The Problem
According to the U.S. Centers for Medicare & Medicaid Services which publishes the National Health Expenditure Projections 2012-2022, approximately $275.9 billion in prescription drugs will be prescribed in the U.S in 2014. By 2020, that number is projected to reach $379.9 billion. A report estimated that 10 to 33 percent of proscribed medicines are not consumed. With a lack of safe and secure disposal options, consumers traditionally have had the option of trashing, flushing or storing these medicines in the home. For example, a City of Roseville telephone survey of residents conducted in January 2014 found that although 48% of respondents used responsible disposal methods, 30% still disposed through the household trash or toilet and 17% did not know how to get rid of unwanted medicines. Numerous studies have documented the widespread consequences of improperly stored and disposed medicines, including the impacts on water quality and public health.
NEW Report “Options for Managing Home Generated Medications in San Joaquin County” released by CPSC on January 29, 2016.
- Fact Sheet for the Report on Options for Managing Home Generated Medications in San Joaquin County – CPSC 2/24/16
To learn more about the problems caused by improper disposal of pharmaceuticals and other health products such as sharps, read CPSC’s “A Prescription for Change,” which appeared as an insert in the Sacramento News & Review in March 2014. A second “A Prescription for Change” for Marin County was published in December 2014, and the third “A Prescription for Change” insert for San Mateo County was published electronically in June 2015. Educational inserts were also published in Alameda County and Santa Clara County in Spring 2016. The inserts can be accessed by clicking on the corresponding cover below.
![]() |
![]() |
![]() |
![]() |
![]() |
![]() |
The Solution – Extended Producer Responsibility
Extended Producer Responsibility (EPR) laws requiring that pharmaceutical manufacturers manage their products’ waste at end-of-life have been implemented throughout the world. To comply with such legislation pharmaceutical manufacturers and others in the product chain will design, manage and fund take-back programs to securely collect unwanted medicines and sometimes their packaging from the public and ensure the collected materials are properly managed.
Pharmaceutical EPR Programs From Around the World
Click flag graphics above for fact sheets and information on international programs.
Pharmaceutical EPR in the United States
Following the lead of Canada, France, Spain, and others, local governments in the United States are beginning to implement pharmaceutical EPR laws through local ordinances since state legislation has not passed.
Resources:
- Product Stewardship Organizations and Consultants
- Webinar hosted by the counties of Marin, San Mateo and Santa Clara, and the City and County of San Francisco to educate producers on how to comply with all four ordinances – 11/4/15
Alameda County, California
On July 24, 2012, Alameda County adopted the Safe Drug Disposal Ordinance. This ordinance is based on the program in British Columbia, operated by many of the same pharmaceutical companies doing business in the U.S. This precedent setting ordinance was the first in the nation to hold pharmaceutical companies responsible for the safe collection and disposal of unused medications from the public, starting with a challenge by the pharmaceutical industry in December of 2012 and two appeals which resulted in the U.S. Supreme Court denying the request to hear the case on May 26, 2015.
On January 26, 2016, Alameda County adopted proposed revisions to the 7/24/2012 Safe Drug Disposal Ordinance. Key changes in the revisions include:
- Adds Over-the-Counter (OTC) medications to the covered items
- Allows for collection of Controlled Substances at both law enforcement AND DEA registrants (Pharmacies and Hospitals)
- Requires the stewardship organization to provide a kiosk to any DEA Registrant even if they have reached the 110 site goal originally stated
- Minor changes to definitions to clarify ordinance, and make enforcement easier
Ordinance Timeline
Alameda County Safe Drug Disposal Ordinance Information
Alameda County Safe Drug Disposal Ordinance Amendment Update Package Slideshow – Bill Pollock, 1/11/16
US Ninth Circuit Court of Appeals Hearing Video – PRMA v. County of Alameda, 7/11/2014:
(Alameda hearing begins at 1:01:50)
King County, Washington
On June 20, 2013 the King County Board of Health in Washington passed the Secure Medication Return Rule & Regulation to create a drug take-back program for King County residents. The program promotes the safe disposal of unused prescription and over-the-counter drugs, and will be funded and operated by the drug manufacturers. On November 27, 2013 four groups of major drug manufacturers sued the County. The suit was dismissed following the U.S. Supreme Court’s 5/26/2015 decision not to hear industry’s legal challenge to the Alameda County Safe Drug Disposal Ordinance.
