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(HealthNewsDigest.com) – As the United States confronts the realities of extending health care coverage, much of the debate has centered on the cost and medical treatment once illness is diagnosed. Too often overlooked, though, are the cost savings that come from preventing factors that can cause illness. One of the least publicized, yet potentially significant, is the presence of pharmaceuticals in our drinking water.
Negative Impact, Unknown Risks
More than four billion prescriptions are written in the United States annually, and up to 35 percent of dispensed medications outside the hospital setting go unused, potentially resulting in millions of pounds of unused medication most often destined for sewers or landfills. Misuse of unused prescription medications, often sitting in the home medicine cabinet, is one of the leading causes of accidental poisonings in the United States. According to the Centers for Disease Control and Prevention (CDC), “deaths by accidental poisonings from all narcotics and hallucinogens were up 55 percent from 1999 to 2005.”
Pharmaceuticals, antibiotics, steroids and similar substances also create potential environmental and drinking water hazards when they enter the water systems throughout the country, often through flushing down the toilet. The federal government does not require any testing for pharmaceuticals in water and has not set safety limits on concentrations. Furthermore, current wastewater technology does not completely remove these compounds. The issue of contaminated drinking water has increasingly been covered by the news media, signaling a growing interest in identifying sources of – and solutions to – the problem:
In September, 2009, the Associated Press (AP) reported that contaminates were found in the drinking water at public and private schools throughout the country.
A 2008 investigation undertaken by the AP showed that a vast array of pharmaceuticals, including antibiotics, anti-convulsants, mood stabilizers and sex hormones, exist in the drinking water supplies of at least 41 million Americans in 24 major metropolitan areas across the country. The AP also reported in 2008 that most unused pharmaceuticals from health care facilities are dumped down sinks or toilets, usually without violating state or federal regulations.
One water utility surveyed 45 long-term care facilities in 2006 and calculated that two-thirds of their unused drugs were scrapped by flushing, according to a National Association of Clean Water Agencies report cited by the AP.
The risks posed by pharmaceutical pollutants deposited or leaching into the water supply are uncertain and largely unknown. While the major concerns over pharmaceuticals in the water supply have centered on resistance to antibiotics and disruption of endocrine systems by natural and synthetic steroids, many other waste pharmaceuticals may have unknown consequences. According to the EPA, there are no known human health effects from such low-level exposures in drinking water, but many potential scenarios. One example is fetal exposure to low levels of medications that a mother would ordinarily be avoiding. This suggests that exposure could cause problems.
Government Action
Drug disposal in healthcare may represent only a small portion of the pharmaceutical waste discarded into our sewers and landfills daily. Consumer disposal of unused medications may be a much bigger dilemma. It is also one that is on the minds of environmental agencies and organizations throughout the country. In February 2007, the White House Office of National Drug Control Policy issued the first consumer guidance for the proper disposal of prescription drugs. It encourages consumers to take advantage of drug take-back or other programs for safe disposal of their unused medications.
There are several examples of states restricting disposal of pharmaceuticals. For example, California has passed SB 996 which requires the California Department of Resources, Recycling and Recovery to develop, in consultation with appropriate government agencies, criteria and procedures for model programs for the collection and proper disposal of pharmaceutical waste. In August the governor of Illinois signed Public Act 96-0121, authorizing the Illinois Environmental Protection Agency to govern household pharmaceutical waste drop-off and disposal. Both states, and a number of others, recognize disposal by mail as a highly practical alternative for waste pharmaceutical disposal.
Unused Medication Disposal by Mail Solution
Disposal by mail systems are designed for both individual consumers and community facilities, such as assisted living, long-term care, hospice and correctional institutions. They may be utilized for the disposal of unused medications other than controlled substances. Disposal by mail consists of a variety of sizes of packaging with pre-paid postage to an authorized treatment facility. All costs of the container, packaging, return postage, destruction and documentation are included in one purchase price. Systems are ordered on an as-needed basis. Once filled, they are simply handed to the postal carrier. These products can also be used in conjunction with “take-back” programs where unused pharmaceuticals are taken to designated collection points and then mailed for destruction.
The greater use of such systems requires the re-education of the community to raise awareness of the dangers and of the solutions to the problem of waste pharmaceuticals. Disposal by mail and take-back programs are convenient options for disposal of most medications. Given the growing dimensions of the waste pharmaceutical problem, disposal by mail is sure to increase as a safe, practical alternative for removal of these products from the environment… reducing the health risks they may cause.
Dr. Burton J. Kunik is Chairman and Chief Executive Officer of Sharps Compliance Corp., a leading provider of cost-effective disposal solutions for medical and pharmaceutical waste generated outside the hospital setting, www.sharpsinc.com
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