from the desk of Ted Duboise
Dispose of Unused Meds Properly
Every year, the amount of medicines that are being produced and prescribed is increasing in volumes. In the U.S., the number of prescriptions rose to 3.7 billion in 2006 and the sales of over-the-counter medicines have increased by 60% since the 1990s.(1)(2) With these increases comes the concern of the fate and effects of these compounds in the environment. The disposal of unused medicine is a growing concern that involves a broad range of issues including human health, environmental health, water quality, solid waste management, law enforcement, and the healthcare industry. Both prescription and non-prescription medicines are of concern along with nutritional supplements, skincare products, and cosmetics. There are thousands of these products and all are specifically designed to interact with biological processes. They can enter the environment when people dispose of them in their trash or toilet. They can also enter the environment after excretion or even by rinsing off the skin.
Recent studies have identified a wide range of these pharmaceutical chemicals in rivers, streams and even ponds nationwide.(3) Studies have also shown that, even at low concentrations, some of these compounds are harmful to aquatic organisms, affecting reproduction and development.(4) A United States Geological Survey (USGS) study analyzed 139 streams in 30 states and found 82 different organic wastewater contaminants, including pharmaceuticals and pesticides. 80% of the streams they sampled had at least one organic wastewater contaminant, 75% of the streams tested had more than one contaminant, 50% had seven or more, and 24% had ten or more.
How Do Meds Enter Our Water?
Once they have been discarded or excreted, pharmaceutical chemicals enter surface waters and groundwater through several pathways:
• Effluent from plants that treat household, industrial, and hospital wastewater
• Septic systems
• Runoff and/or groundwater from uncontrolled landfills or landfill leachate sent to waste water treatment plants
• Controlled industrial discharges
• Commercial animal feeding operations and aquaculture
• Surface application of manure and biosolids
The long-term impact of medicine disposal on our health and the environment is not fully known at this time. However, with the increase in medicines each year, the quantities of these chemicals reaching our waterways will increase unless we take action.
What Can Be Done?
The issues surrounding medicine disposal are complex. Improper disposal of unwanted medicines can pose a risk to children and pets. For example, medicines placed in the trash without taking precautions to secure the container, make the medication unpalatable, or disguise the content, are often accessible to children and pets, sometimes resulting in unintentional poisonings. And medicines disposed with their original labels intact can result in identity theft and drug theft. This is an especially important issue for the elderly, who are the biggest consumers of prescribed medicines.
So How Do You Dispose of Unused Medicines?
In early 2007, both the American Pharmacists Association(5) and the Office of National Drug Control Policy(6) issued guidelines for medicine disposal, following on the heels of several states providing advice to their citizens. The two main components of both sets of national guidelines are:
1. Don’t flush medications down the toilet and instead,
2. Remove labeling from packaging and dissolve solid medications, mix with unpalatable items (kitty litter, coffee grounds, etc.) and seal in a bag before placing in the trash. Disposal to trash is considered by some organizations to be an interim solution because medicines placed in landfills may ultimately reach wastewater treatment plants and local streams and rivers. Illinois-Indiana Sea Grant believes that currently, the best disposal solution is incineration of medications in a regulated incinerator. There is, however, a very long list of hurdles to overcome before a national disposal plan can be implemented that is protective of humans, pets and our environment. These hurdles include identifying safe and convenient medicine collection pathways and determining who will pay for this service.
Learn More With Resource Kit
A resource kit has been created to help communities design, establish and implement safe and proper collection programs. Included in the kit are several examples of pamphlets, fact sheets and education materials that have been developed by communities and states as they wrestle with this complicated issue. The recommendations and advice vary because jurisdictions are finding different ways to deal with the fact that only interim solutions are available currently. You can access the kit here: Unwanted Meds.
Watch A Video: One Way To Properly Dispose of Unused Medicines
The good news about this issue is that it touches upon so many different aspects of our lives that there is no end of partners to join with to educate and reach out to the public. This issue impacts the elderly through drug and identity theft issues, accidental poisoning, and health care costs. It matters to the police because prescription drug abuse by teenagers is on the rise. Concerns for the safety of children and pets also can drive behavioral change. And for all of us, our health depends on the health of our environment, including rivers and streams and the creatures that live in them.
Sources:
1. Ann Pistell, Maine Department of Environmental Protection. Presentation at Northeast Water Science Forum, August 9, 2007.
2. “IMS Intelligence.360: Global Pharmaceutical Perspectives 2006”, IMS Health Report, February 22, 2007. http://www.imshealth.com/ims/portal/front/articleC/0,2777,6599_40183881_81567488,00.html
3. Kolpin, Dana W., et al. “Pharmaceuticals, Hormones, and Other Organic Wastewater Contaminants in U.S. Streams, 1999-2000: A National Reconnaissance.” Environ. Science and Technology.Vol. 36 no. 6 (2002): pp. 1202-1211.
4. For example, see Nash, Jon P., et al. “Long-Term Exposure to Environmental Concentrations of the Pharmaceutical Ethynylestradiol Causes Reproductive Failure in Fish.” Environmental Health Perspectives. 112.17 (2004): pp. 1725-1733.
5. These guidelines were issued in cooperation with the U. S. Fish and Wildlife Service and can be found online at http://www.aphanet.org/AM/Template.cfm?Section=News_Releases1&CONTENTID=7481&TEMPLATE=/C M/ContentDisplay.cfm
6. Office of National Drug Control Policy
