There are numerous ways that medications, at varying levels of concentration, can enter the environment. A consideration of these pathways illustrates the complexity and pervasiveness of the contamination problem. The following are some main ways the environment becomes tainted by medications:
The only way to redress current practices is to pinpoint the ways in which the environment is vulnerable to pharmaceutical exposure. A multipronged effort is necessary at every level of society, including consumer education on how to properly dispose of medications, safer production practices at pharmaceutical companies, and national legislation to govern the drug manufacturing and disposal process.
According to Yale Environment 360, a publication of the Yale School of Forestry and Environmental Studies, concerns about the impact of drug manufacturing on the environment led to federal regulation in this area as early as 1938. Today, the movement to protect the environment and waterways from pharmaceutical manufacturing practices is known as “green pharmacy.”
The concept of green pharmacy embodies a commitment to designing the drug manufacturing process to make the lightest footprint on the environment. Such measures are not only desirable, but also necessary over the long term. The following are facts about how drugs are damaging nature:
Researchers have found trace amounts of more than 150 different human and veterinary medications in landscapes as far away as the Arctic.
A United States Geological Survey found that 80 percent of American’s streams and almost 25 percent of US groundwater was contaminated by numerous medications.
In 2008, the US pharmaceutical industry sold over $773 billion in drugs worldwide, which was more than double than the amount sold in 2000, and the pharmaceutical industry only continues to grow.
Medications can pass through the human body and into waste facilities that end up tainting the land. For instance, vultures in South Asia have been poisoned by the anti-arthritis painkillers that humans consume.
|Synthroid: 22.6 million||Diovan: 11.4 million|
|Crestor: 22.5 million||Lantus Solostar: 10.1 million|
|Nexium: 18.6 million||Cymbalta: 10 million|
|Ventolin HFA: 17.5 million||Vyvanse: 10 million|
|Advair Diskus: 15 million||Lyrica: 9.6 million|
Green pharmacy concerns clearly illustrate that the earth is a great recycling machine, one that unfortunately fuels the problem of drug contamination. Not only do the chemical byproducts of the manufacturing process end up in our water supply and soil, but the drugs we consume and subsequently excrete also share that fate. Compounding this problem, these drugs are re-consumed by humans, other animals and plant life.
Further, drug residues can impact microorganisms and potentially pose a public health threat. The emergence of antibiotic resistant pathogens (microorganisms that cause diseases) demonstrates this point well. Scientific researchers have found that bacteria resistant to medications are most common in places where antibiotics are heavily used. This is an undesirable and health-defeating consequence of the proliferation of antibiotics.
Yale Environment 360 believes that drug manufacturers should focus on making drugs that are easily biodegradable and have a more benign impact on the environment. They reported that the U.S. Food and Drug Administration (FDA) only legally requires drug manufacturers to do an environmental impact assessment when the company plans to make more than 40 tons of any given drug. In 2008, this rule resulted in only 20 drug manufacturers being required to conduct an environmental assessment. Green drug manufacturing is not impossible, but this area needs further development and the help of federal and state laws that are pro-environment, and in turn, pro-public health.
The National Resources Defense Council (NDRC), a non-profit environmental advocacy group, has collected helpful data on water contamination. According to NDRC, in 2008, the Associated Press reported that researchers surveyed the drinking water of 24 major urban cities, serving 41 million people, and found several pharmaceutical contaminants, including antibiotics, anticonvulsants and mood stabilizers. NRDC urges that further research should be conducted to evaluate the threat of pharmaceuticals in our drinking water supply.
Pfizer is one of the largest pharmaceutical companies in the world and has become a household name synonymous with prescription and over-the-counter drugs. In 1849, Pfizer got its start with one production complex in Brooklyn, New York. Today, Pfizer has a presence in 180 countries, employs over 110,600 people internationally, and, in 2011 alone, had amassed over $65 billion in revenue. Pfizer is also one of the obvious targets of any debate on the potential hazardous impact of drug manufacturing on the environment. For this reason, it is no surprise that Pfizer funds its own research on the effects of manufacturing on the supply of drinking water, among other things.
According to Pfizer, the number one cause of pharmaceutical contaminants in water stems from consumer use (which accounts for 90 percent of all trace concentrations found). As discussed, the body excretes small concentrations of pharmaceuticals that, down the road, end up in the water supply. Even then, the level of medication in the drinking water is at least a thousand-fold less than minimum treatment doses. Pfizer notes that there are no reports that trace amounts of manufactured drugs (prescription and over-the-counter) in the water supply adversely affect the population.
Ecosystems are delicate. The introduction of a drug, even trace concentrations, can deleteriously impact the habitat and reproduction success of a species. For instance, a research study on the topic of the “feminization of male fish” found that drugs are threatening the survival odds of fish. Women all over the world use oral contraception as a birth control practice. Trace amounts of these drugs find their way into the water supply (again, most often through the sewage system) and end up being consumed by fish. In the case of male fish, studies show that the consumption of hormones in birth control cause them to breed at lower rates. The threat, of course, is that over time species of fish that are chronically exposed to these hormones may become extinct.
