Today is National Clean Out Your Medicine Cabinet Day, and chances are you haven’t given much thought to the unused medications taking up space in your medicine cabinet.

A new Consumer Reports Best Buy Drugs nationally representative survey of 1,006 American adults found that about one-third of Americans haven’t cleaned out their medicine cabinets in a year or more; and nearly a fifth (19 percent) haven’t done so in three years.

But those leftover pills are far from harmless.

Taking a drug not intended for you (or one taken by your child accidentally) could mean a trip to the emergency room—and can even prove deadly. Of particular concern are leftover opioids—narcotic painkillers such as Oxycontin, Percocet, and Vicodin.

A survey last June published in JAMA Internal Medicine suggests that there are a lot of opioids in people’s medicine cabinets: 60 percent of respondents who had been recently prescribed an opioid reported holding on to the drugs for future use. Almost half said that they weren’t aware of how to properly store or dispose of opioids.

Don’t Hang on to Your Meds

Dan Budnitz, M.D., M.P.H., director of the Centers for Disease Control and Prevention’s Medication Safety Program, suggests doing a yearly inventory of what’s in your medicine cabinet and discarding unused meds. Doing so will cut down on the risk of someone misusing a medication in your home—and not just young children, but teenagers, too.

When it comes time to clean out the cabinet or drawer, you might be tempted to just toss pills or other drugs into the trash. But because pills can easily be fished out of the garbage by a kid, you’ll want to take safer precautions instead:

1. Return unused medication to your pharmacy. (Or you can return it to a hospital, clinic, long-term-care facility, or narcotic treatment program.) New rules in 2014 from the Drug Enforcement Administration allow pharmacies to voluntarily take back your medications. This is an especially good option for opioids, ADHD drugs, and benzodiazepines (think: Xanax). Places that accept your unused medications are usually part of take-back programs, such as DisposeMyMeds, that collect and destroy (usually by incineration) unused drugs.

If you’re not sure what pharmacies accept meds, you can search for an authorized collector near you at DisposeMyMeds.org or DEAdiversion.usdoj.gov and search for “drug disposal.” Or call the DEA’s Registration Call Center at 800-882-9539. It can also point you to fire and police departments, community hospitals, independent pharmacies, and other collection sites.

2. Drop off unused meds during National Prescription Take-Back Day on Saturday, April 29.
Twice a year, the Drug Enforcement Agency holds National Prescription Take-Back Day, where you can drop off all your leftover medications at designated police departments, fire stations, and other specially designated facilities in your community for proper disposal. Drop-off is completely free and anonymous. If you miss this one, the DEA hosts a second one in the Fall.

3. Mail medication to a collection site.
Costco, CVS, and Rite-Aid pharmacies sell postage-paid envelopes for customers to mail any prescription, including opioids, and over-the-counter medications to a disposal facility.

4. Use a self-service disposal kiosk.
Walgreens offers free, anonymous, and secure kiosks in almost all states, and you can drop off any medication. To use one, remove your personal information from the bottle or packaging and drop your unwanted or expired medication, including controlled substances, in the slot.

5. Be responsible if you put pills in the trash—hide them in coffee grounds, sawdust, or kitty litter, then seal both in a plastic bag.
If your local pharmacy won’t accept your medication and drop-off at an authorized location is not an option, you can toss most pills in your household trash—just be sure to mix them with a substance that makes them less recognizable. (Don’t do this with opioids or other dangerous meds—it’s too easy for kids to fish these out of the trash and ingest them.)

6. For dangerous drugs, the FDA says flushing is an option.
But trace amounts of drugs can end up in the water supply and possibly harm aquatic life. Flush dangerous drugs such as opioids only if there is absolutely no other choice.

What About Needles?

Most collection sites won’t accept asthma inhalers, needles, insulin syringes or any other syringes, marijuana, mercury thermometers, and medications containing iodine.

In some areas you can put asthma inhalers in the trash or recycling, but in other municipalities they’re considered hazardous waste and can’t be tossed in the regular trash. Check with your local sanitation company, recycling facility, or the health department for the rules where you live.

For disposal information and drop-off locations for syringes, needles, and other injectables—for example, expired EpiPens — go to Safe Needle Disposal or call 800-643-1643.

When in doubt about how to safely dispose of a medication or medical device, check with your pharmacist.

Editor’s Note: This article and related materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

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