Recycling relies entirely on donations from people whose prescribed drugs became unusable due to death, side effects or treatment failure. This makes for an unstable supply that may lead to the promotion of drug-resistant HIV strains. Because some of the recipients of these medications are not receiving medical supervision, the risks for wrong dosing, drug interactions and dangerous side effects are too great to ignore. Individuals and organizations send anywhere from a few pills to a few months' worth of anti-HIV and OI medications overseas. Organizations tend to have a more structured approach to the collection and distribution of drugs and also tend to partner with other organizations in receiving countries.
Individuals usually respond to individual requests and are less standardized in their methods.
Since there is no established procedure for drug recycling, there are no guidelines or controls. One of the goals of the forum at GMHC was to start a dialog between groups and individuals that have been involved in the practice but have not been working in unison. Although many informal recycling efforts operate without ensuring that drug recipients have proper medical supervision, two organizations that have implemented drug recycling guidelines are AID for AIDS in New York and Union Positiva in Miami. As representatives of both organizations explained at the forum, they are careful about expiration dates and the time since the prescription container was first opened. Shipments are made once a month to patients who have provided a prescription from a physician in their respective countries.