Aruru Meghana V1, Salmon JW2., Salmon B.R3 1Roosevelt University 2,3University of Illinois at Chicago
Introduc:on
Results
Pharmaceu;cals are oHen improperly disposed, leaching ac;ve ingredients that contaminate our soil, water and air. Serious environmental consequences may poten;ally be risks to aqua;c and soil environments, food supplies, along with growth and resistance of microorganisms in sewage treatment. Drugs for humans end up in the sewage system from dumping expired and unused prescrip;ons and hospital and nursing home dumping from deceased pa;ents. Ecologically, biologically ac;ve, toxic, and hormone disrup;ng compounds may lessen sewage plant effec;veness and eventually contaminate water in municipal water supplies. LiIle tes;ng is done to detect drug residues that may addi;onally accumulate due to leakage from landfills and runoffs from agricultural land. Direct consequences of drug residue and ac;ve metabolites in the environment may be related to rising disease epidemics of unknown e;ology. Consider that new paIerns of breast cancer, rare site CA, an;bio;c resistance, au;sm, ADHD, early onset puberty, MRSA, mental disturbances, and more, may have origins from unprescribed medica;ons in water. EPA, DEA and FDA policies on p r o p e r d i s p o s a l o f p h a r m a c e u ; c a l s a r e contradictory, and drug disposal is not well regulated nor hardly enforced. There is no substan;al data on how minute quan;;es of powerful and dangerous pharmaceu;cal mixes affect the fetus, children, folks with chemical sensi;vi;es, and other vulnerable groups of pa;ents.
The over prescrip;on of pharmaceu;cals by providers and not counseling pa;ents on safe disposal are major policy issues that have not been adequately addressed. Non-‐adherence is a documented reality, which leads to greater disposed quan;;es. Safe disposal of prescrip;on and non-‐prescrip;on OTC drugs, along with upgrading for proper s e w a g e t r e a t m e n t , a r e n e c e s s a r y a H e r implemen;ng beIer public policies, strengthening the regulatory agencies, and promo;ng community ac;ons. Lack of personnel to ini;ate large-‐scale pharmacy take-‐backs by drug stores and within communi;es can prevent misuse as well as reduce environmental contamina;on, but consumer educa;on about this cri;cal issue is s;ll lagging. Different federal agencies regulate poorly and enforce liIle, oHen being contradictory and out of s y n c w i t h s t a t e a n d l o c a l a u t h o r i ; e s . Pharmaceu;cal plant waste needs careful monitoring in addi;on to drugged livestock waste that flows into river tributaries. Nevertheless, the main culprits seem to be dumping expired drugs and unused medica4ons into toilets and landfills in homes, hospitals and Par:cipants nursing homes. In the absence of more effec4ve regulatory oversight, organized take-‐back programs have spread across communi4es and produced a greater public awareness of ecological issues. However, there is s;ll a great need for scien;fic inves;ga;ons to determine poten;al long-‐term hazards from minute exposures to mixtures of powerful and dangerous unprescribed substances, which are needlessly medica;ng our popula;on. Proper safe disposal methods, such as incinera;on or landfills, are also s;ll ecologically undetermined. As municipal water treatment plants and infrastructure become an;quated, with liIle systema;c tes;ng of water for drug residues, correc;ve federal and state policies need to be formulated now.
Methods This study assesses policies related to crea;ng environmental responsibility for all par;es; it cri;cally examines the role of various agencies in the absence of coordina;ng efforts of personnel and authority to impose penal;es for non-‐ compliance. A select community drug take-‐back program in Montana is highlighted as an example of community ac;on.
Contact: Meghana V. Aruru, Ph.D
[email protected]
Conclusions ü Pharmaceu;cals in our water supplies are always found ü safer public health. in mixtures, though liIle systema;c tes;ng is undertaken. Given a societal acceptance of ecological ü Drug store take-‐back programs have been degrada;on, it remains paramount that communi;es spoIy and haphazard with few efforts by become aware of poten;ally dangerous drug disposal pharmacies and manufacturers to inform prac;ces and seek to remedy them. Pharmaceu;cal consumers of “best prac;ces” for disposal. firms, chain drug stores, prescribers, and health ins;tu;ons bear the chief responsibility for drug ü The FDA, EPA, DEA, DOA, and the U.S. disposal and should be mobilized for correc;ve ac;on Geological Survey should review their policies, and bear costs of local governments for improving coordinate and then seek strengthening of their sewage and landfill cleanup. Providers must lead by authori;es to assist states and local example and educate pa;ents on proper disposal of governments in efforts to address these issues. pharmaceu;cals and drug waste. Policymakers should find funding for interven;ons within the Pharmaceu;cal ü Scien;fic inves;ga;ons are long overdue to evaluate industry and corporate chain drug stores, and the poten;al detrimental effects from pharmaceu;cal make sure health care ins;tu;ons enact proper waste to our bodies and the ecology. Moreover, data on disposal prac;ces. current disposal prac;ces is not even available ongoing disease condi;ons, let alone to seek remedies for
Spotlight: Great Falls, Montana Prescrip:on Drug Take-‐Back
s
In response to the high diversion of pharmaceu:cals for abuse (est. $19.6 M), the Montana State Highway Patrol and the Great Falls Weed & Seed began a voluntary prescrip;on drug take-‐back, Opera:on Medicine Cabinet, in April 2011. Prescrip;on drug abuse was iden;fied as the second commonly abused illicit substances and a threat to public safety in Montana. A lockbox was provided at the Highway Patrol office to receive prescrip;on and illicit drug drop-‐offs daily. Special events collected 800-‐1200 lbs. over weekends across Montana, indica;ng heavily u;liza;on with wide community support. Opera;on Medicine Cabinet overcame several obstacles with incinera;on, MEPA oversight, finances, and
Take-‐Back Success
law enforcement constraints. However, Opera;on Medicine Cabinet and other programs similar to it across the country con;nue to face poli;cal, regulatory and opera;onal difficul;es. Without policy support in place, state and local prescrip;on drug disposal programs will con;nue to face uphill baIles for safe remedies. Nevertheless, Great Falls can be considered a model voluntary take-‐back program of significant success for drug diversion, heightened consumer awareness of disposal dangers, and coalescing public support.
Prescrip;on Drug Drop-‐Box Incinerator Unit
