Pharmaceutical Pollution: How Medication Impacts the Environment
Written by Alexandria Yarborough, PharmD
As a community pharmacist for the past seven years and a millennial, I often think about what happens to the many bottles and packages of medications I distribute to my patients each day. I know I am not the only one.
There is a growing concern about the occurrence of pharmaceuticals in both natural bodies of water and our drinking water. Most pharmaceuticals contaminate the water supply via human excretion and by drugs being inappropriately flushed down the toilet. Most people assume wastewater treatment plants treat the water to be clear of these contaminants but regrettably, they pass through water treatment and flow into ground and surface waters.
As a result, more than 4,000 prescription medications find their way into the environment. Ultimately, becoming chemicals that affect the health of those who drink the water–you, me, and wildlife
What Is Pharmaceutical Pollution?
Pharmaceutical Pollution is defined as the unintended presence of pharmaceutical compounds in the environment resulting in harm. Unintended or not, the harm is definitely present. Aquatic life is swimming in a concoction of antidepressants, amphetamines, birth control, and more. Research shows that these compounds alter organisms and put ecosystems, drinking water, and human health at risk.
So, who is responsible for pharmaceutical pollution? There are three main sources, and one might surprise you.
First, United Geological Survey scientists have found that pharmaceutical manufacturing facilities are responsible for a significant source of pharmaceuticals to the environment. However, the source of pharmaceuticals in water is not just from manufacturing plants. Antibiotics and drugs are used in the livestock industry and for streams receiving their runoff, pharmaceuticals are always present.
Another source is you and me. Medications that people take – prescription and over-the-counter – are not all metabolized in the body, and the excess ends up in our wastewater. They then enter the sewage-treatment plants, are not treated, and assimilate back into our drinking water.
Alexandria Yarborough, Pharm D, is a Community Pharmacist and Pharmacist in Charge at Sam’s Club in South Carolina. She has almost a decade of experience in the field of pharmacy.
Pharmaceutical Consumption in the U.S.
At my pharmacy location, the average patient picks up four to five bottles of medication each month. They contribute to the more than 4 billion prescriptions Americans fill each year.
Millennials are responsible for picking up 22% of those dispensed medications. In fact, a recent study on millennial prescription medication use found that 68 percent of millennials take at least one prescribed medication.
While the pharmaceutical industry is often a controversial topic, there is no denying that it is an integral part of the US economy and has produced many life-saving and life-improving drugs. As of 2020, the US pharmaceutical market accounted for 48% of the global pharmaceutical market. In 2021, Americans spent $576.9 billion on medicine.
Most of the increase in consumption is driven by a growing need for drugs to treat age-related and chronic diseases. For example, the consumption of cholesterol-lowering drugs had nearly quadrupled, the use of antidepressant drugs doubled, and the consumption of antihypertensive and anti-diabetic drugs nearly doubled in the last 15 years. The increase in the global population is also contributing to an exponential increase in people consuming pharmaceuticals.
Effects of Pharmaceutical Waste on the Environment
There is evidence that even low concentrations of pharmaceutical contaminants are harmful to the environment.
A wide range of impacts has been reported including effects on the sexual maturation of aquatic animals, impacts on insect physiology and behavior, inhibition or stimulation of growth in aquatic plant and algae species, and the development of antibacterial resistance in soil microbes.
Steroids from birth control are suspected to affect the fertility and development of fish, reptiles, and aquatic invertebrates. In addition, many pharmaceutical contaminants cause death in invertebrates, by reduced feeding, disruption of water balances, reduction of growth rate, and disruption of mating.
While many of these observations have been noted, the significance of the presence of pharmaceutical contaminants in surface water in terms of environmental health has yet to be established.
How to Dispose of Medication and Pharmaceutical Waste
Millennials are interested in purchasing products made from sustainable and biodegradable ingredients and that’s no different when it comes to healthcare.
According to studies, 75% of Millennials are eco-conscious to the point of changing their buying habits to favor environmentally-friendly products. Unfortunately, there are few options when it comes to prescriptions. That prompts the question, “What happens to all the empty prescription bottles?” The answer is complicated as most curbside recycling programs generally do not accept these plastic bottles. Still, there are other ways to recycle them properly and keep them from ending up in landfill.
Every recycling facility has different criteria for what it will accept for recycling — an issue that leads to confusion. These bottles — the translucent orange containers that come with a white, child-proof lid — are made of polypropylene, a recyclable plastic marked by #5.
Despite being made of recyclable material, most recycling systems are unable to recycle them properly because of their small size. To find a recycling program near you that accepts #5 plastic, you can search on the Recycle Nation website. You can narrow your search by putting in your zip code and selecting the type of waste you’re looking to dispose of (in this case, plastic #5 or polypropylene).
In every state, biannually, there are National Drug Take Back Days that allow for the disposal of both medications and bottles. You can use the U.S. Drug Enforcement Administration to find out when those days are and the location of drop-off centers. Some drop-off centers will accept both the bottles and the unused medication it contains, but you’ll want to check the specific guidelines first. If unsure, remove the medication from the container and dispose of it according to U.S. Food and Drug Administration (FDA) guidelines.
One way to reduce the volume of containers you receive is to request a 90-day supply of your prescription; some pharmacies are able to provide these in one larger bottle, which will reduce the number of bottles you use over time. One of the best ways to reduce waste is to reuse the containers. Popular repurposing ideas include:
travel-sized container for shampoo, conditioner, or lotion
a cotton swab /bobby pin container
an earbud holder
Polypropylene bottles are still the most widely-used containers for prescription medications, but groups of environmentally conscious people have been working toward developing alternatives. One promising alternative is the Prescription Paper Pill Bottle, a 100% compostable and biodegradable option. Another is ECOvials, a plant-based prescription vial.
Until these options are standard, the best way to dispose of expired and unused medications is through a take-back program. You can check with your local pharmacy about its on-site drop-off programs or mail-back programs to safely dispose of your unused medications. You can also use the U.S. Drug Enforcement Administration’s search tool to find a drop-off location near you.
If you can’t find a convenient way to drop off or mail back unused medications, the FDA recommends disposing of the medications in your household trash. To do this properly:
Remove the substance from its container and mix it with another material, such as coffee grounds, cat litter, or spoiled food to make the item undesirable.
Dispose of the container separately, making sure to hide your personal information.
Never flush medications down the toilet unless there is a risk of a household member suffering serious consequences including death if exposed to the medication.
There are certain medications that the FDA recommends flushing down the toilet. The FDA’s flush list will help you determine whether a specific medication is OK to flush.
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