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Pharmaceuticals in some form date back to the Middle Ages, but in modern days there are hundreds of prescription and over-the-counter medications available. Not only do humans consume pharmaceuticals, but livestock consumes millions of doses, as well. The global pharmaceutical market continues to grow year by year, and with it environmental concerns pertaining to not just production, but also consumer waste and disposal.
The US Department of Health and Human Services reports that at least half of all Americans take a minimum of one prescription drug, with one in six taking three or more. This doesn’t include the frequent use of over-the-counter medications for easing a headache, such as acetaminophen, aspirin, ibuprofen, naproxen sodium, or one of the many other maladies people suffer from on an occasional basis. Unused medication piles up in many households and waits for its final disposal. But where does it usually end up? Unfortunately, not always in the right place.
Pharmaceutical pollution is created by human activity. Residues come from manufacturing, veterinary use, agribusiness, hospitals, and community use. According to the US Geological Society, non-prescription drugs and steroids were more often detected in streams than prescriptions drugs, though a variety of prescription drugs were also present.
Improperly disposed medications, considered a toxic waste that finds its way into streams and drinking water, negatively impact humans, wildlife, and agriculture. At this time, many unknowns remain regarding the possible adverse effects on ecological receptors and humans from exposure to pharmaceutical pollutants in the environment. However, the possible risk to aquatic organisms due to exposure to these pollutants in the environment has been identified as a primary concern.
For medications intended for discard, pharmacists are expected to comply with a federal law, the Resource Conservation and Recovery Act (RCRA), as well as other regulations, for both hazardous and non-hazardous pharmaceuticals. However, many hospitals, unfortunately, continue to dispose of pharmaceuticals, except chemotherapy agents, by simply throwing them down the drain or sending them to the landfill.
According to the Minnesota Pollution Control Agency, the preferred method for destruction of household pharmaceuticals is incineration. If household garbage goes to an incinerator, medication gets disposed of safely. If household garbage goes to a landfill, it is not preferred over taking them to designated pick up sites, but is still preferable over flushing them down the toilet.
One topic that has not been discussed is pharmaceutical waste that comes from us, people. After taking medications each day, a large percentage of the active ingredients does not metabolize and ends up in human waste. Excess drugs in the bloodstream leave the body through urine and fecal matter, and the excreted chemicals flow with the sewage out of our homes to the streams and lakes. How can we help this form of pollution? Is it possible at this time?
Pharmaceutical Pollution Concern around the World
North America represents approximately 38% of the global pharmaceutical market with Europe following closely [Figure 1]. Like in the US, the role of pharmaceuticals in water pollution is being taken as a major concern. The European Commission unveiled a new set of water rules, which for the first time included certain pharmaceutical products. Particular medications, such as pain relieving drug Diclofenac, are on the watch list.
According to Nature, an international weekly journal of science, “Many of Europe’s rivers are home to male fish that are ‘intersex’ and so display female sexual characteristics, including female reproductive anatomy. Some males also produce vitellogenin, a protein normally found in eggs that can be induced in males by hormone exposure. In one of the largest studies of the problem in 2004, the UK government’s Environment Agency found that 86% of male fish sampled at 51 sites around the country were intersex.” Toxicologists blame this feminization on endocrine-disrupting chemicals — particularly the active ingredient in the contraceptive pill, ethynyl oestradiol (EE2). This is a specific example of the pharmaceutical industries effect on the environment
One very recent case of pharmaceutical pollution by a large company is a recent scandal in China. The Harbin Pharmaceutical Group, a major company in China’s HeiLongJiang province decided to relocate after waste gases and water that exceeded legal pollution limits were released into the environment. They received a steep fine, but other types of penalties have not yet been published.
Drug companies around the world are increasing production of both prescription and non prescription pharmaceuticals for a growing market. As people continue to increase their intake of medication, so must they increase awareness of pharmaceutical pollution, and hold the health care industry accountable, as well.
Tackling the Problem
Pharmaceutical pollution can be stopped for the most part, but currently there are no commonly used methods of preventing it from human or animal waste. Instead, we must concentrate on ways of proper disposal and actually using them. We meaning consumers, hospital staff, pharmacy staff, scientists, and pharmaceutical companies.
In the United States, many environmental groups, health organizations, police, drugstores, and drug manufacturers participate in drug take-back programs. The only difficulty with these programs is that environmental groups and health organizations are sometimes inconvenient to reach, police may only take the drugs on certain days of the year, and some drugstores in certain states require payment for “envelopes” used for disposal. In addition, controlled substances may not be accepted by anyone other than the police since it is illegal to hand such medications over to someone else. Given this, some people who may normally recycle or properly dispose medication may resort to flushing them down the toilet or throwing them in the garbage for potential roving hands or animal thieves.
Unfortunately, people in many states in the US do not even know about the proper disposal of medications. The communication of proper medication disposal methods varies from state to state. Luckily some states have been successful in gathering unwanted medication. In Washington State alone, more than 75,000 pounds of drugs were returned to such places in 2 years alone.
How SHOULD pharmaceuticals ideally be disposed of? Currently high temperature incineration at suitably permitted facilities is the safest disposal method for toxic left-over medications. This is the method the pharmaceutical industry uses to dispose of their unwanted medicines. As the dangers of pharmaceutical pollution are becoming more and more apparent, awareness of regulatory institutions and pharmaceutical companies rises, as well. With more disposal centers, regulation, and education of the population, many of detrimental impact of pharmaceutical waste might be successfully negated in the near future.
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