October 28 is National Prescription Drug Take Back Day

Many of us have old prescription medicines we no longer need in our cabinets, or old expired over the counter medicines. Taking expired medications isn’t safe, and storing unneeded medication increases the risk a child could get into the medicines and be poisoned. Other medications are sometimes abused, and these could be taken by teenagers at risk for substance abuse. In order to help people dispose of medicines safely, the Drug Enforcement Administration (DEA) is holding an National Prescription Drug Take Back Day on October 28. The National Prescription Drug Take Back Day has a search for collection sites near you.

While it’s best to get rid of old medicines with a prescription drug take back program, if you need to you can dispose of them other ways. The Food and Drug Administration has directions on how to safety throw away old medicines, and has a list of medicines that they recommend flushing. Medicines on the “flush list” are especially dangerous because they are easy to overdose on, and some are frequently abused. If you have one of the medicines on the “flush list” and no longer need it, it is best to get rid of it immediately by flushing it down the toilet instead of waiting for a drug take back event.


What is kratom? 

Kratom is an herbal extract made from the leaves of a tropical evergreen tree. It is sold as a herbal supplement in the United States. Kratom has some properties similar to opioids, but also can act as a mild stimulant. Some people take kratom to reduce opioid cravings or treat pain. Others take it recreationally, believing it helps improve mood. 

Kratom was first introduced into the US in the late 1990s and for years its use was very limited. In recent years kratom use has become much more common, possibly because of the opioid epidemic and people trying to use kratom to reduce their dependence on opioids. A recent study on Poison Control Center calls related to kratom found they’ve become much more common in the past few years. In 2011 Poison Control Centers received 13 calls about kratom. This rose to 682 in 2017, and two-thirds of the 1807 kratom-related calls between 2011–2017 happened in 2016 and 2017. 

Is kratom safe? 

The Food and Drug Administration (FDA) has warned people not to take kratom because of safety concerns and the risk of addiction. The sale of kratom is not approved by the FDA, meaning the FDA has not determined kratom to be safe or effective and does not inspect products to make sure they contain the ingredients they’re supposed to, the concentration of the active ingredients are correct, or that they are not contaminated. Because of this, different products can differ in strength and could have unknown contaminants. Companies selling kratom don’t have to follow safe manufacturing regulations, and in 2018 there was an outbreak caused by Salmonella bacteria in kratom that made people sick in 41 states. 

People can overdose on kratom, and it can interact with other medications, alcohol, or recreational drugs in ways that can be dangerous. Kratom has been linked to drug-associated deaths.  In mostly of these kratom was taken along with other drugs, but in a few cases kratom was the only drug used. Kratom can be addictive, and babies born to mothers who use kratom sometimes have to be treated for opioid withdrawal symptoms. 

Is kratom legal? 

Some states or localities have laws against the sale or possession of kratom. In Virginia in 2023 it was made illegal to sell kratom to people under the age of 21 and to sell products without a warning label. There are currently no federal laws regulating kratom, although the FDA has used its authority to regulate unapproved drugs and unapproved dietary additives to restrict the import of kratom. 

What are the side effects of kratom? 

Kratom is a drug and can have side effects that can be dangerous. Kratom causes loss of appetite, insomnia, tremors, and rapid heartbeat. People often report feeling itchy after taking it. It can cause nausea and vomiting. At high doses kratom can cause seizures. People who take kratom regularly can develop liver injury. 

I have been using kratom, what should I do? 

Talk to your doctor about why you’ve been using kratom and ask about alternative medications and possible side effects when quitting. Even if you don’t plan to stop taking kratom you should talk to your doctor about potential interactions with other medications or drugs or alcohol and the possibility of becoming dependent on kratom. Women who are pregnant, planning to become pregnant, or nursing should stop taking kratom to protect their baby from exposure. Like all drugs, kratom should be stored out of the reach of children. 

If you or someone else, especially a child, ingests kratom accidentally, call the Poison Control Center hotline at 1-800-222-1222. If the person is having severe side effects, call 911. 

Where can I get more information?


Updated 2023

DEA Public Safety Alert on Xylazine Mixed with Fentanyl

Dangers of Xylazine

The US Drug Enforcement Agency issued a public safety alert today about an increase in the trafficking of fentanyl mixed with xylazine. Xylazine is a veterinary drug used to tranquilize horses, and is not approved for use in humans. In the past few years xylazine has begun to turn up as an additive in many street drugs. It has been found mixed with fentanyl, heroin, cocaine, and other drugs.  It is sometimes sold alone as “tranq”.

Someone who takes xylazine can get groggy and pass out, and can have low blood pressure, slowed heartbeat, and slowed breathing.  This can cause a person to die if they overdose. Xylazine and fentanyl taken together are especially dangerous, since both drugs slow down breathing and can cause someone to stop breathing completely. Overdose with opioids like fentanyl can be reversed with naloxone (Narcan), but naloxone does not work for xylazine overdose. Xylazine can also cause skin ulcers when it is injected. This can cause deep sores that do not heal and sometimes require amputation.

How to Get Help

If you or someone you know has been using xylazine or other drugs, you can call the SAMHSA National Helpline at 1-800-662-HELP (4357) for information on substance abuse and resources to help quit. You can also get information about addiction treatment programs in your area at FindTreatment.gov.

The Virginia Department of Behavioral Health & Developmental Services has information about substance abuse, services for people who use drugs or alcohol and could become pregnant or could become pregnant, and training in how to use naloxone for opioid overdose.

The Virginia Department of Social Services has information for people who want help with substance abuse and are on Medicaid or uninsured.