A resident pours unwanted prescription medications into a drum of methanol to dissolve them as deputized La Crosse County employees document the medications collected for disposal at the county's Household Hazardous Materials Facility. - 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 cause 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 also benefit fish, mussels, and other aquatic life that inhabit the 261-mile long Upper Mississippi River National Wildlife and Fish Refuge.

The La Crosse County Board of Supervisors met on 17 May to consider the plan and unanimously authorized the HHM staff, in cooperation with the Sheriff’s Department, “to develop and implement a medication collection and disposal program that meets local, state, and federal regulations, that uses an environmentally sound means of disposing of collected medications, and that operates on a permanent basis”. 

Four HHM employees were later deputized by the county sheriff with the authority to accept and dispose of unwanted medications, including controlled substances.  On 1 June, deputized HHM staff began to accept medications at their convenient, drive-through facility.  In its first three months of operation, the program filled seven 55-gallon drums with 2,180 pounds of bulk medications (no packaging) that were collected for disposal from about 200 residents and 10 businesses (e.g., nursing facilities, pharmacies, public health programs, care maintenance organizations). 

With its mobile collection trailer, the La Crosse County HHM staff will also act as the disposal vendor for one-day medicine collections from residents of six nearby Wisconsin counties (Grant, Vernon, Monroe, Trempealeau, Sauk, Adams) in 2007 and plans to expand this service to residents of Houston County, Minnesota, in 2008. 

This program represents the first permanent medication collection program in Wisconsin and is one of only a few in the nation.  An indication of Federal government approval for this newly established program came when U.S. Drug Enforcement Administration officials in Milwaukee recently referred to it as a disposal option for remaining medications at a Wisconsin retail pharmacy scheduled to close for business. 

Jeff Gloyd, La Crosse County Special Waste Manager and program administrator, recently presented program information to the Pharmacy Society of Wisconsin and has gained support for the program from the Wisconsin Pharmacy Examining Board.  Gloyd is also scheduled to present program information at the 2007 North American Hazardous Materials Management Association Conference that meets 8-12 October in San Diego, California. 

The noteworthy success of this recently established program presents a model for the development of similar partnerships to raise awareness of the need to safely collect and dispose of unwanted medications in other portions of the country.