[Pharmwaste] Water Pollution: Pharma's Next Big Headache?

Tenace, Laurie Laurie.Tenace at dep.state.fl.us
Fri Sep 4 11:47:56 EDT 2009


At a recent gathering of sustainability people from some of the world's
largest pharmaceutical companies (or "Environment, Health and Safety" people
as they tend to be called in the pharmaceutical industry), I got a glimpse of
what could be the next headache for the oft-beaten up industry. This insight
came not from what they talked about the most, but rather what they did not
talk about enough: The question of pharmaceutical residue in the water

Over the two-day conference, one person after another presented detailed
information on the tremendous progress their organizations have made in
reducing the use of toxic chemicals in the manufacturing process by finding
less toxic -- and sometimes even benign -- alternatives; how they have driven
down energy use at their facilities and in so doing cut greenhouse gas
emissions; and other impressive "greening" efforts. They spoke proudly of
these accomplishments, as well they should: These gains are impressive and
the questions posed by peers following each presentation showed that everyone
in the room had devoted a lot of time to tackling the same issues.

But when the discussion moved to the question of trace amounts of
pharmaceuticals in the water supply, everything seemed to go off the tracks.

First, there was spirited discussion of programs under which the pharmacies
that sell prescription and over-the-counter medications would have to take
them back. This reduces the likelihood of people flushing unused drugs down
the toilet or tossing them into the trash, where they leech from landfill
into the water table. This has been done in some European locations with
mixed success: Lackluster results in some locations were blamed on poor
public education.

Here in the U.S., the solutions are not so easy. Many drugs are controlled
substances and it is not clear that pharmacies are legally allowed to take
them back. The EPA may support the approach, but the DEA is less
enthusiastic: Drugs are carefully controlled on their way out the door but
there are no such controls or even procedures to handle these drugs when they
come back. 

And while a pharmacist earning $90,000 per year may not risk his license to
divert returned pharmaceuticals into his own pocket (or sell them), what
about the $10-an-hour pharmacy technician who is not licensed? Some small
pharmacies have launched pilot programs to test prescription takebacks, but
the big national chains don't like the idea.

Other ideas such as having local law enforcement serve as collection points
were also discussed, but that approach has its own limitations. The police
are busy maintaining law and order, can they also be asked to manage waste
disposal? Sure, they can hold onto a small quantity of drugs taken from a
suspect and hold it as evidence, but can they be asked to manage hundreds of
pounds of pills that include everything from antibiotics to OxyContin?

Then the real challenge made its way into the discussion: What is the source
of the trace amounts of pharmaceutical products being found in water
supplies? Some conference attendees confidently stated they must coming from
people tossing unused pills into the toilet; if they are right, then some
kind of take-back program is a good solution, however tricky it may be to

Others were not so confident or the contamination's source; they asserted
with equal conviction it was coming from human excretions. Since most drugs
don't completely metabolize in the body, a little or a lot (depending on the
drug) is released in the patient's urine. If this is the source, take-back
programs won't do anything to solve the problem.

The biggest and most looming challenge seemed to be that the people in the
room did not agree on this basic question, and it turns out that the few
studies done so far have also not delivered clear answers.

This is clearly a challenge: If you don't know the source, how can you devise
an approach to tackle it?

And this is scary stuff, both from a health perspective and for the industry
itself: The public can be counted on to react with emotion and not
well-thought-out reason. A situation like this can also be easily grabbed by
the media and turned into a sensational story. Activists will seize the issue
and use it as a baseball bat to beat up on their favorite scapegoats. And
let's face it, the pharmaceutical industry is one that many of them love to

I thought of the challenges Monsanto faced when, much to its chagrin,
environmentalists were not elated that the company's genetically modified
crops would help feed the world's hungry and instead vilified them for
creating "Frankenfoods." 

I thought also of the industry response to concerns about vaccines and
autism. There is no scientific evidence to support this theory, yet after
years of insisting there is no connection (a position supported by the CDC),
the industry eliminated the use of thimerosal in vaccines, the ingredient
pointed to by many as the culprit. This put the industry in the uncomfortable
position of having to maintain that thimerosal was never a problem, while
also explaining why they stopped using it.


Right now, drug stores are the ones bearing the brunt of this issue. But how
long will it be before attention turns to the pharmaceutical industry? Seven
states already have proposed legislation to mandate take-back programs, while
the state of Maine is limiting how big a supply doctors can prescribe for
first-time users of certain medications. France has a mandatory program that
is paid for by the industry. I expect it won't be long before the
conversations about this hot potato subject turn more serious.

Laurie Tenace
Environmental Specialist
Waste Reduction Section
Florida Department of Environmental Protection
2600 Blair Stone Rd., MS 4555
Tallahassee FL 32399-2400
P: 850.245.8759
F: 850.245.8811
Laurie.Tenace at dep.state.fl.us 

Mercury: http://www.dep.state.fl.us/waste/categories/mercury/default.htm 

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