Another study found that otters that had been exposed to two common non-steroidal anti-inflammatory drugs developed severe liver damage. This finding is only the tip of the iceberg in terms of how sea animals are likely being negatively impacted by human drugs altering their environment. Otter livers have not evolved to metabolize drugs to which they are now exposed, which may be a reason for the acute liver problems reported.
These findings on the impact of drugs on wildlife call into question whether drug contaminants in the environment are contributing more to the extinction of various species than is known. Research is required wherever there is life, including the ocean, though the challenges of covering so much land and oceanic mass are readily apparent.
A research study on the impact of commonly used drugs on lettuce and radish plants found damage to the growth of these plants even at low levels of concentration in the environment. These drug contaminants, such as trace amounts of ibuprofen, find their way into the soil through various channels, including the use of waste water for irrigation and sewage sludge for fertilizer. The study considered specific changes in plants exposed to trace amounts of drugs, including the plants’ water content, length of root and shoot, size overall, and the impact on the photosynthesis process. Each drug had a specific impact on each type of plant. For instance, ibuprofen had a significant impact on the early development of the root of lettuce plants. The study did not consider the impact of these foods on humans who consume them.
Interestingly, the Pfizer study discussed earlier found that trace amounts of ibuprofen in drinking water does not adversely affect humans, but that outcome changes when plants are considered. The differential impact of ibuprofen traces on different species, such as animal versus plant, is a testament to how difficult it can be to determine the true impact of drugs on the environment. The lettuce and radish research study directors specifically noted that more efforts must be made to determine the impact of drugs on flora and fauna.
Thus far, the discussion has centered on the impact of lawfully manufactured drugs on the landscape; however, illegally manufactured drugs are also a threat, and possibly more so because they escape regulation. For instance, the chemicals used to convert the coca leaf to saleable cocaine and opium latex to heroin are hazardous materials. Annually, millions of liters and tons of chemicals are cast off into the environment after these illegal drugs are produced, or when law enforcement confiscates and destroys these drugs.
Despite the ripeness for research in this area, studies lag. One study, conducted in 1992 in the Chapare area of Bolivia found that chemical waste involved in the manufacture of illegal drugs was diluted during high rainfall and only caused some loss of soil and microorganisms, but no perceivable damage to the fauna or flora was noted. Regarding further research, one concern, however, is that the illegal manufacturer of drugs happens in many third-world countries that do not have adequate research funding to conduct an in-depth study. Of course, in addition, the underground nature of illicit drug manufacturing makes it difficult to study.
Illicit crop eradication involves international policy and calls into question how to balance the need to stem drug production while at the same time not having a detrimental environmental impact. Further, when it comes to the environment, each nation needs to think globally. For example, the US has researched the use of mycoherbicides to eradicate coca and opium poppy plants but has not developed the technology because of concerns over the impact on the environment and public health. The key lesson here is that while certain methodologies may be useful to control the manufacture of drugs, such practices do not occur in a vacuum; the US and all countries have the need to protect both the public and the environment.
Drug companies that are not forced by law to make more ecofriendly versions of their drugs have little incentive to do so unless there is a profit associated with the change. At present, a lack of compelling research that the afterlife of pharmaceuticals is dangerous insulates these companies against having to change. Although drug companies may not be the ones to drive major change, the government and consumers may be able to do so.
The FDA is helping to educate consumers on how to safely remove unwanted drugs from medicine cabinets. Here are some helpful tips:
According to the Natural Resources Defense Council (NRDC), there are numerous steps that can be taken to lighten the footprint of drugs on the environment. NRDC recommendations include:
Before drugs are approved for distribution, the FDA can change its guidelines to require environmental assessments in more cases, as necessary.
Implementing technologies and practices to reduce waste would result in less drug residue leaking out into the environment.
America is arguably the most overmedicated society. One way to control contamination is for Americans to learn to rely less on prescription pills and over-the-counter medications, and instead utilize more holistic methods to manage conditions.
As an alternative to flushing pills or throwing medications in the trash, some communities have drug take-back programs and this model, along with education, can be used on a national scale.
These measures can help to better protect the environment and those we share our environment with against drug contaminants. Current research on the impact of drugs on the environment cannot control for the effect of future medications. It is possible that certain drugs may be developed in the future that may slip through the assessment process and detrimentally impact the environment. For this reason, preventative efforts and a tightening of FDA regulations are necessary.
 Shah, S. (Apr. 15, 2010). “As Pharmaceutical Use Soars, Drugs Taint Water and Wildlife.” Yale Environment 360. Accessed Feb. 27, 2015.
 Natural Resources Defense Council (Jan. 2010). “Dosed Without Prescription: Preventing Pharmaceutical Contamination of Our Nation’s Drinking Water.” National Resources Defense Council. Accessed Feb. 27, 2015.
 Carrington, D. (Oct. 12, 2014). “Drugs Flushed into the Environment Could be Cause of Wildlife Decline.” The Guardian. Accessed Feb. 27, 2015.
 “Dosed Without Prescription: Preventing Pharmaceutical Contamination of Our Nation’s Drinking Water.”