I've posted before on the unfortunate tendency of excreted pharmaceuticals to accumulate in the environment. The ecotoxicological effects are becoming increasingly worrisome, especially those related to birth-control pills, antibiotics, and antidepressants (the latter two, of course, are massively overprescribed and misused).
To make matters worse, it turns out that the law actually forbids responsible disposal of unused and expired drugs:
This is something Grace Welham, a Dean Health System pharmacist, discovered earlier this year. Working on a newsletter for Dean Health, she thought a clever theme for her April pamphlet would be a medicine cabinet "spring cleaning."You have to admire this thinking, unless your heart is as cold and inert as formica. Before you can contaminate the environment with a pharmaceutical, you must first add to the bulk and toxicity of your waste by packaging it redundantly in plastic and duct tape.
It didn't take her long to realize her patients had one of two options: "You can flush them - or place them in a plastic container taped shut with duct tape, which then has to be placed into another duct-taped plastic container, and toss that in the trash."
Why not take 'em back to the pharmacist? Extended producer responsibility laws are all the rage, after all, and this is a case where they make even more sense than usual.
It turns out that in this instance, the possibility of a take-back program is severely curtailed by federal law:
Pharmacies can't take back unused medications because of concerns they'll work their way back into the system. Before anyone can collect used drugs, an armed DEA officer or sheriff's deputy must be present, along with a written manifest, and a licensed pharmacist.On top of which, there are laws regulating the transportation of pharmaceuticals, which limit the ability of local municipalities to collect them through HHW programs:
That came as a disappointment to Milwaukee Metropolitan Sewerage District officials, who had proposed piggybacking pharmaceutical disposal with their mobile hazardous waste collection program. The sewerage district sets up various sites in Milwaukee County on certain days throughout the year, to allow residents to dispose of hazardous household goods such as pesticides and paints.The article goes on to say that Milwaukee is working on a take-back program that'll meet federal requirements; that's an idea every municipality should be looking into. In the meantime, the DEA is said to be "looking for possible solutions"...hardly comforting, given that agency's history of incompetence and irrelevance. Clearly, the laws need to be changed to make safe pharmaceutical disposal mandatory, rather than an inconvenient option.
3 comments:
This is very frustrating.
Flushing them down the toilet puts them beyond inappropriate use, but you list some of the hazards. I'll add another.
A few months ago, I needed to dispose of some old Cipro (ciprofloxacin), an antibiotic. Flushing that down the toilet could damage the bacteria that process the sewage. I wound up putting it in the trash, although I don't like that either.
Takeback is probably the best. I suppose I could have mixed it with chlorine bleach, but who knows what that would have produced. Burning might work, too, although, again, there might well be harmful partial oxidation products.
CKR
On the other hand, drug manufacturers and wholesalers "donate" mass quantities of expired and spoiled medications to relief operations.
Anonymous, I would think that your cipro would be so diluted in the system that it wouldn't have any discernible effect on the sewage treatment process. A far bigger concern is development of antibiotic resistant bacteria. Burning such a small quantity of material would probably be just fine.
The story changes, of course if we are talking about mass quantities.
It's frustrating, alright. When millions of people are consuming or disposing of something at once, it's logical to think it'll create problems. And indeed, we've seen cities with measurably caffeinated harbors, and shellfish whose natural protections against pollution are compromised by commercial musks in perfumes and the like.
We're culturally focused on mass marketing, but so far we're unwilling to consider the effects of mass production and mass discarding. Generating culture-wide desires without having an infrastructure in place to deal with their consequences is a problem. The relatively new policy of mass marketing prescription drugs is a perfect example...and it's also worth mentioning that given the current state of health care, there's an increasing tendency for doctors to give poorer patients free drug samples in lieu of a prescribed treatment course. Thus, we could end up in a situation where people who may have strep throat get a newer, less easily tolerated antibiotic, and end up discontinuing the treatment early and tossing the leftovers.
And I didn't even bother to mention biopharming, which is an absolutely horrible idea.
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