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December 25, 2014
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Where does it hurt?


Last month a friend of mine asked me for advice on how to properly dispose of her unused and expired medications and their packaging. She knew that improper disposal poses a threat to humans as well as aquatic and terrestrial wildlife.

Americans fill more than 3.3 billion prescriptions per year. Recent investigations have found measurable amounts of the most commonly prescribed drugs in virtually every body of water in the country, as well as in municipal water supplies, groundwater, streams and domestic wells. The most commonly found chemical toxins correspond to the most frequently prescribed drugs: painkillers, anti-depressants, antibiotics, anti-hypertensives, birth control pills and hormone replacement therapy.

Many of these medications act in the environment as endocrine disruptors, resulting in wildlife abnormalities for organisms that live in water. Hormone exposure, for instance, results in fish with intersex characteristics. Diclofenac, a non-steroidal anti-inflammatory drug, has killed tens of millions of vultures in Asia.

Pharmaceuticals are considered hazardous waste, and their disposal is regulated by both state and federal agencies; however, neither universal regulations nor enforcement exist.

The most recent EPA recommendations warn against flushing pharmaceuticals down the toilet. The following steps are now suggested: Remove prescription drugs from their original containers; conceal or remove any personal information, including Rx number; mix the drugs with an undesirable substance such as coffee grounds or kitty litter; put the resulting mixture into a bag or can to discourage children or pets from ingesting it; and throw the container in the trash.

This method of disposal, intended to keep drugs off the streets, doesn’t keep the drugs out of the environment. The trash goes to the landfill where its contents leach into the soil and eventually into the water.

Another alternative is to take unwanted medications to a pharmacy with a take-back program. These programs, whose purpose is to decrease drug abuse by keeping narcotics off the streets, proved difficult to find. I called pharmacies in Honesdale and Hawley and discovered that only one participated in a day-long event this summer, initiated by the Pennsylvania State Police. The police have no plans for another event. A chain pharmacy in Hawley told me I could bring in a small amount of drugs that they would pass off to a company that would take it away. Away to where? I asked. She didn’t know.

The World Health Organization delineates a myriad of ways in which leftover medications are treated, many of which do not protect the aquifers and watercourses. The most effective method, high temperature incineration, is complicated and expensive. Medications can also be immobilized by encapsulation or inertization, or they can be disposed in landfills, processes which do not prevent leaching.

Although not a priority with Big Pharma, the nascent field of sustainable pharmacy presents some hope for the future. It considers factors like the designs of compounds, their packaging, manufacture, prescribing and disposal; in short, the entire lifecycle of a drug in an effort to reduce risks to wildlife and the environment.