Status – On October 16, 2015, King County approved the Return Meds LLC stewardship plan and rejected the King County MED-Project LLC stewardship plan. The MED-Project submitted a revised proposed stewardship plan for review in accordance with the December 14, 2015 deadline. The compliance deadline for the approved stewardship plan to be fully implemented is no later than April 13, 2016.
- King County Secure Medicine Return Program website
- National Press Release – King County and Alameda County Secure Medication Return 6/26/13
- King County Medication Take-Back Fact Sheet 5/7/13
City & County of San Francisco, California
In 2010, San Francisco introduced a Safe Drug Disposal Ordinance. However, in 2012 the city chose to instead accept $110,000 from PhRMA and Genentech to fund a pilot project to collect data on the issue. In August 2013 the same two organizations provided another payment of $125,000 to fund the pilot project an additional year. A separate Safe Drug Disposal Information Ordinance was passed in May 2011 to supplement the PhRMA-funded pilot program by requiring pharmacies that won’t host a bin to advertise those that do.
The Safe Medicine Disposal Pilot program has been well-utilized, with over 37,000 pounds collected in the first 26 months.
Following the U.S. 9th Circuit Court of Appeals ruling upholding Alameda’s ordinance, San Francisco Board President David Chiu reintroduced the Ordinance on October 21, 2014. Board President Chiu was elected to the California State Assembly in November 2014 and Supervisor London Breed became the author of the ordinance and was elected President of the Board of Supervisors. The ordinance was heard in committee on February 26th with a 3 – 0 vote to move the ordinance to the full Board. The ordinance was heard before the full Board twice – once on March 10, 2015 where it received an 11 – 0 vote to adopt and again on March 17, 2015 where it received a second and final unanimous vote to adopt. San Francisco Mayor Edwin Lee signed the legislation on March 26, 2015 and the ordinance’s date of enactment is 30 days after signing.
- Safe Drug Disposal Stewardship Ordinance – signed 3/26/2015
- Resources:
- SF Environment Safe Drug Disposal Stewardship Ordinance Information
- Safe Drug Disposal Stewardship Ordinance Fact Sheet – San Francisco Department of the Environment, revised 3/16/2015
- San Francisco Board of Supervisors Meeting 3/10/2015 – Meeting video, San Francisco Government TV, 3/10/2015 (Ordinance discussion begins 00:16:20)
- Government Audit and Oversight Committee Public Hearing – Hearing video, San Francisco Government TV, 2/26/2015
- Creating Safe Medicine Disposal Options – Op Ed by London Breed, San Francisco Examiner, 2/25/2015
- San Francisco May Be First Major U.S. City With a Drug Take-Back Program – Ed Silverman, Wall Street Journal, 3/25/2015
San Mateo County, California
- 4/28/15 – Ordinance adopted on consent
- Resources:
- San Mateo County Health System Safe Medicine Disposal Ordinance Information
- County of San Mateo Board of Supervisors Meeting 4/14/15 – Meeting video, San Mateo County YouTube Channel, 4/14/15 (Ordinance discussion begins 1:39:31)
- Proposed San Mateo County Ordinance Would Require Drug Companies to Pay for Disposal Program – Kamala Silva Wolfe, San Francisco Examiner, 1/14/2015
- Educational insert piece: A Prescription for Change: How Improperly Disposed Medications and Needles Are Affecting Our Community Health – San Mateo County Environmental Health, 6/2015
- Summary of Medication Disposal Consumer Survey Results – San Mateo County [PDF]
Santa Barbara County, California
- 6/7/16 – Board of Supervisors heard staff presentation and public comment on their proposed pharmaceutical EPR ordinance and passed by a 3-1 vote, with one Supervisor abstaining. The ordinance can become law after a final vote in two weeks.
- 5/19/15 – Board of Supervisors Hearing held on unused pharmaceuticals; Board directed staff to begin stakeholder process. 10/6/15 – agenda item 15-00784 passed by a 5-0 vote and directs staff to draft an EPR ordinance for pharmaceuticals and return to the Board in early 2016.
