Disposal of unused medicines--concern grows over environmental impacts.

It used to be thought that the best way to dispose of old or leftover medicine was to flush it down the toilet. That way children and animals wouldn't inadvertently become poisoned. But environmental scientists are now warning people: "Do not flush."

Antibiotics, hormones, painkillers, antidepressants, and an array of other medications are finding their way into the nation's waterways--raising disturbing questions about potential health and environmental effects, according to the Associated Press article, "Flushing Expired Drugs No Longer Recommended." Besides individuals who flush prescriptions, nursing homes dispose of anywhere between $73 million and $378 million worth of drugs each year. Some of these drugs are incinerated, but many are flushed.

U.S. EPA is studying whether to develop formal recommendations for what to do with old or leftover drugs. "Flushing medication down the toilet is probably the least desirable of the alternatives," says Christian Daughton of U.S. EPA's Las Vegas laboratory.

Studies have linked hormone exposure to reproductive side effects in fish (see "They're in the Water. They Make Fish Change Sex. Endocrine Disruptors. What Are They Doing to You?" in On Tap, Winter 2003). Scientists also worry about environmental exposure to antibiotics because they fear microbes may become drug resistant.

The Food and Drug Administration (FDA) is re-evaluating its policy about labeling drugs with instructions for disposal. In addition, some states are working to allow nursing homes to donate medications to indigent patients, as long as the drugs aren't opened or tampered with in any way. Until labeling is in place, though, environmental experts offer consumers this advice:

* Take all of a prescribed medication unless there's a good reason not to, such as a bad side effect.

* Trash is better than the toilet. Proper precautions against accidental ingestion of medications by children or pets include breaking up capsules and crushing tablets, and then putting the remains back in the original container. Tape the container and double-bag it before tossing.

* Check to see if a local household hazardous waste collection site will take old prescription drugs.

* FDA suggests asking pharmacies to take old medications back.

(Adapted, with permission, from On Tap, a publication of the National Drinking Water Clearinghouse, Fall 2003.)