Pulse
Disposal Proposal
Duluth officials find it’s easier to collect unused drugs than get rid of them.
For decades, the advice from pharmacists and physicians has remained unchanged: Patients should get rid of the medications they don’t use by flushing them down the toilet. But three years ago, as research began to reveal traces of endocrine-disrupting drugs in wastewater around the country, environmentalists started thinking about how to keep pharmaceuticals out of the water.
Officials at the Western Lake Superior Sanitation Department (WLSSD), a water treatment plant and site for hazardous waste collection that sits near the shores of Minnesota’s Great Lake, were concerned. “It’s always easier to prevent pollution than to try to figure out how to clean it up after the fact,” says WLSSD environmental program coordinator Gina Temple-Rhodes.
To keep the medicines out of the sewage system, WLSSD decided to organize a series of pharmaceutical collection events, which they called Medicine Cabinet Clean-Out Days. Residents in the vicinity of the Duluth wastewater treatment plant were invited to drop off their outdated or unwanted prescription and over-the-counter medications. From there, the stuff would be hauled to an incinerator.
What was clear from the very first event, held in October 2007, was that a pharmaceutical collection answered a real need. “We weren’t sure if anyone would show up,” says Karen Anderson, director of community relations for WLSSD. But she and colleagues were amazed to see cars lined up at the WLSSD hazardous waste collection facility as drivers eagerly passed bags of medications out the window. “Folks were glad to have a safe, legal way to dispose of pharmaceuticals,” she says. Some people, in fact, had been so paralyzed by their desire not to send the drugs down the toilet that some of the medication they finally culled from their bathrooms dated back to the 1970s.
Hired pharmacists sorted the medications, noting down to the pill what was handed over. The very first event yielded 229 pounds of noncontrolled medication and 21 pounds of controlled substances, 1 pound of veterinary vaccines, 4 pounds of chemotherapy drugs, and 3 pounds of insulin and epinephrine pens. Altogether, the collection filled nearly three 55-gallon drums.
Charting New Waters
The event wasn’t the first of its kind in the country, but it was a first for Minnesota. Creating an alternative method to dispose of unused pharmaceuticals was no small feat, notes Temple-Rhodes. In fact, from the start, it required persuading many agencies to re-examine entrenched practices and review established laws about drug handling and disposal.
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Keeping unused drugs out of the water, the hands of children and drug abusers, or the clutches of animals requires effort.
Photo courtesy of WLSSD
Don't Flush It Away
Although drug collection events may eventually become more common around the state, current practices still require getting unused drugs safely into the trash. The Minnesota Pollution Control Agency says doctors should tell their patients to:
- Keep the medication in its original container. When you’re throwing out medications, leave the drugs in the bottle with the content information visible and any personal information scratched out or covered with a permanent marker.
- Modify the contents to discourage consumption. If you’re throwing out pills, add a small amount of water to partially dissolve them. For liquids, add table salt, flour, charcoal, or nontoxic powdered spice (like turmeric or mustard) that will make the mixture unpalatable to a curious child or a garbage-foraging animal. If the medication comes in blister packs, wrap the packages in multiple layers of opaque tape, like duct tape.
- Seal and conceal. Tape the medication container lid shut with packing or duct tape and put it inside a nontransparent bag or container such as an empty yogurt or margarine tub to ensure that the contents cannot be seen.
- Discard the container in your garbage can. Don’t put the container in the recycling bin. Do not conceal medicines in food products because they could be inadvertently consumed by wildlife.
- Work with your provider. Your physician or pharmacist can help you properly dispose of chemotherapy drugs, as these medications may require special handling.
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Even the first step, procuring funds to pay for publicity and for staff at a drug-collection event, involved making a convincing case about the effects of pharmaceuticals on the environment. When WLSSD officials applied to Minnesota’s Lake Superior Coastal Program, part of the Department of Natural Resources, which offers federal matching grants for projects affecting waterways, they had to explain why this was a water issue, Temple-Rhodes recalls. “It was such a new concept for a lot of people.” As discussions evolved, however, the Coastal Program quickly got on board.
But the next steps proved to be even more challenging. Because the drugs collected would include controlled substances, the agency appealed to the Drug Enforcement Administration (DEA) in Minneapolis/St. Paul for guidance on how to proceed. No local officials had experience with such an event, and Temple-Rhodes was referred to DEA headquarters in Washington, D.C. The U.S. office had consulted for collection events in a handful of other states including California, Washington, and Maine. The federal office determined that a drug collection event would be safe and legal but that law enforcement agents would need to be present because some of the drugs would be controlled substances. So the WLSSD hired Duluth police officers to take immediate custody of those medications.
Getting rid of the goods proved to be a bigger challenge than initially anticipated. Even with the involvement of law enforcement, federal and state laws quickly became ensnarled when it came to destroying the controlled substances. “It’s been remarkably complex,” acknowledges Anderson. In Minnesota, pharmaceuticals that have already been prescribed are considered hazardous waste and must be hauled by designated contractors to specific incineration sites. The nearest one is in St. Louis, Missouri. This system works well with noncontrolled substances, but becomes challenging when controlled substances are involved. The police department could take the controlled drugs, but then wasn’t able to transfer them to hazardous waste hauling contractors because of DEA regulations.
“Even with all the best intentions,” Anderson notes, “no organization had ever looked at this issue holistically.” As a stop-gap measure, the police agreed to take the controlled medication from each of the events and store it in a secure site at the station until a solution could be found.
Watershed Events
Since the first event, the WLSSD has held three more Medicine Cabinet Clean-Out Days, each bringing in more unused drugs than the last. The most recent one pulled in more than 600 pounds of unused medication.
Despite their success, the events have illustrated how complex it can be to change disposal practices. “It’s not something you can just decide to do one day and have people bring in their drugs,” notes Temple-Rhodes. A new grant from the Environmental Protection Agency will solve the problem of the controlled substances that are being held at the police department, providing funds that will enable the police to escort the drugs from Duluth to the St. Louis hazardous waste incineration site. In the meantime, the WLSSD is working with the MPCA “to clarify some of the rules about hazardous waste transport and the destruction of medication,” Temple-Rhodes says.
The hope is that collection practices will eventually branch out to other parts of Minnesota. In Chisago County, where some drug collection efforts have begun, officials are also grappling with the issues raised by controlled substances, and the WLSSD is investigating how drugs may be transferred legally from that county’s law enforcement offices to Duluth police to consolidate the disposal effort.
But if the response from citizens is any indication, such events will become more common in the future. Temple-Rhodes says, “People come to our events and say, ‘This is so great,’ and ‘Thank you for doing this,’ and ‘We’ve always wondered what to do with these drugs, and now we feel like we’re doing the right thing.’”—Kate Ledger