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The leftover prescription drugs sitting around your house are at the center of a fight between small government and big pharmaceutical companies. Two West Coast counties have passed laws requiring drug makers to pay for the safe disposal of unused medications. In Sacramento, Pauline Bartolone reports that these laws are part of a broader movement, forcing manufacturers to rethink how they do business.

PAULINE BARTOLONE, BYLINE: Mary Hill is a social service coordinator at a retirement home in Oakland, California. She's been accumulating prescription drugs in her office.

MARY HILL: I have here morphine from people like who have cancer. I have Vicodin.

BARTOLONE: Hill's been storing leftover drugs from residents who have died or don't know how to get rid of them safely.

HILL: This is methadone.

BARTOLONE: Hill is in a quandary. She wants to keep the drugs away from recreational users and out of the water supply, but the retirement home has no formal way to dispose of the drugs. And if she drives the drugs offsite she could be stopped for possession of pharmaceuticals that don't belong to her.

HILL: We don't want to put it in the garbage bin outside. They can't flush it, so I don't know what to do.

BARTOLONE: Alameda County has a safe drug disposal program at a couple dozen locations. But Alameda County's supervisor, Nate Miley, says the program needs to be more convenient and the wrong people are footing the bill. He authored a local ordinance that requires drug makers to design and pay for a comprehensive take-back program.

NATE MILEY: This is not something taxpayers should be paying for. It seems like when products have reached their life cycle, it should be the responsibility of the manufacturers to have a way of properly disposing of those products.

BARTOLONE: Alameda County has the first producer-responsibility-drug-take-back law in the country. Miley says the local government stepped up because states and the federal government have not.

MILEY: We can't wait for Sacramento. We can't wait for the federal government. We're hoping that other counties would see what we've done and have the courage to follow our lead.

BARTOLONE: Pharmaceutical companies challenged Alameda County's ordinance in federal court. The local law was upheld and drug makers have appealed. Another county in the Seattle, Washington, area is following Alameda's lead. And now the pharmaceutical industry is challenging their law too.

MIT SPEARS: Running, if you will, a waste disposal authority is something that's really not in the institutional competence of manufacturers.

BARTOLONE: Mit Spears is general counsel for Pharmaceutical Research and Manufacturers Association, or PhRMA.

SPEARS: Local governments have been in the waste disposal business for a very, very long time and, and they know more about it. They know more about how to take care of their citizens and what the needs are.

BARTOLONE: Spears also says if pharmaceutical companies have to pay for the programs, industry will pass the costs on to consumers.

SPEARS: We think it's unfair to basically put upon a Medicaid or a Medicare beneficiary in Tennessee a higher cost on their product so that we can pay for a state-of-the-art take-back program in Alameda, California.

BARTOLONE: PhRMA questions whether local governments can regulate interstate commerce. But Heidi Sanborn of the California Product Stewardship Council says the discussion should focus on responsibility.

HEIDI SANBORN: Is the appropriate role of government to pay for the end of life for products put on the market that have an end-of-life cost? Or is it the appropriate role of the private sector to design life cycle systems that are basically cradle to cradle?

BARTOLONE: Whether it's electronics, pharmaceuticals or other consumer products, Sanborn says pushing manufacturers to be accountable for their waste makes them rethink production.

SANBORN: If they have an economic incentive that drives them to redesign and rethink the product, what it's made out of, how it works, how long it lasts, then we'll see hopefully greener design. And that's ultimately our goal.

BARTOLONE: Pharmaceutical companies must deliver a safe drug disposal plan to Alameda County this May. In the meantime, California lawmakers will look at a state proposal to force the industry to pay for its waste. For NPR News, I'm Pauline Bartolone in Sacramento.

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