medicines.  The man was not a hoarder, but knew that medications should be kept out of the reach of children, which he had been doing – for quite some time!  However, when he started running out of room, a problem presented itself.  How was he going to get rid of them?

He was savvy enough to know that if he just ditched them in the local rubbish bin, the recyclers would definitely consider them treasure trove, and he could foresee some untrained person attempting to differentiate the various pills and tablets and sell them somewhere.  Paracetamol tablets do generally look the same after all, white round ones, but so also do many other medications, which are not as relatively safe to be taken indiscriminately.

He then thought about flushing them all down the toilet, but decided that 1.44 kg of strange tablets might just block the precarious plumbing that pervades in Thailand.  When the locals are afraid of putting soluble toilet tissue down the loo, what would strange foaming tablets do?  Let alone capsules and lozenges.

The next resort was to borrow a mortar and pestle from the local ‘som tum’ roadside kitchen and having ground them all to a paste then spread the resulting pulverized mass over the garden as a somewhat powerful weedicide.  At least the grass would be germ-free!  However, this was not really practical either, as the som tum lady couldn’t wait the several hours that was going to be necessary.

So I then became the last option, and with a smile he presented me with the aforesaid 1.44 kg bag, with wishes for a very happy Xmas.

Abandoning my initial thoughts of hurling them from the top of the 15 storey hospital building and watching people scrabble for free tablets, I saw the senior pharmacist in charge of the Pharmacy at the Bangkok Hospital Pattaya who assured me that yes, they could dispose of the 1.44 kg bag and contents, as there was a service to allow total destruction of medications such as these, under very secure circumstances, run by the Thai government, and he would be happy to forward the 1.44 kg bag of goodies.

So there you are.  It is probably a good idea as part of your New Year’s resolutions, to clean out your bathroom cabinet of old, half used, undated, expired and unknown medications, tablets, lozenges and mixtures.  If the quantity is too great for flushing down the loo (and 1.44 kg is too great), then bring them to the closest hospital and ask that they supervise the destruction.

Of course, as mentioned above, when you are prescribed a course of medication (antibiotics in particular) you should keep taking them until the course is finished.  We don’t prescribe ‘extras’ just to fill up the bag!  Take the complete course!