Evidence is mounting that prescription and over-the-counter medications are polluting the water supply worldwide. It is also known that the most common source of prescription and over-the-counter medications abused by teenagers is their family’s and friend’s medicine cabinet. For these reasons, there is growing awareness of the need for better disposal of unused and unwanted medications. Earlier this year the American Pharmacists Association recommended that most medications be disposed of by taking drugs out of their original packaging, mixing them with a little water, mixing them with undesirable materials such as coffee grounds or cat litter and throwing them in the garbage. The most highly abused drugs such as narcotic pain medications should continue to be disposed of by flushing down the sink or toilet. Additionally, organizations and states are experimenting with take-back programs and other drug disposal procedures. Complicating disposal guidelines are the myriad of state and federal organizations that regulate the distribution and disposal of medications and hazardous materials.

Beginning in the 1990s the Environmental Protection Agency (EPA) started to monitor the occurrence of certain pharmaceuticals and personal care products in the environment. Since then the EPA, the US Fish & Wildlife Service, and the US Geological Survey have found evidence of an unexpected array of chemicals in the water supply including caffeine, acetaminophen (an over the counter pain reliever), erythromycin (an antibiotic), fluoxetine (an antidepressant), and albuterol (a bronchodilator). Scientists admit that they are still trying to understand more about contaminants. An EPA supervisor stated that there is insufficient knowledge that exposure to these chemicals actually occurs or what happens in real-world conditions. Many scientists remain unconvinced that there is enough scientific evidence to warrant concern about the impact that medications have on the environment.

It is also unknown how much disposal contributes to the overall problem because various amounts of all drugs taken by people are excreted in the urine and feces and end up in the water supply. Excretion can range from almost nothing to almost 100%. Veterinary medicine is also another significant source of contamination, especially for antibiotics and growth hormones. Even though questions remain regarding the impact drug disposal has on the environment, the EPA has chosen to take a proactive stance in part because when drugs are flushed down the toilet they momentarily release a much higher concentration than occurs during excretion. It is believed this higher concentration could contribute to problems such as increased bacterial resistance to antibiotics.

Concerns regarding disposal extend beyond environmental impacts. The careless handling of controlled substances contributes to drug diversion and drug abuse. Of primary concern is the abuse of medications by teens who acquire them from unused prescriptions or over-the-counter packaging found in the homes of their friends and families. Federal data now shows that prescription medications trail only marijuana as drugs abused by 12- to 17-year-olds. This has been identified as a global problem not limited to the US.

References: http://www.drugtopics.com/drugtopics/article/articleDetail.jsp?id=452449&sk=&date=&pageID=3, http://www.pharmacist.com/AM/Template.cfm?Section=Search1&template=/CM/HTMLDisplay.cfm&ContentID=9154.

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