- 6/7/16 – Board of Supervisors hearing held on proposed pharmaceutical EPR ordinance; ordinance passed by a 3-1 vote with one Supervisor abstaining.
- 6/21/16 – Proposed ordinance passses with 4-1 vote to adopt. Ordinance becomes effective 7/21/16
- Resources:
- County Board of Supervisors Meeting 6/7/16 – Item #7, Stewardship for Safe Drug Disposal
- County Board of Supervisors Meeting 6/21/16, Stewardship for Safe Drug Disposal
- County of Santa Barbara Press Release – Santa Barbara County Board of Supervisors Adopt Safe Drug Collection Program Ordinance, 6/21/16
Santa Clara County, California
- 3/14/17 – Ordinance to amend the existing Safe Drug Disposal Ordinance in order to clarify and strengthen ordinance requirements prior to implementation of MED-Project’s proposed stewardship passed by a 3-0 vote with two Supervisors recusing themselves.
- 5/19/15 – Ordinance introduced at Board of Supervisors Meeting and passed by a 3-0 vote with two Supervisors recusing themselves due to pharmaceutical investments. 6/23/15 – Ordinance second reading before Board and received a unanimous 3 – 0 vote to adopt, with two Supervisors recusing themselves due to pharmaceutical investments. 7/23/15 – ordinance went into effect.
- Resources:
- County of Santa Clara Safe Drug Disposal Ordinance Information
- County of Santa Clara Board of Supervisors Meeting 5/19/15 – Meeting video, County of Santa Clara Board of Supervisors, 5/19/15 (Ordinance discussion begins at 3:47:20)
Marin County, California
- 7/28/15 – Ordinance first reading at Board of Supervisors Hearing and received a 4-0 vote to approve, with one Supervisor recusing themselves due to pharmaceutical investments. 8/11/15 – Ordinance read the second time and received a 4-0 vote to adopt, with one Supervisor recusing themselves due to pharmaceutical investments. 9/11/15 – ordinance went into effect.
- County of Marin Safe Drug Disposal Ordinance – Adopted, 8/11/15
- Press and Resources
- County of Marin Safe Drug Disposal Ordinance Information
- Marin Joins List of County Drug Takeback Ordinances As Local EPR Goes Nationwide – California Life Sciences Association, 8/10/15
- Marin: Drug Firms Must Pay for Disposal of Their Medications, Nels Johnson, Marin Independent Journal, 8/12/15
Los Angeles County, California
- 8/11/15 – agenda item #4 passed by a 4-0 vote with one Supervisor abstaining; directed staff to initiate the stakeholder process for development of a pharmaceutical and medical sharps EPR ordinance. 11/13-15 – public stakeholder meeting held at the Kenneth Hahn Hall of Administration.
- 5/17/16 – After three previous postponed votes, the LA County Board of Supervisors postponed voting on their proposed pharmaceutical and sharps EPR ordinance. The item will be rescheduled for the next Board public meeting held June 14, 2016. The Board heard public comment and asked a few questions.
- Coverage of 5/17/16 vote to postpone:
- Video of EPR ordinance public comment and Board discussion
- Vote on LA County drug take-back proposal delayed again – Stephanie O’Neill, Southern California Public Radio, 5/16/16
- LA Times Column Covers LA County Proposed EPR Ordinance – California Inc., David Lazarus, 5/16/2016
- Dangerous prescription drug battle plan for LA County: Let’s put it off, Hoa Quach, MyNewsLA.com, 5/17/16
- 6/14/16 – The Board of Supervisors voted 3-0 with two supervisor’s abstaining in favor of a motion that will have industry contribute funding towards quarterly take back events, study the results of Walgreen’s voluntary medication collection program in LA County, and create an education campaign on existing take back locations and disposal in the trash. The EPR ordinance may be reconsidered in November 2016.
