Unwanted medications should not be flushed into wastewater systems as a means of disposal. Photo credit: USFWS.

La Crosse County officials use this mobile trailer to transport hazardous materials and unwanted medications that are collected for disposal from homes and businesses in other portions of Wisconsin and nearby states. Photo credit: USFWS.

Trace amounts of medications occur in surface waters that supply drinking water to millions of Americans.  Although human health effects of these exposures are uncertain, laboratory and field observations indicate that environmentally relevant concentrations of some commonly prescribed medications can cause physiological changes to fish and mussels that may adversely impact populations, as well as individuals.  While there is no practical technology currently available to prevent the discharge of medications that have entered wastewater treatment systems, communities can take actions to reduce the quantity of unwanted medications that are often flushed into wastewater systems for disposal.  In western Wisconsin for example, representatives of the U.S. Fish and Wildlife Service, Mayo Health System, and La Crosse County met early in 2007 to discuss the need to establish a safe and effective means for residents to dispose of unwanted medications.  This diverse team developed a plan for a medicine turn-in program that would utilize the infrastructure and compliment the services of an existing county-operated facility that accepts unwanted household hazardous materials (HHM) from 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.  The County Board of Supervisors unanimously approved the plan and authorized 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; uses an environmentally sound means to dispose of collected medications; and operates on a permanent basis.  The sheriff subsequently deputized several HHM employees with the authority to accept and dispose of unwanted medications, including controlled substances.  Deputized staff began to accept medications at the HHM facility on 1 June 2007 and collected more than 2.5 tons by the end of that year.  The program experienced even greater success during 2008 (its first full year of operation) by serving as the disposal vendor at one-day medicine collections for 185 businesses and 36 other counties in Wisconsin and Minnesota, destroying more than 4 tons of unwanted medications, and generating more than $28,000 of new revenue for La Crosse County.   This is the first permanent medication collection program in Wisconsin and one of only a few in the nation.  The noteworthy accomplishments of the program present a model for the development of similar partnerships to raise awareness of the need to safely collect and dispose of unwanted medications to improve water quality in other portions of the country.