Hoping to keep streams and groundwater cleaner, the people who run sewage plants around California want to change the way we get rid of old medicines.

The toilet is out.

The hazardous-waste site is in. Except where it's not.

Then there's the trash.

Advocates hoping to deliver the message "No Drugs Down the Drain" are struggling with exactly where else unwanted medications should go.

"Everybody is trying to do the right thing, and right now our laws just haven't caught up with what the right thing is," said Jen Jackson, the effort's statewide coordinator.

To help people navigate the legal morass, the campaign is coordinating special drop-off events statewide, including two planned for Saturday in Auburn and Roseville. It's also publicizing hazardous-waste sites that routinely accept medications, including four in the Sacramento region.

People are getting increasingly worried about drugs that make their way into America's waterways. An Associated Press investigation this year found traces of prescription and nonprescription medicines in the drinking supply of 41 million Americans.

Many of those drugs make a stop in the human body first, as people take birth control pills, antibiotics or painkillers and then eliminate what their bodies don't use up.

Americans also discard plenty of medicine – one estimate is 10 million pounds a year, Jackson said.

"The piece that we can address right now, in an immediate way, is what people throw away," she said.

Her group wants those drugs out of our waterways because they appear to be affecting sexual development in fish, and probably also have impacts on microbes, plants and other aquatic life. The chemicals might be too diluted to affect people, but no one knows for sure.

Some of the biggest groups that deal with sewage treatment are behind the collection drive: the League of California Cities, the California Association of Sanitation Agencies, and the California Water Environment Association. Even so, there are only around 100 special collection sites planned during the eight-day drive.

"Our coverage is not fabulous yet. A lot of regulatory issues make it very hard to set up programs," Jackson said.

Among them: If a pharmacy collects unused medications, it is considered medical waste, and that's expensive to get rid of. If a waste site takes it, technically a law enforcement officer has to be there, because controlled substances make up about 10 percent of discarded medicine.

Federal drug law forbids passing along to others painkillers such as Vicodin, which contains hydrocodone. The same law restricts handling of things people might not think of as controlled substances, including Ritalin and other medications with methylphenidate, and even cough syrups that contain codeine.

Both Jackson and a DEA spokeswoman in Washington confirmed that in theory, a law officer needs to take custody of such controlled drugs. The DEA is looking into revising its policies. The agency generally focuses on bigger players than waste disposal sites.

The county of Sacramento might be glad to hear that, since its household hazardous- waste site has long accepted a smattering of medicines, controlled or not.

"It's been an extremely minute amount of business, maybe two or three drop-offs a week," said Chris Andis, public information officer for the county's solid waste program. The medicine seems unlikely to fall into the wrong hands, since an employee stands next to a big barrel where people can deposit wet waste, pharmaceuticals and toxic materials.

"Just picture in your mind dumping drugs into a goopy mess. They're not really usable" after that, Andis said.

The city of Sacramento's household hazardous-waste site, by contrast, doesn't accept any medicine, partly because of "security" issues, said spokeswoman Jessica Hess. The city of Folsom, which sends crews to residents' homes by appointment to pick up hazardous wastes, will take all medicines except controlled substances.

The patchwork of polices means there is no simple recommendation for how to clean out a medicine cabinet.

"We used to recommend for children's safety that you just got rid of them through flushing them," said Michelle White, a Placer County environmental resource specialist. "Now, we realize it is harmful to the environment and our drinking water and our groundwater," she said.

Other options include special collections, like the one next week; a hazardous-waste site that may accept drugs you want to dispose of; or your own garbage can.

The toss-it-yourself plan comes with an elaborate set of precautions. Recommendations include removing personal data from the label, mixing the drugs with something inedible, putting it back in its own container and then hiding that container inside something else so no one can tell there are drugs in your trash.

Oh, and it doesn't hurt to leave the drug name on the label. That way poison-control workers can refer to it in case, despite all your efforts, someone's pet or some unwary person ingests it.

Call The Bee's Carrie Peyton Dahlberg, (916) 321-1086.