- Video of 6/14/16 Board of Supervisors meeting staff report, public comment, and Board discussion
- LA County Supervisors set — again — to vote on drug take-back ordinance, Stephanie O’Neill, Southern California Public Radio, 6/13/16
- L.A. County supervisors roll back plans for a drug take-back program, Abby Sewell, Los Angeles Times, 6/14/16
- Pharma loses one batter over drug take-back programs, but wins another, Ed Silverman, STAT News, 6/16/16
- 8/26/16 – County of Los Angeles disapproves the revised plan submitted on 8/12/16 in a letter to industry and identifies areas where the plan needs improvement
- Resources:
- Letter of Support from CPSC and 11 other signatories and List of Key Elements of a Properly Constructed Ordinance, 11/9/15
- County of Los Angeles Department of Public Health Pharmaceutical Take-Back website
Santa Cruz County, California
- 9/1/15 – agenda item #27 passed and directed staff to initiate the stakeholder process for development of a pharmaceutical and medical sharps EPR ordinance. 10/8/15 – a public stakeholder meeting was held at the Santa Cruz County Board of Supervisors Chambers. 11/10/15 – Ordinance read for the first time at the Santa Cruz County Board of Supervisors Hearing and received a 5-0 vote to approve the first reading and then approved again at the second reading 12/8/15 with a 5-0 vote. 1/8/16 – Ordinance goes into effect.
- 8/9/16 – City of Santa Cruz proposed Safe Drug and Sharps Disposal Ordinance passes by a 7-0 vote. Ordinance goes into effect 9/9/2016
- City of Santa Cruz and National Stewardship Action Council press release, Updated 10/21/16
- 8/25/16 – City of Capitola proposed Safe Drug and Sharps Disposal Ordinance passes by a 5-0 vote. Ordinance goes into effect the 31st day after passage.
Snohomish County, Washington
- 6/14/16 – Ordinance passed by Board of Health
- Snohomish Health District Pharmaceutical Stewardship
Sonoma County, California
- 10/4/16 – Sonoma County Board of Supervisors held a Safe Medicine Disposal – EPR Study Session (Agenda Item #21) at their public Board Meeting and directed staff to continue working cooperatively with the existing Safe Medicine Ordinance Collaborative, cities, and other stakeholders and return to the Board with a pharmaceutical EPR ordinance proposal that includes a deeper analysis and recommendations regarding the ordinance options and a program implementation plan.
- Sonoma County Press Release – Sonoma County to Develop Safe Medicine Disposal Ordinance, 10/4/16
- Video of 10/4/16 Board Study Session:
Contra Costa County, California
- 12/20/16 – Final Safe Drug Disposal ordinance adopted on consent. Ordinance is effective 30 days from passage. County staff will return to the Board with an update before July 2017 and work to address multiple additional items including the makeup of the Stewardship Organization that implements the program to be listed as a 501-c3 and adding specificity to the method of medication disposal.
- 12/13/16 – Motion to waive the ordinance reading and fix 12/20/16 as the adoption date of the revised ordinance passes unanimously by 5-0 vote.
- Video of 12/13/16 Board of Supervisors Meeting:
Transitional EPR Local Programs for Pharmaceuticals
San Luis Obispo County, California
- 3/11/15 – Ordinance passed by the the San Luis Obispo County Integrated Waste Authority (IWMA) Board of Directors by an 11-0 vote with two Directors absent. Ordinance is “Transitional to EPR” policy since a different group in the product chain – in this case retailers – is having to pay for the program but not producers. 4/11/15 – Ordinance takes effect. Effective 9/11/15, retail pharmacies in the IWMA region are required to provide a mail back program and/or collection receptacle program to dispose of unwanted prescription drugs as required under the Ordinance
Voluntary Pharmaceutical Stewardship
Walgreens Leads National Chains on Medication Take Back![]()
In 2016 Walgreens became the first retailer to implement an ongoing national stewardship program by installing safe medication disposal kiosks in more than 600 drugstores in 45 states and Washington, D.C. to make the disposal of medications — including opioids and other controlled substances — easier and more convenient while helping to reduce the misuse of medications and the rise in overdose deaths. To date they have collected 72 tons of meds! In a Walgreens press release announcing the program, Richard Ashworth, Walgreens president of pharmacy and retail operations said “Walgreens pharmacists play an important role in counseling patients on the safe use of their medications, and now we are leading the way in retail pharmacy’s fight against prescription drug abuse.
