Homepage                                     Back to May 2007 Issue

In years past, people were advised to flush unwanted medications down the toilet to prevent misuse by someone else. It seems nobody thought about these drugs traveling through the waterways and being absorbed by our fish until the United States Geographical Survey studied that question in 2000. They found drug remnants of antibiotics, hormones and antidepressants in 80 percent of the 139 streams they sampled across the country. With more than three billion prescriptions filled each year in the US, disposing of our medications properly is crucial to keeping this contamination in check.

Fish On Drugs
Timothy Gross, a USGS toxicologist, studied carp, largemouth bass and razorback suckers in streams near Las Vegas and found “a very large and marked decrease in sperm quality and quantity.” When studying the Boulder Creek Watershed in Colorado, the USGS also found endocrine disorders in fish there. These results are thought to be caused in part from hormonal medication absorption.

Scientist Rebecca Clapper of the University of Wisconsin exposed fathead minnows to a cholesterol medicine at doses a bit higher than the amount found in contaminated streams but stopped the experiment when her fish began dying from the exposure. And a Baylor University study found Prozac (main ingredient fluoxetine) in channel catfish and black crappie at a site near Dallas that was fed from water treatment plant runoff. A similar antidepressant ingredient, duloxetine hydrochloride is “highly toxic to green algae and fish, [and] moderately toxic to aquatic invertebrates,” according to its material safety data sheet.

What About Maine?

Though Maine was not included in the original USGS study, evidence of pharmaceuticals and personal care products (PPCPs) was found in eighteen out of nineteen Maine sites tested by the Environmental Protection Agency in 2002.

Study Results:
The EPA looked for six toxic PPCP elements in each site and found that one sight had none, one sight had one, two sights had two, ten sights had three, four sites had four, and one site had five.

One of the elements measured in 2002 was triclocarban, an ingredient in antimicrobial soap, which, according to Ann Pistell, an environmental specialist at Maine’s Department of Environmental Protection is “totally unnecessary, makes us no cleaner and is found everywhere [in the waterways].”

Maine’s water samples also proved positive for endocrine system disrupters like those found out west that come from plastics, canned goods, dental fillings, birth control pills and hormone balancing medications. Besides affecting sperm quantity and quality, these endocrine disruptions can cause low male to female ratio.

Another Maine site was remarkably high in the antibiotic azithromycin, a common drug for upper respiratory infections.

“Medications that are flushed down the toilet or thrown straight into the garbage can and do find their way into our nation’s waterways every day. Those dugs are present in water that supports many species of fish and other wildlife,” said H. Dale Hall, the Director US Fish and Wildlife that released the SMARxT DISPOSAL plan with the American Pharmacists Association at their meeting in Atlanta on March 20, 2007.

Because the bioactivity of drugs remains active after medication leaves the body, it is suspected that some of the pharmaceutical pollution comes from urine output and unfortunately, waste water treatment plants are not designed to filter this or any directly flushed pharmaceutical residue.

Following the SMARxT DISPOSAL plan is a crucial part of keeping our waterways safe for fish. The plan recommends:

1. DO NOT FLUSH unused medications. If drugs have a high risk of abuse potential ask your pharmacist for disposal advice.

2. Before tossing medications in the trash, take the following steps:

• Crush solid medications or dissolve them in water (dissolve liquid medications) and mix with an inedible substance like kitty litter, sawdust or sand. Then place in a sealed plastic bag before tossing away.

• Remove and destroy all identifying personal information from the prescription containers before tossing them out.

• Check for approved collection programs in your community. Your pharmacist may be aware of these programs if they exist.

SMARxT DISPOSAL recommends that states institute medication disposal plans with drop boxes and mail-in programs, such as 22 MRSA 2700 – An Act Regarding the Unused Pharmaceutical Disposal Program brought before the Maine legislature by Cumberland County Senator Lynn Bromley in 2005. The bill, which passed but is pending implementation funds, calls for a full time employee to manage mailbox collection for pick up by the Drug Enforcement Administration. The University of Maine has applied for an Environmental Protection Agency grant, which could fund the pilot of this program.

How Are Drugs Disposed Of Safely?
“Incineration is the best way to dispose of unwanted medications,” said Pistell. Maine has three or four existing solid waste incinerators however, medications requiring hazardous waste incineration, like some cough syrups, nicotine patches and chemotherapy drugs, are taken to sites out of state.

Brunswick’s MidCoast Hospital sponsored three half-day Drug Collection events. Drop boxes were set out at places in the community, such as a church and the fire station, where people could safely dispose of unwanted or expired medications. All drugs from these successful collections were sent for hazardous waste incineration that Ann Pistell helped to arrange.

“Medications are not your typical household waste,” she said. “When disposed of improperly they have a devastating impact on our aquatic system.”

Pistell, who feels that we need both mail-in and drop-off drug collection programs, is eager to assist other communities in setting up Drug Collection events and can be reached at 287-7703 or by email Ann.E.Pistell@maine.gov.

homepagearchivessubscribeadvertising