Disposal of unused medications in sewer systems can ultimately harm aquatic life. The Service is working with others to encourage legitimate alternatives to sewer system disposal that will protect human and environmental safety. - FWS photo

Recent surveys of surface water quality in public waters around the U.S. have frequently detected the presence of a variety of potent chemicals that can disrupt the normal physiology of certain aquatic animals. 

Some of these chemicals can cause a fish to simultaneously express intersex (both male and female) characteristics while another chemical can cause a female mussel to prematurely release its larvae. 

Many of these biologically active chemicals have a common source: prescription medications that are flushed into sewer systems for disposal.  This practice was long considered a “safe” means to get rid of unused or expired medications and prevent accidental human poisonings. 

However, the cumulative impacts of this widespread disposal method on environmental quality were not readily apparent until other recent studies, many conducted near wastewater treatment plant outfalls in the U.S., found unexpectedly high numbers of intersex fish.  

Waterways that receive discharge from municipal wastewater treatment plants also provide drinking water to millions of Americans daily.  Because current wastewater treatment technologies are unable to filter these chemicals or inhibit their biological activity, individuals who wish to dispose of unused or expired prescription medications that contain these compounds (or others which may harm the environment) have few legitimate options that are fully safe. 

However, a small but growing number of communities with environmental foresight in Wisconsin and other states have recognized this medication disposal dilemma and formed local partnerships to address it. 

The typical solution is a turn-in program that operates one or two-days per year (often in summer) and requires the voluntary cooperation of licensed pharmacists and local law enforcement authorities who receive unused medications from individuals and ensure these materials are securely maintained until destroyed in an environmentally safe manner.

In western Wisconsin, representatives of the U.S. Fish and Wildlife Service (La Crosse Fishery Resources Office), Mayo Health System (Franciscan Skemp Healthcare, La Crosse Campus), Gundersen Lutheran Health System, and La Crosse County (Household Hazardous Materials (HHM) Program) began meeting early in 2007 to discuss the feasibility of establishing a safe and effective turn-in program for the disposal of unused or expired medications that would meet the needs of the county’s 109,000 residents. 

The members of this diverse team later developed a conceptual plan for a year-round medicine turn-in program.  This plan would utilize the infrastructure and compliment the services of an existing county-operated facility that currently accepts HHM from county residents and businesses, at little or no cost, throughout the year. 

This HHM service is also provided to others in southwest Wisconsin, southeast Minnesota, and northeast Iowa for a nominal fee.  The establishment of a medication turn-in program here, and perhaps in other communities that discharge treated municipal wastewater into the upper Mississippi River, could  benefit fish, mussels, and other aquatic life that inhabit the 261-mile long Upper Mississippi River National Wildlife and Fish Refuge.

On March 5^th, planning team members convened a meeting at the Franciscan Skemp Healthcare La Crosse Campus to introduce the conceptual plan to a group of about 20 invited guests representing several municipalities, health care providers, and retail pharmacies in the county.  The response from this group was overwhelmingly supportive. 

This encouraged team members to subsequently draft a more detailed plan that will be formally introduced for consideration by elected representatives and officials of county government.  Estimated costs to enhance security at the existing HHM facility to accommodate medication turn-ins and to promote this program in its initial year are $16,000 and $8,000, respectively. 

Program partners and potential cooperators would also commit to ongoing outreach efforts in a variety of locations (retail pharmacies, nursing homes, clinics, schools, festivals) and formats (print, television, radio, Internet) to inform the public about the benefits this service will provide their community. 

If established, the proposed program would be: one of the few year-round turn-in programs for unused medications in the country; a model for like-minded communities to strive for; and an active supporter of SMARxT DISPOSAL, a U.S. Fish and Wildlife Service-American Pharmacists Association joint effort to publicize potential environmental and health impacts when unused medications are flushed into our nation’s sewer systems.