Many Americans turn to both prescription and over-the-counter medications for the health needs on a daily basis. For many, medications are necessary in order to live or to conduct a normal life so imperative to work and home. But, there are environmental considerations that must be appreciated by all, because the consequences of not paying close attention may be quite dire. This paper briefly explores the effects that prescription and over-the-counter medicines have on the environment when not disposed of properly. While there still remains much research to be conducted on this issue, most in high authority recognize that medicines have leached into the water system in this country and the potential results could in fact be devastating.
Prescription medications play an essential role in the health and wellbeing of millions. A number of studies have shown that in excess of 2,000 medications are being prescribed in the United States in order to treat or manage the range of medical issues, which is very big business considering that gross profits from dispensing medicine to the masses equates to approximately $1.8 billion annually (Ruhoy & Kaye, 2009). Such benefits aside, there are side-effects to medications only a relative few were aware of only a short time ago but has become an increasingly pressing issue of late. According to Ruhoy & Kaye (2009), “It is now widely recognized that pharmaceuticals reside in water systems across the country, with unwanted effects on the environment, wildlife, and humans.” (p. 26) In fact, the problem had become of such great importance that it resulted in the collaboration of three federal agencies for purposes of releasing guidelines for the safe disposal of prescription medication: the White House Office of National Drug Control Policy, Department of Health and Human Services (DHHS) and the Environmental Protection Agency (EPA; Editor, 2007).
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In 2008, a year after the release of the guidelines, a summit was held, attended by representatives of the above referenced agencies along with academic researchers, special interest groups and representatives of the pharmaceutical industry (Tillett, 2009). Perhaps a learning lab for some in attendance, specifics of the conference had to do with an increase of toxic levels in the country’s drinking water attributed to medication. What was learned at the 2008 meeting was that slightly over 40 million people drink water from the tap that has been found to contain trace pharmaceuticals. These traces are not only attributed to flushing medication down toilets, but are also excreted as waste. Even drugs administered for veterinary purposes, especially in large agribusiness operations, have now leached into water systems throughout the country. While modern water treatment methods are successful at preventing some of these toxic substances from entering water systems, they cannot prevent all related chemicals from leaching into America’s waterways (Tillett, 2009).
Considering the numbers of medications prescribed in this country and the range of chemical substances each contain, the aggregate in terms of what is dispensed into the water system is quite disturbing. Each type of medication carries into the water system its own particular removal rate, meaning how quickly or slowly it breaks down to become inert (Farré, Petrovic & Barceló, 2007). As may be imagined removal rates are not constant, they vary from compound-to-compound and are predicated upon a number of considerations such as the treatment processes being employed, environmental temperatures and light. Another factor has to do with the type of medications making their way into water systems. For example, non-steroid anti-inflammatory drugs (NSAID) are used, for example, for their analgesic effects and in most cases may be purchased without a prescription. NSAIDs contain high levels of salicylic acid which has not only been identified as being water soluble, but also being inefficient in terms of degradability (Farré, et al., 2007). What is now understood is that sewer systems contain high traces of salicylic acid which eventually leach into ground water, reservoirs and aquifers (Farré, et al., 2007). Imagine how an additional 1,900-plus medications being added to NSAIDs may be doing to our drinking water as a result.
This issue is so prevalent that even the World Health Organization (WHO) has released its own guidelines to instruct consumers on the best ways to dispose of medication, which actually occurred in 1999 when tons of donated medications were left to waste after the war in Bosnia (Wick, 2012). However, the issue of medication as a threat to water supplies is now being addressed in two significant ways. First, pharmacies and medical practitioners alike have been provided with the necessary tools in which to deploy effective programs and strategies to safely dispose of medications. Second are programs that educate the public in appropriate disposal methods. Such efforts include, mixing unused medicines with used coffee grounds and then placing the mixture in an empty can for disposal; or return unused prescriptions to pharmacies participating in safe disposal programs (Editor, 2007). But, with the prevalence of both prescription and over-the-counter drug use in this country, it would appear that efforts to decrease and eventually eliminate pharmaceuticals from reaching U.S. waterways will be a never-ending affair.
This paper serves as a precursor to future exploration into this pressing issue. It would appear that the very compounds which are medically beneficial may also serve to be quite detrimental to millions of Americans. It would also seem that, considering the amount of medications taken on an annual basis in this country, greater attention should be paid to this pressing issue. What this paper has not explored relates to the consequences to wildlife who, like us, depend on clean water for purposes of survival.
- Editor. (2007, April). New guidelines urge careful disposal of prescription drugs. The Nation’s Health, 25.
- Farré, M., Petrovic, M., & Barceló, D. (2007). Recently developed GC/MS and LC/MS methods
for determining NSAIDs in water samples. Analytical & Bioanalytical Chemistry, 387(4), 1203-1214. doi:10.1007/s00216-006-0936-x - Ruhoy, I. S., & Kaye, L. W. (2009). Pharmaceuticals in the water: Relevance to older adults.
Generations, 33(4), 26-32. - Tillett, T. (2009). Summit Focuses on Pharmaceuticals in Drinking Water. Environmental Health
Perspectives, 117(1), A16. - Wick, J. Y. (2012, September). Responsible drug disposal: Creating a green practice. Pharmacy Times, 46-48.
