Missourians turned in nearly 28,000 pounds of unused and expired medications during the U.S. Drug Enforcement Administration's National Prescription Drug Take Back Day in April, helping the state rank fifth in the nation for drug collections.
Nationwide, Americans surrendered about 321 tons of unwanted medications during the event, according to the DEA.
While the collections highlight growing participation in safe disposal programs, advocates say it's difficult to measure how much medication is still being improperly discarded. Neither Missouri nor most states track the amount of household pharmaceuticals that are thrown away or flushed, and there is no federal requirement to monitor those disposal practices.
Robert Churchwell, a group supervisor with the DEA's St. Louis Division, said the agency's take-back events are primarily designed to prevent prescription drugs from falling into the wrong hands.
"We don't want to see medications being discarded into a dumpster or trash bin where somebody could retrieve them," Churchwell said. "These medicines are prescribed to specific patients by licensed practitioners and should only be used by the people they're intended for."
According to the Centers for Disease Control and Prevention, more than $1 billion worth of unused and expired medications are discarded, flushed or left in medicine cabinets across the United States each year.
The DEA hosts National Prescription Drug Take Back Day twice annually and also operates an Everyday Take Back program, which allows residents to dispose of medications year-round at participating pharmacies, hospitals and law enforcement agencies. The collected medications are ultimately destroyed through incineration.
Churchwell said take-back day totals alone do not necessarily reflect how safely residents are disposing of medications.
"If people are using the Everyday Take Back program more frequently, then we're naturally going to collect fewer pounds on our take-back days," he said.
To make disposal sites easier to find, the Missouri Product Stewardship Council maintains an online map of free medication drop-off locations across the state.
Angie Snyder, a board member of the council, said proper disposal helps reduce the chances of pharmaceutical compounds entering landfills and waterways.
"Even though a modern landfill is an engineering marvel with layers of protection, anything we can keep out of the landfill is better," Snyder said. "When you're talking about medicines, you're still talking about chemicals entering that system."
Snyder, who organizes medication take-back events in the Springfield area, said older adults tend to make up the majority of participants.
"Typically at take-back events we see older demographics," she said. "The younger demographics are still the lower ones that are turning in the meds. We hope they're using the take-back kiosks."
Environmental experts warn that medications can reach waterways when they are flushed down toilets or discarded in household trash. In landfills, pharmaceuticals can dissolve into liquid runoff known as leachate, which forms as rainwater and decomposing waste move through buried trash.
Although modern landfills and wastewater treatment systems are designed to manage leachate, they are not always able to remove every pharmaceutical compound.
Researchers have identified more than 900 pharmaceutical ingredients in rivers and streams worldwide, raising concerns about potential impacts on aquatic ecosystems and water quality.
Michael Paris, director of Solid Waste Management Program of the Missouri Department of Natural Resources, said landfills are equipped to manage pharmaceutical waste but residents should still use dedicated disposal programs whenever possible.
"When they make their way into landfills, they interact with the waste and eventually merge into the leachate," Paris said. "That leachate is then managed through onsite systems or wastewater treatment systems."
For residents in rural areas without easy access to disposal kiosks, experts recommend at-home medication disposal packets that deactivate drugs before they are thrown away.
Irina Butler, executive director of the Pharmaceutical Product Stewardship Work Group, said the packets provide a practical alternative for people who live far from collection sites.
"It's essentially an envelope with a substance inside," Butler said. "You put your medicines in it, mix them around and it dissolves the medicine. Then you can safely put it in the trash."
Butler's organization operates a website which helps users locate medication disposal kiosks and sites that distribute free disposal packets.
