Managing hazardous drug (HD) waste remains quite a challenge for many facilities, although incremental improvements are occurring. Those adopting the cradle-to-grave approach to disposing of this potentially damaging waste remain in the minority, probably due to the lack of clarity from regulatory agencies. In response to conflicting mandates from the EPA, DEA, and DOT, some facilities choose to avoid waste stream sorts altogether and simply dispose of all their waste as hazardous. 

Hospitals are increasingly confident in their abilities to identify the HDs in their facility, using a variety of approaches from labeling to creating NDC linked alerts in the EMR and pharmacy information systems. Notably, those facilities with a RCRA committee in place tend to have strong HD waste processes in place.