Don’t Rush to Flush, Meds in the Bin We All Win! Medicine Collection Program
CPSC received a grant from the Rose Foundation to establish a medication collection program in Sacramento and Yolo counties in July 2013. The resulting program,
named “Don’t Rush to Flush, Meds in the Bin We All Win!” (DRTF) established six permanent medication sites available to the public free of charge in Sacramento and Yolo counties and has since expanded to Contra Costa, Santa Clara, and Madera counties. DRTF is being licensed and sold to communities across the country. Email info@calpsc.org for more information.
- Website – www.dontrushtoflush.org
- Facebook – www.facebook.com/DontRushToFlush; Twitter- www.twitter.com/DontRushToFlush
Dispensary of Hope
An estimated $2.2 billion in sample medications provided to medical practices go to waste each year, meanwhile millions of uninsured patients go without the medications they need. Dispensary of Hope is a national, not-for-profit social enterprise that serves patients by recovering donated surplus medication from physician offices, hospital pharmacies, manufacturers, distributors, and other licensed healthcare providers. The medication is given away for free to patients who lack healthcare insurance and are under 200% of the Federal Poverty Level. The list of sites is available here.
- An Rx for Surplus Meds
- Case Study: Sentara Medical Group
- Case Study: St. Vincent Medical Group
- Dispensary of Hope Impact Report
Click here to connect with Dispensary of Hope on Social Media!
SIRUM
Supporting Initiatives to Redistribute Unused Medicine (SIRUM) is 501(c)3 nonprofit that has developed an online platform to connect safety-net clinics with donated medications from suppliers, pharmacies, and health facilities. They give pharmacies an option to donate rather than destroy their unused & returned medicines. To learn more about SIRUM, watch this video.
Click here to connect with SIRUM on Social Media!
Safely Dispose of Your Medications
- CalRecycle – Statewide
- Don’t Flush Your Meds by Regional San – Sacramento Region
- Don’t Rush to Flush Take-Back Sites – Contra Costa, Santa Clara, Sacramento, and Yolo counties
- Earth 911 – Nationwide
If you see any missing locations, please send them a message - Safe SF Bay – San Francisco Bay Area
Their list is compiled from information found on CalRecycle’s and Earth 911’s sites. If you see any missing locations, contact CalRecycle and Earth911 (see above)
Articles & Press
- Drug companies should pay for the proper disposal of leftover drugs, Jeff vonKaenel, Sacramento News & Review, 5/18/17
- Pharma loses one batter over drug take-back programs, but wins another, Ed Silverman, STAT News, 6/16/16
- LA County Supervisors set — again — to vote on drug take-back ordinance, Stephanie O’Neill, Southern California Public Radio, 6/13/16
- Big Pharma Under Pressure to Pay For Drug Take-Back Programs – Sy Mukherjee, Fortune, 4/30/16
- Proposed LA County Law Would Make Pharma Pay for Drug, Sharps Disposal – Stephanie O’Neill, Southern California Public Radio, 4/22/16
- Shareholders Challenge Pharmaceutical Industry To Take Back Unused Drugs – As You Sow Press Release, 4/22/16
- OP/ED: The Truth About Costs of the LA County Drug Take-Back Ordinance – Arthur J. Shartsis and Heidi Sanborn, Los Cerritos News, 4/20/16
- What to do with old prescription drugs? Four O.C. Walgreens will be take-back sites for medications – Jenna Chandler, Orange County Register, 2/22/16
- Safe and Convenient Medicine Collection is Good Medicine for LA County – Op-Ed by Heidi Sanborn, Los Cerritos News, 2/12/16
- Drug Disposal Bins Welcome Tool in Opioid Fight – Sacramento Bee Editorial, 2/11/16
- Walgreens Leads Fight Against Prescription Drug Abuse with New Programs to Help Curb Misuse of Medications and the Rise in Overdose Deaths – Walgreens Press Release, 2/9/16
- California Product Stewardship Council and Others Urge Federal Agencies to Revise Recommendations for Safe Medicine Disposal – California Product Stewardship Council Press Release, 1/26/16
