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Disposing of old medicines can be tricky business

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Medicine disposal
Researchers are finding endocrine-disrupting chemicals in many lakes and rivers. They come from medicines and common household products. Legislation to be introduced in Minnesota would make it easier to dispose of unwanted medicines.
MPR Photo/Stephanie Hemphill

Researchers have long been finding residues from pharmaceuticals and personal care products in our lakes and rivers. Some of them are endocrine disruptors and can cause fish to develop both male and female characteristics.

Traces of pharmaceuticals are even showing up in some cities' drinking water supplies, though not in Minnesota. No one knows yet whether these drugs are having a significant impact on human health, but biologists are clearly worried.

The Western Lake Superior Sanitary District in Duluth has been organizing special medicine collection events. One day in late January, a steady stream of drivers pull up at the Household Hazardous Waste Facility. Each driver handed over out-of-date pills, old cough medicine; drugs that someone stopped taking.

They know these drugs should not be flushed down the toilet.

The standard advice these days is to dilute the medicine with something unpleasant like kitty litter or vinegar, stash it in a nondescript container like a yogurt tub, wrap that with duct tape, and throw it in the trash.

That would work if the trash were going to an incinerator. These compounds are easily destroyed in a good fire, but Duluth's trash goes to a landfill. The sanitary district's Environmental Program Coordinator, Gina Temple-Rhodes, said that as rainwater leaches through the landfill, it picks up some of the chemicals in the medicines.

"The leachate is collected, and usually ends up at a wastewater treatment plant, so the leachate is not going to contaminate the surrounding area," Temple-Rhodes said. "But it does come to a wastewater treatment plant and then we are back at square one."

Hazardous Waste Facility
Duluth-area residents line up to drop off old medicines at the Western Lake Superior Sanitary District's Household Hazardous Waste Facility. The district has held six collection events, and each one has yielded bigger quantities of old medication.
MPR Photo/Stephanie Hemphill

Square one means the chemicals are released from the treatment plant into rivers and lakes.

Researchers are looking for ways to capture some of the chemicals, but the systems would be very expensive. So, the sanitary district is trying to slow the flow of the chemicals at the source.

But there's a complication, and this is where police get involved. At the collection event, pharmacist Barry Snyder sorted through the pills to separate out the controlled substances -- drugs that are strictly regulated because of their potential for abuse.

"Most of the controls that we're seeing are either pain medications or medications used for attention deficit disorder -- Ritalin, that sort of thing," Snyder said.

Snyder gives the controlled substances to a sheriff's deputy on site. According to federal law, only law enforcement officers are allowed to possess these types of drugs.

Some law enforcement agencies are getting into the old-medicine collection business themselves. In Chisago County, the sheriff's office collects five pounds of medicines every day.

The program was started to address the environmental concerns from discarded medicines, but the sheriff's office said it's also helping to keep dangerous drugs out of the hands of potential abusers.

Sorting medicines
Pharmacists sort through the medicines. They place controlled substances -- drugs that are strictly regulated because of their potential for abuse -- to the side to be handled by sheriff's deputies.
MPR Photo/Stephanie Hemphill

But here is another complication: All these drugs -- the controlled substances and the ordinary things like aspirin -- have to be taken all the way to Illinois to be burned. That's because in Minnesota, medicines are classified as hazardous waste, and we don't have a hazardous waste incinerator in the state.

A bill to be introduced at the Minnesota legislature this session is designed to untangle some of those complexities. DFL Rep. Paul Gardner of Shoreview said his measure would also help pay for disposing of old medicines.

"What I have in the bill is a product stewardship system similar to what we have for electronic wastes," Gardner said. "You'd be able to bring in your old drugs to a venue your county chooses, and the costs for that would be covered mostly by the pharmaceutical companies."

The drug industry says such a program wouldn't make a dent in the problem because people excrete more than they throw away. Drug manufacturers also warn it would increase the cost of medicine. Gardner said a similar program in Washington state adds three cents or less to the cost of a prescription.

Gardner and others working on the issue also want the state to allow at least some types of drugs to be incinerated here.

The legislation would also prohibit health care facilities from flushing medicines; currently, state rules require them to flush. It would prohibit drug companies from giving free samples to doctors; they could get vouchers for free prescriptions to be picked up at a pharmacy. And it would limit the initial supply of newly prescribed maintenance drugs when paid for by Medicaid.

Experts say many patients stop using new medications because they have undesirable side effects.