LAYTON, Utah – A steel mailbox-sized bin in the lobby of a police department in northern Utah was full again, crammed with half-full prescription bottles, over-the-counter cold meds and even an odd topical cream from 1983.
"It's anything and everything," Layton police evidence supervisor Holly Plotnick said as she and a co-worker transferred 28 pounds of medications into a garbage bag and readied it for the incinerator.
The program is one of dozens around the country as communities ramp up efforts to clean out America's medicine cabinets by setting up drop-boxes or other disposal methods for people to dump their unused and expired prescription drugs. At least 20 states now have collection programs for unused medications, and several saw record hauls in 2009.
Many of the programs were initially motivated by concerns about flushed pharmaceuticals reaching drinking water supplies. A 2008 Associated Press investigation found at least 46 million Americans are supplied with drinking water that has tested positive for traces of pharmaceuticals.
The programs are also surging for another reason: prescription drug overdoses. Utah, for instance, saw a 500 percent jump in the number of deaths attributed to pain medications between 1999 and 2007.
"A lot of the pharmaceuticals sold on the street or consumed by young people come out of home medicine cabinets," said Terry Keefe, chief of police in Layton, a city of 65,000. "This is one attempt to reduce the availability of these type of drugs."
The police department's medication dropbox in Layton — one of 37 in police stations across Utah — took in 738 pounds in 2009. The box sometimes takes just days to fill up.
The drugs are a concern because of their threat to the environment, too. Researchers also have found evidence that even extremely diluted concentrations of pharmaceutical residues can harm fish, frogs and other aquatic species in the wild.
Advocates say the 90 or so take-back programs across the country are a good start but not well-funded enough to expand to a mass scale. Some are floating legislation to have pharmaceutical companies foot the bill, modeling the idea on similar state laws requiring electronics manufacturers to cover the costs of recycling TVs and computers.
"The biggest barrier to the takebacks is funding," said Scott Cassel, director of the Boston-based Product Stewardship Institute, which works with governments and others on environmental issues. "None of these states or local governments really have the money to take an action that will fully resolve the environmental issues or reduce that impact."
The Pharmaceutical Research and Manufacturers of America says regulatory agencies have already established ways to safely dispose of drugs in the household trash. The group has generally been dismissive of take-back programs, saying that collecting drugs in one place raises the risk that they might be stolen and misused.
Forcing pharmaceutical manufacturers into a take-back program would likely drive up costs for patients, the group says.
"These costs can be avoided if patients dispose of medicines in the household trash, which can be done in compliance with federal laws and is environmentally responsible," according to a statement from senior vice president Ken Johnson.
The drop-off programs include a mail-in program in Maine that has collected 2,000 pounds since 2007, a six-county effort in Washington state involving pharmacies and clinics where 35,000 pounds have been collected over three years, and three collection stations in Palo Alto, Calif. The Palo Alto stations are rarely advertised, but more than 5,400 pounds were dropped off last year.
"This is an issue that will not go away," said Len Kaye, who runs Maine's program and noted similar widespread take-back programs for tires and mercury thermometers. "There is no reason in the world we could not and should not do the same for unused pharmaceuticals."
In Utah, where police station collection bins have netted some 5,000 pounds since 2007, it's clear residents have been hoarding medicines for years.
"People literally come in with boxes and bags," says Leah Ann Lamb, who helps coordinate the state's programs.
The oldest and strangest? A 1958 bottle with a label that only said "For achy legs."
Strict rules governing certain substances, especially narcotics, can limit the type of drugs that can be included in the take-back programs. Pending legislation in Congress would change handling protocols for certain controlled substances. Some states, including Washington and Maine, will consider legislation to have pharmaceutical companies pay for the take-back programs.
Advocates say that's the only way large-scale take-back programs can take hold.
"We do know that there are significant amounts of meds that go unused and for most locations there is no safe and secure place to take them," said Cheri Grasso, who helps run King County's pharmaceuticals project in Seattle.