[Pharmwaste] Unused drugs, unknown harm - article from CA

[Tenace, Laurie]

Unused drugs, unknown harm
http://www.sanluisobispo.com/mld/sanluisobispo/news/15729441.htm  
By Sarah Arnquist
sarnquist at thetribunenews.com

Details about the dangers of flushing prescription drugs down the toilet 
The medicine cabinet is full of expired medications, and you want to get rid
of them - but how?

For many, flushing them down the toilet seems the easiest and best option,
but pharmacists and environmentalists caution against it.

Flushing medications - both prescription and over-the-counter - down the
toilet puts pharmaceuticals into the water system. That could have
consequences, namely poisoning aquatic environments and contributing to
bacterial resistance to antibiotics, said Ed Guerena, a local pharmacist and
member of the county Health Commission.

"More and more, (disposing of medications) is going to be a problem because
people are using more prescriptions than they ever have before, and there are
more drugs that will accumulate in the environment," he said.

Unlike some other counties in California, San Luis Obispo County does not
have an organized system for disposing of unneeded or expired medications,
Guerena said.

Most pharmacies won't take back old prescriptions because it costs them money
to dispose of them. And throwing old pill bottles in the trash raises the
possibility that someone will find them and use the pills inappropriately, he
said.

The best option, he said, is to dissolve pills in water to make them
unusable. Keep them in the original container but scratch off the name to
protect identity, wrap the bottle in duct tape and throw it in the trash.

"That's the best that we have, which is still not very good because it's
still going in the landfill," where there's the possibility of contamination,
Guerena said.

Medicines in streams

Scientists have detected small amounts of medications in bodies of water
across the United States, and though the effects of their presence are
unknown, environmentalists and health experts are increasingly concerned.
Their major worries include increased antibiotic resistance of bacteria that
evolve into tougher strains and interference in growth and reproduction of
aquatic life.

The U.S. Geological Survey in 2000 tested 139 streams across the nation for
95 medications and found that 80 percent of the waterways were contaminated
with traces of acetaminophen, steroids, hormones, codeine, antibiotics and
ibuprofen.

Local officials said they do not know how much medication, if any, is ending
up in the county's wastewater. State environmental regulations do not require
wastewater treatment plants to test for traces of drugs, said John Beaton,
water quality manager for the county Public Works Department.

But in wastewater and environmental fields, the issue comes up with
increasing frequency, he said.

"I would not be surprised if we had to (test for it) in the future," Beaton
said. "It's an emerging issue."

Beaton said he knew not to put his old medications down the drain but was
unaware of the best alternative.

"I have a cabinet full of old medications, and I wonder about it myself," he
said. "What should I do with them?"

Checking disposal advice

The Tribune called four pharmacies in San Luis Obispo County to find out what
they recommend people do with expired prescriptions. Each pharmacy technician
gave different advice.

One recommended diluting pills in water and flushing them down the toilet.
Another said, "I would pull the label off, crush it and disperse it through
the trash evenly." One said, "You can just pitch it."

One pharmacy worker gave the recommendation of the California Board of
Pharmacy, which matches Guerena's advice.

People need consistent and accurate information on how to properly dispose of
their old medications, Guerena said.

Counties such as Los Angeles, Orange and Ventura have collection programs in
which people can bring their old medications (except controlled substances
such as morphine) to sites where they bring other hazardous waste, such as
batteries and paint.

San Luis Obispo County lacks a similar program. Most pharmacies have programs
with drug manufacturers to send back undistributed drugs. But pharmacies
refuse to take back medications from the public because they have to pay to
dispose of them, Guerena said.

Most hospitals pay licensed hazardous waste companies to destroy their unused
prescriptions, Guerena said.

Ellen McDonald, director of nursing at Woodside Nursing Center in San Luis
Obispo, said state regulations require the nursing home to send unused
medications back to the pharmacy or pay a hazardous waste company to destroy
them.

"We used to just flush them down the hopper, but we haven't been able to do
that for years," McDonald said.

***
The on-line article includes this link:
http://www.sanluisobispo.com/mld/sanluisobispo/news/special_packages/extras/1
5725805.htm 

Laurie J. Tenace
Environmental Specialist
Florida Department of Environmental Protection
2600 Blair Stone Road, MS 4555
Tallahassee, Florida 32399-2400
PH: (850) 245-8759
FAX: (850) 245-8811
Laurie.Tenace at dep.state.fl.us  
 
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