Disposing Of Medication Safely

Dear Greenius,

I’m cleaning out my medicine cabinet and have a lot of expired or unused medication. Can I flush them?

Toilets seem to offer up the perfect “out of sight, out of mind” repository, being used for everything from dead pets (RIP Goldie!) to used condoms, a hundred million of them worldwide, according to one estimate, that make their way into bodies of water either because of sewer system overflow or lack of sewage processing.

So though it seems like the perfect solution – dump the contents of the expired Advil or unused birth control pills (oops!!) into the toilet and flush away – but let’s not forget that out of sight does not mean gone. Indeed, for the sake of public education, let’s look at where our flushed meds actually end up.

An inquiry made public in 2008 by Associated Press revealed that drinking water in many cities across the U.S. plays host to many pharmaceuticals, including over-the-counter medications, such as ibuprofen and acetaminophen. Not surprisingly, a study in Canada turned up similar results.

In a fact sheet addressing “pharmaceuticals and personal care products as pollutants – PPCPs”, the EPA acknowledged that PPCPs “...comprise a diverse collection of thousands of chemical substances, including prescription and over-the-counter therapeutic drugs, veterinary drugs, fragrances, lotions, and cosmetics.” It also acknowledged that many of these are turning up in our water bodies and that our water treatment systems cannot, for the most part, remove them.

The question, of course, is should we be concerned? The answer seems to depend on whom you ask. The U.S. Environmental Protection Agency insists that, “…to date, scientists have found no evidence of adverse human health effects from PPCPs in the environment.”

Olga Naidenko, a senior scientist at Washington, D.C.-based Environmental Working Group, admits that levels of these drugs in our water bodies are fairly low – generally less, she says, than taking one tablet of the pharmaceutical. The concern for humans, she says, is long-term exposure. “The trouble is neither the EPA or the FDA (Food and Drug Administration) is studying long-term exposure,” according to Naidenko. And she’s also quick to point out that ANY exposure could be dangerous to certain segments of the population, such as pregnant women and young children.

Rob Davis, an expert in wastewater treatment and president of EcoEthic, a Canadian line of eco-friendly, septic-safe cleaning products, sees first-hand the effects that some drugs, such as chemo medication, have on wastewater treatment. He often gets called to look at septic systems that were working fine then suddenly weren’t. He opens up the tanks and knows immediately that chemo medication has passed through. “It’s completely dead,” he says, of the system of biological organisms that break down our waste. And, of course, this chemo medication makes its way right into our waterways.

Scientists at the U.S. Environmental Protection Agency agree that caution is warranted. Sewage systems are not equipped for PPCP removal. The risks – both to aquatic health and human health – are uncertain. The good news is that there’s a lot more research going on now. Will it be enough?

Naidenko is skeptical. Special resources need to be allocated to this, she says. “We cannot take healthy, clean water for granted. We need to do more.” She also says that new pollutants are being created all the time. “The scale of the problem is huge.”

And, while the alarm is largely over the effect of these drugs on human beings, we can’t overlook the impact the issue has on aquatic life as it tends to be more dramatic and more immediate. Scientists have reported that hormone disrupting chemicals affect development of fish, such as making male fish capable of laying eggs. And no, this is not a good thing.

One solution being explored by pharmaceutical companies is the notion of “green” drugs or, as they’re sometimes called in the industry “benign by design” drugs. It’s not an entirely new arena, as pharmaceutical companies have been researching ways to produce their products using green chemistry principles for some time now. The impetus, however, has generally been to reduce costs by using less water and fewer chemicals.

Klaus Kümmerer, a noted European expert in exploring the effect of pharmaceuticals on the environment, is a firm believer that it’s entirely possible to create these benign-by-design drugs. Indeed, he points out, many already exist on the market. He spoke in April 2008 at a conference on Sustainable Pharmacy and has gone on record as pointing to a number of further solutions, such as hospitals having in-house water treatment, a database offering doctors information on drugs with less environmental impact and more. Kümmerer also told a reporter that the obvious solution regarding concerns about the impact of low levels of drugs over long exposure is to prevent the exposure in the first place.

However, while we can’t prevent what enters wastewater after it has been ingested, we can certainly take steps to ensure our waterways don’t become a repository to dump out-of-date, excess or unwanted medication.

Pushing more pharmaceutical companies and pharmacies to adopt “take-back” programs is a good start. And there are local and national take-back initiatives afoot. Your hazardous waste disposal depot often collects unwanted medication but call ahead and find out what they’ll accept and what they won’t. You can “unofficially” take your drugs back to a pharmacy or hospital. Earth911.com also offers information on where you can take your unused medication.

Finally, you can take this solution offered up by the GreenYour.com website: Remove prescription drugs from their original containers and mix them with coffee grounds or kitty litter (something that will deter animals or kids). Put this mixture into an empty can or bag and throw the container into the trash.

But please, don’t play doctor yourself and offer up your unused medication to a friend, relative or the family dog. And definitely don’t flush.

Leslie Garrett is an award-winning journalist and author of The Virtuous Consumer: Your Essential Shopping Guide for a Better, Kinder, Healthier World (and one our kids will thank us for!). Visit her at www.virtuousconsumer.com

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