Medicines Reports

The Royal Society: Special edition on pharmaceuticals in the environment

The Royal Society published a special issue on "Assessing risks and impacts of pharmaceuticals in the environment on wildlife and ecosystems" in October 2014: 

Expanding and aging human populations require ever increasing amounts of pharmaceuticals to maintain health. Recent studies have revealed that pharmaceuticals, both human and veterinary, disperse widely in aquatic and terrestrial environments with uptake into a range of organisms. Pharmaceuticals are designed to have biological actions at low concentrations rendering them potentially potent environmental contaminants. The potential risks that pharmaceuticals pose to the health and long-term viability of wild animals and ecosystems are only beginning to be assessed and understood.
This theme issue introduces the latest research investigating the risks of environmentally relevant concentrations of pharmaceuticals to vertebrate wildlife... With thousands of pharmaceuticals in use globally, this issue presents approaches for prioritising which products have the potential to cause harm to wildlife and ecosystems. Given the many benefits of pharmaceuticals, there is a need for science to deliver better estimates of the environmental risks posed by pharmaceuticals.

From Discard Studies, via UPSTREAM.

Alameda County Safe Medication Disposal Initiative Assessment

Key findings of an analysis by the Teleosis Institute of the medicine take-back programs operating in Alameda County, CA from 2007 to 2014:

  • In 2009 just 473 pounds were reported from one site. By 2013, the most recent year accounted for, 13,919 pounds were collected and disposed, with an average of 449 pounds per site.
  • The largest collection sites are the Alameda County Sheriff’s Station (1100 pounds), Eden Medical Center (1036 pounds), Washington Hospital (960 pounds) and Ted’s Pharmacy (936 pounds).
  • In 2013, the extrapolated costs of disposal are $27,838, with an average costs per pound of $2.00, down from $2.51 per pound in 2009.

Teleosis Institute's recommendations:

  • Establishing one centralized agency to oversee a countywide program would minimize operational overlap and thus improve collection efficiency.
  • With roughly 51% of the county citizens within close proximity to a take-back site, new sites are necessary for residents that lack easy access to take-back sites.
  • Establishing new sites in larger medical institutions, such as hospitals, would likely provide the most efficient and effective results.
  • Educating pharmacists would likely improve collection rates in pharmacies and educating health executives, health professionals in primary care and end-of-life caregivers will likely improve program outcomes.
  • Centralizing management would simplify the waste collection system and drive cost of disposal down.
USGS Study: Pharmaceuticals and Other Chemicals Common In Landfill Waste

Summary from Municipal Solid Waste Management journal, Technical Announcement: Pharmaceuticals and Other Chemicals Common In Landfill Waste, Aug. 17, 2014:
Pharmaceuticals, personal-care products, and other contaminants are widespread in water that has passed through landfill waste. The samples of this liquid, also known as leachate, were collected from within each of the studied landfills. This study by the U.S. Geological Survey is the first national assessment of these chemicals of emerging concern in landfill leachate in the United States.

NWPSCPH:ARM Pilot Team: Pharmaceuticals from Households: A Return Mechanism

A coalition of government and private partners in Washington State are currently collaborating to design a simple, effective system to take-back pharmaceuticals from residential consumers known as the Unwanted Medicine Return Program. The coalition is the PH:ARM Pilot Team (PDF file, 89KB) (Pharmaceuticals from Households: A Return Mechanism). Two local companies, a local retail pharmacy chain and a clinical managed care organization will serve as locations for collection during the pilot program. This includes approximately 70 locations in the state of Washington. The pilot launched in 2006 and will last until the end of 2008

Current regulations do not allow a pharmaceuticals take-back program for controlled substances, and the PH:ARM Pilot Team is currently pursuing options to either obtain a waiver for a pilot, or change legislation.

The set up costs for the pilot are financed by public agencies, private and public grant foundations, and participating private companies, with the goal of a long term project being financially supported by the pharmaceutical industry. Costs include purchasing secure containers, advertising, collection and transportation, project management and disposal costs.

During the pilot, volumes will be measured and a sample survey will assess aspects of consumer behavior and knowledge. Environmental data will be monitored at the final disposal site as part of the pilot. See the April 2008 Progress Report (PDFfile, 92KB) and the presentation from the 2008 Medicine Return WorkshopWashington PH:ARM Pilot Project Report.

See the primer, revised in December 2007, outlining the barriers and opportunities for the collection and disposal of pharmaceuticals: Disposal of Medications from Residential Consumers (PDF file, 494KB).

The PH:ARM Team includes: Local Hazardous Waste Management Program in King CountySnohomish County Solid Waste Management DivisionPublic Health - Seattle & King County, Northwest Product Stewardship Council, Washington Citizens for Resource Conservation, and Washington State Department of Ecology, and advised by the Washington State Board of Pharmacy.

We are especially grateful to our funders: King County WaterWorks, Seattle Public Utilities, King County Voucher Incentive Program, Group Health Community Foundation, Russell Family Foundation, Seattle Biotech Legacy Foundation, Puget Sound Action Team, Snohomish County Solid Waste Management Division under the Coordinated Prevention Grant program, and the Snohomish County Marine Resource Council.

Oregon Pharmaceutical Take Back Stakeholder Group

In October 2006, a group of stakeholders formed a working group to study the disposal of unwanted and unused drugs from households and care facilities in Oregon. Stakeholders included experts ranging from law and drug enforcement; public water agencies; pharmaceutical groups; environmental organizations; medical, health care, recycling and poison center representatives; and city and county governments. The stakeholders researched and analyzed existing and proposed drug take back programs with the intent of recommending a take-back program for Oregon that is effective, fair, and economical, and includes both controlled and routine drugs.

In July 2007, the Oregon Pharmaceutical Take Back Stakeholder Group Final Report (PDF file, 2.03MB) was released, along with the Executive Summary (PDF file, 71KB). The report includes background on drug take back programs, an overview of the regulatory framework, a survey of existing drug take back programs, Oregon program options, subgroup findings, and Oregon program funding options and recommendations.

See a presentation from Janet Gillaspie of the Oregon Association of Clean Water Agencies about Building an Oregon Drug Take Back Program. Read the June 25, 2008 Oregonian editorial Pill makers and pill poppers must heed the call of the Oregon ethos for disposing of unused medicine.