- Preventing Prescription Drug Diversion – Janet V. Dumonchelle, Journal of Addictions Nursing, Fall 2015
- Local Drug Take-Back Programs Could Be Preempted by State Regulations – George Lauer, California Healthline, 11/2/2015
- California Wins Big Against Big Pharma: Organization Hopes Other States Follow the Lead, Addiction Campuses, 10/29/2015
- Supreme Court Upholds the Alameda Ordinance that Producers Share in Responsibility for Product Waste: What Does That Mean for the Waste Industry? – Heidi Sanborn, Waste Advantage Magazine, August 2015
- Drugging the Environment – Megan Scudellari, The Scientist Magazine, 8/1/15
- CVS Wants to Help Cities Safely Dispose of Old Medications – Alexis Petru, Triple Pundit, 5/20/15
- Pharma Frets as Local Governments Adopt Drug Take-Back Programs – Ed Silverman, Wall Street Journal, 5/1/2015
- Challenged in Court, Killed in Legislature, Drug Take-Back Taking Root in Counties – George Lauer, California Healthline, 3/30/2015
- Supreme Court Could Weigh Local Mandates on Drug Makers – Michael Warren, Washington Examiner, 3/27/2015
- Should Pharmaceutical Companies Pay for Local Drug Take-Back Programs? – Go Green Radio episode, 3/6/2015
- Prescription Drugs are Polluting Our Waters – Carren Jao, KCET, 12/1/2014
- Ninth Circuit Upholds Alameda County’s Drug Take-Back Ordinance – Maureen Gorsen, Cathy Burgess, and Elise Paeffgen, Alston & Bird L.L.P., 10/6/2014
- That Flushing Sound: Pharma Must Pay for a Drug Take-Back Program – Ed Silverman, Wall Street Journal, 10/1/2014
- Alameda County’s Pioneering Drug Disposal Law Upheld in Federal Court – Bob Egelko, San Francisco Chronicle, 9/30/2014
- DEA to Allow Return of Unused Pills to Pharmacies – Catherine Saint Louis, New York Times 9/8/2014
Studies
- Landfill Leachate as a Mirror of Today’s Disposable Society: Pharmaceuticals and Other Contaminants of Emerging Concern in Final Leachate from Landfills in the Conterminous United States – Masoner, Jason R., et al., Society of Environmental Toxicology and Chemistry (2015)
- Evaluating the Extent of Pharmaceuticals in Surface Waters of the United States Using a National-Scale Rivers and Streams Assessment Survey – Batt, Angela L., et al., Society of Environmental Toxicology and Chemistry (2015)
- Taking Stock of Medication Wastage: Unused Medications in US Households – Law, Anandi V., et al., Research in Social and Administrative Pharmacy 11 (2015)
- City of Roseville Environmental Utilities Residential Customer Telephone Tracking Survey
Summary Report of Survey Results – 1/2014, January 2015 - Alameda County Safe Medication Disposal Initiative Assessment, 2007 – 2014 – Dr. Joel Kreisberg, Teleosis Institute, July 11, 2014
- National Drug Control Strategy – US Executive Office, July 2014
- Contaminants of Emerging Concern in Ambient Groundwater in Urbanized Areas of Minnesota – U.S. Geological Survey and the Minnesota Pollution Control Agency, 2014
- Estimated Number of Emergency Department Visits for Misuse or Abuse of Pharmaceuticals More Than Doubles from 2004 to 2010 – Center for Substance Abuse Research, 7/23/2012
- Pharmaceuticals in the Environment: Looking to Green Governance for a Remedy – Ryan Albrecht, Journal of Energy & Environmental Law, Summer 2012
- Emerging Contaminants at a Closed and an Operating Landfill in Oklahoma – Ground Water Monitoring & Remediation, National Ground Water Association, 2011
- Dosed without prescription: Preventing Pharmaceutical Contamination of our Nation’s Drinking Water – Natural Resources Defense Council. 2009
Links
- Alameda County Department of Environmental Health Safe Drug Disposal
- Alameda County Medicine Education Disposal Safety (MEDS) Coalition website
- King County Secure Medicine Return Program website
- King County Secure Medicine Return Rule and Regulation website
- Los Angeles County Department of Public Health Pharmaceutical Take-Back website












