At one time, pharmacies and physicians were OK with consumers flushing unwanted or expired medications down the toilet or throwing them in the garbage.

Now, we know better.

Evidence of the medications' harmful effects have been surfacing in our waterways, landfills and marine life. A nationwide study released in 2002 by the United States Geological Survey showed trace levels of chemicals found in prescription drugs in 80 percent of the streams across the country.

Putting medicines in the garbage also can lead to accidental contact by children and animals. The Centers for Disease Control and Prevention points to an increased risk of accidental poisoning from unwanted or expired medications sitting in medicine cabinets. Plus, the old medicines still can end up in the soil through landfills.

So what to do?

"We see this all the time, patients come to us and say please help us figure this out," said Shirley Reitz, associate director for clinical pharmacy services at Group Health. "We needed a way to do this without flushing them down the toilet or putting them in the garbage can," she said.

As a result, a coalition of government and non-profit groups throughout the state, including Group Health, the Department of Ecology and the Washington State Board of Pharmacy, have developed a program to offer a better option -- the first program in Washington that collects unwanted pharmaceuticals and disposes of them safely.

The program is running in pharmacies at seven test sites throughout the state, including three in King County. Each has a large, blue, highly secure medical disposal unit in the customer waiting area where consumers bring unwanted medications in the original containers and drop them in the box, Reitz said. The materials are then transported to a hazardous waste destruction site for environmentally safe disposal.

The program is modeled after one in British Columbia, established by pharmaceutical companies in 1996, which lets consumers return medication at more than 90 percent of its pharmacies.

"This is a baby step toward that system -- that's the end game and what we're trying to build toward," said Sego Jackson, principal planner with Snohomish County's solid waste division. The county also is participating in the statewide effort to have all pharmacies offer medicine disposal sites.

"This pilot is a win for health and safety and a win for the environment," said Snohomish County Executive Aaron Reardon. "By partnering with agencies like Group Health, we hope to ultimately see convenient and safe disposal sites for medications at pharmacies across the state."

Bartell Drugs also is involved in the program, and plans to establish a pilot site.

During the past two months, the test sites collected 45 5-gallon buckets of medications, Reitz said. The coalition plans to establish as many as 25 permanent sites throughout the state, once finished working out final details of the program, including making sure there are enough resources at each site to handle the volume and finalizing the state contract with the hazardous waste plant incinerating the medication. In a January report by Washington Citizens for Resource Conservation, just over half of King County residents surveyed said medicine manufacturers should be responsible for funding a safe and convenient disposal solution. Nearly 75 percent said they would properly dispose of medications if they knew of a convenient location. Eighty percent said they were likely to return their unused or expired medicines in a secure drop box set up at a pharmacy.

"When it comes to dangerous garbage, we know how to bury things and burn things," said Will Perry, health and environmental investigator with Public Health -- Seattle & King County. "I don't think there are any gross human public health concerns yet, but there is enough reason for potential environmental problems and we want to be paying attention to this."

Local hospitals also are taking steps to make sure unused medications don't end up in waterways and landfills. At the University of Washington Medical Center, medications are returned to the manufacturer for credit when possible. For narcotics, the medical center contracts a reverse distributor who logs the drugs, fills out the necessary Drug Enforcement Agency forms and has the drugs incinerated, said Shabir Somani, the medical center's pharmacy director.

Dr. Alison Lewis, a family physician for Group Health, said she has patients come in daily with bags full of pill bottles, many expired, and are confused about which ones they can still take.

"I frequently see young kids taking their parent's or grandparent's narcotics," she said. "It's an invitation for abuse if you don't lock medications up or throw them away." Patients should encourage their doctors and pharmacists to make a safe disposal system available to them so they don't flush or throw them away, Lewis said.

"There really is no other way right now."

DRUG DISPOSAL

What is safe to return:

Prescription and over-the-counter medication

Medication samples

Veterinary medications

Vitamins

Medicated ointments and lotions

Inhalers

Liquid medication in glass or leakproof containers

What can't be returned:

Needles

Thermometers

IV bags

Bloody or infectious waste

Personal-care products

Controlled substances

Hydrogen peroxide

Empty containers

Business waste

Where to take it

The Medication Take-Back program is available at these seven pilot Washington pharmacies, with more sites statewide scheduled to be available soon.

Burien Medical Center Pharmacy

140 S.W. 146th St., Burien, 206-901-2405

Everett Medical Center Pharmacy

2930 Maple St., Everett, 425-261-1560

Olympia Medical Center Pharmacy

700 Lilly Road N.E., Olympia, 360-923-7600

Eastside Hospital and Specialty Center Pharmacy

2700 152nd Ave. N.E., Redmond, 425-883-5940

Renton Medical Center Pharmacy

275 Bronson Way N.E., Renton, 425-235-2855

Silverdale Medical Center Pharmacy

10452 Silverdale Way N.W., Silverdale, 360-307-7410

Riverfront Medical Center Pharmacy

322 W. North River Drive, Spokane, 509-324-6464

Learn more

For more information on how to properly dispose of medications or other health materials, call the state Department of Ecology at 800-RECYCLE (800-732-9253).

Sources: Group Health Cooperative, Public Health -- Seattle & King County