I am lucky as most of my ideas for this blog come from conversations with friends, and this is no different. A good friend of mine recently asked me the best way to dispose of old medication. I immediately said “don’t flush it!” It’s true none of us want to just throw old pill bottles into the garbage as it feels like we are gift wrapping them for a child, pet, or illegal use. But flushing medications is harmful to our waterways, and not the proper way of disposal. Now I give notice that these next few paragraphs may be a little scientific and wordy for some, but I don’t want to just say “don’t flush your medications because I said so!” I want everyone reading this post to know why you shouldn’t and what’s happening to your medications if they should get into the environment.
So bear with me, take your time, and learn. This is vital, we have a limited amount of water on our planet and learning how to keep it clean is important for all of us.
There are three major, related groups of potential contaminants from medications, endocrine-disrupting compounds (EDCs), pharmaceutically active compounds (PhACs), and personal care products (PCPs). Endocrine disrupting compounds (EDCs) are chemicals which interfere with the synthesis, transport, and/or action of natural hormones responsible for the reproduction, development, and/or behavior of an organism. Some examples of EDCs include birth control pills and other synthetic hormone treatments. They can also be found in anthropogenic substances such as detergents, pesticides, and plasticizers.
Pharmaceutically active compounds (PhACs) encompass some of the hormone-based compounds already noted as EDCs, and also include antibiotics, anti-epileptic medications, heart medications, pain medications, analgesics, anti-depressants, and cancer medications. This category also covers veterinarian drugs and feed additives used for livestock. Personal care products (PCPs) refer to common, anthropogenic products such as shampoos, fragrances, over-the-counter medications, and herbal remedies.
The regulation of these compounds is relatively new and most of the chemicals are still being researched to find their specific effect to human health. According to the USEPA, some 87,000 chemicals are in need of assessment. This large number of potentially harmful chemicals which fall into these categories of compounds is reflective of the potentially wide-ranging nature of this issue.
What we know for sure, through recent research, is that these compounds are in our water bodies, both natural and municipal. PhACs, EDCs, and PCPs can enter water bodies from residential or commercial discharges including hospital effluent, runoff from livestock facilities, and your toilet.
So we know these compounds are in our water bodies, but before I talk about why they are harmful I want to explain where the water goes when it leaves you house and how it is treated so you can understand why these compounds are not being removed.
Water flows into your house from either a public water system or a personal well. This water fills your toilet and when you flush, it (along with all your other household wastewater from sinks, shower, laundry, dishwasher, etc.) either goes into a septic system on your property or through a sewer system to a wastewater treatment plant. If you have a septic system your house’s wastewater goes into a septic tank (that thing you must get pumped occasionally). In this tank are good bacteria which break down a lot of the organic material in your water. These bacteria and other large pieces of material in the water settle to the bottom of the septic tank, the cleaner water at the top of the septic tank leeches out into your leech field where it is allowed to flow through layers of sand and soil until it either reaches ground water (water which flows underground) or a stream, lake, pond, etc. The act of the water flowing through these layers of ground also helps to clean the water before it reaches a surface water source.
If you’re on a city sewer system the water is pumped to a wastewater treatment facility where it is treated through a series of processes such a sedimentation tanks, and chlorination. It is then pumped into a body of water such as a lake, river, the ocean, etc. Both of these methods have varying abilities to remove PhACs, EDCs, or PCPs, so when the treated wastewater reaches the stream or lake etc., anything not removed during treatment is expelled into that body of water and influences whatever lives in or comes in contact with that water. This is not to say septic systems or treatment plants do not do a sufficient job cleaning your water, they do a very good job which is always being increased with increasing technology. The problem is the specific effects of PhACs, EDCs, and PCPs on humans is not proven, and so many are not regulated or removed in treatment processes. There are ways of treating these harmful compounds which are implemented in many treatment plants. So before you run out and buy gallons of bottled water, I assure you, as a person with a Master’s degree in environmental engineering and a thesis topic based on drinking water treatment, the water coming from your tap is safe for drinking!
Now we know what PhACs, EDCs, and PCPs are and how they get into our waterways. The reason these compounds are thought to be harmful to humans is due to research findings of adverse affects on aquatic organisms. One adverse effect observed was caused by high levels of estrogenic hormones (from birth control pills) detected in trout and silvery minnows. These fish were found to become sexually mutated. Male fish were found producing eggs and fish were found with both male and female sexual organs. The other main effect found is the development of antibiotic resistance in organisms. The concern is that long-term exposure to low dose concentrations of antibiotics, such as those present in wastewater and surface water, could result in the development of antibiotic-resistant organisms. Sewers downstream from hospitals have displayed an increased prevalence of bacteria resistant to oxytetracycline (a commonly used antibiotic used to treat a wide variety of bacteria). Sewers downstream from pharmaceutical plants showed an increased prevalence of bacteria resistant to multiple drugs, including sulfamethoxazole, another widely used antibiotic. Bacteria and viruses are fighters and can easily mutate to ensure their survival. If harmful bacteria and viruses have too much exposure to our antibiotics, they will mutate and become immune to our methods of killing them which could prove dangerous for human health.
Unfortunately, this problem can not be stopped by proper medication disposal alone. Many of the PhACs, and EDCs found in waterways and wastewater streams come from human body waste. When we take medications, such as daily birth control pills or heart medications, they are intended to be used up completely by the body. In many instances, depending on the person and dosage as much as 50% to 90% of an administered drug may be excreted by the body in a biologically active form. I’m not telling you to go off your medication, but since our bodies are already excreting these medications into the environment through our body waste, we should do our best not to add to the problem with incorrect medication disposal.
Now you know why proper disposal of medications is important. I’m sure your dying to finally know the proper procedure for medication disposal. It’s actually extremely simple. According to the FDA the proper disposal steps are:
1. Take your prescription drugs out of their original containers.
2. Mix drugs with an undesirable substance, such as cat litter or used coffee grounds.
3. Put the mixture into a disposable container with a lid, such as an empty margarine tub, or into a sealable bag.
4. Conceal or remove any personal information, including Rx number, on the empty containers by covering it with black permanent marker or duct tape, or by scratching it off.
5. Place the sealed container with the mixture, and the empty drug containers, in the trash.
That’s it. An option is to smash the tablets in the sealed bag with the kitty litter or coffee grounds. There may also be drug take-back programs available in your community which will properly dispose of medications.
I appreciate your reading and learning with this post. This is an important subject, and I believe as more research is done, this problem will become an important regulatory issue. Overall, any drinking water issue is important as our water resources dwindle and we need to find ways of maintaining clean drinking water. Try to keep PhACs and EDCs levels low by proper disposal of your old medication, and PCPs level low by choosing environmentally friendly personal care products.
Work Cited:
Brown, K. Pharmaceutically Active Compounds in Residential and Hospital Effluent, Municipal Wastewater, and the Rio Grand in New Mexico. Water Resources Program The University of New Mexico. January 2004. http://www.unm.edu/~wrp/wrp-9.pdf
Proper Disposal of Prescription Drugs. Office of National Drug Control Policy. October 2009. http://www.whitehousedrugpolicy.gov/publications/pdf/prescrip_disposal.pdf
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