Finally, a safe, environmental way to get rid of old medicine

Don't know what to do with your old, expired medications?

Until now, there has been no safe and environmentally benign way to dispose of unused or expired medicine.

Old drugs left in the medicine cabinet are too often used by mistake or by someone seeking a high. If thrown in the garbage or flushed down the toilet, they can give an unintended dose to fish and other wildlife.

That's beginning to change here, thanks to the nation's largest program for returning unused drugs.

Group Health Cooperative pharmacies, in cooperation with government agencies and environmental groups, are accepting unused prescription and over-the-counter drugs, then sending them away to be incinerated. By the end of last month, shortly after the program was expanded to 25 Group Health pharmacies in King, Pierce, Snohomish, Kitsap, Thurston and Spokane counties, patients had returned 2 tons of drugs.

It will become even easier to return medications next month when Bartell Drugs puts the first secure drop box in one of its stores and then rolls out the service in more stores. The opening dates for the service and the locations of those stores have not yet been announced.

Group Health's motivation, when starting the program in October 2006, was to take hazardous medications out of circulation.

"Let's take them out of people's homes, let's get them out of hands where people could get hold of them, where they might be used or abused by elderly persons who are confused and might take the wrong one," said Shirley Reitz, Group Health associate director for pharmacy clinical services.

For the interagency Local Hazardous Waste Management Program in King County and the state Department of Ecology, the concern has more to do with what happens to the environment when pharmaceuticals end up in streams, lakes and Puget Sound.

Scientists are finding medications in waters around the country.

A 2004 Department of Ecology study found 16 chemical compounds, including the hormone estrone and pain relievers acetaminophen and hydrocodone, in treated wastewater from two Sequim sewer plants. A diabetes-control drug, metformin, was tentatively identified in a nearby well and creek.

County scientists last year reported that a synthetic female hormone used in birth-control pills and hormone-replacement therapy was turning up in storm water flowing into the Sammamish River in Redmond. It is not known if the hormone, ethynylestradiol or EE2, played a role in "feminizing" male sole in Elliott Bay. A large number of those fish carry a protein normally found in females with developing eggs.

Researchers don't know what proportion of pharmaceuticals in the environment got there by being flushed down the toilet and how much was excreted by people who ingested the drugs as directed.

"It's a concern to see these biologically active chemicals out there — everything from ibuprofen to controlled substances — narcotics — although we don't know how significant that is in relation to other environmental issues. It is one it seems like we should be paying more attention to," said Dave Galvin, program manager in the Local Hazardous Waste Management Program.

Under Washington's program, tamper-proof metal bins similar to mailboxes are bolted to the floor of a pharmacy and periodically emptied.

Group Health started the program after learning that four out of five consumers surveyed by Washington Citizens for Resource Conservation said they would return unused medicines to their local pharmacy.

Because federal law doesn't allow consumers to deliver narcotics to anyone other than law-enforcement agencies (and most police departments aren't prepared to accept them), prescription narcotics such as codeine and oxycodone can't be put in the take-back bins.

To allow it, Galvin said, the federal Controlled Substances Act might have to be amended, or the U.S. Drug Enforcement Agency would have to interpret the act differently.

Until authorities find a legal way to accept and destroy unused narcotics, they advise consumers to mix them with something unappetizing like coffee grounds or kitty litter, put the mixture in an opaque bag and throw it out with the trash.

The medicine-return program is funded by government and private sources through the end of 2008. Its future beyond that is uncertain.

State Rep. Dawn Morrell, D-Puyallup, a critical-care nurse, has introduced a bill, HB 3064, that would require drug manufacturers to take back unused medications for disposal.

Keith Ervin: 206-464-2105

or kervin@seattletimes.com

Group Health accepts most prescription, over-the-counter and veterinary medications. (COURTNEY BLETHEN / THE SEATTLE TIMES)