Roosevelt Institute | Cornell University

A Prescription for Medical Waste

By Kelsey CloughPublished October 20, 2014

Within the past century, the medicalization of society has shaped American society. This conditioned proclivity for pharmaceutical solutions to social problems, has exponentially expanded the production and sale of medical remedies. The explosion of pharmaceutical drug use, however, poses grave threats for the environment.

By Kelsey Clough, 10/20/14

"We're a heavily medicated society. All the drugs we take: Prozac, Effexor, Valium. I thought for the last ten years, we've been on some weird…drug- the whole country." — Robin Williams, in Robin Williams: Weapons of Self Destruction (2009)

He was right; today, there is a pill to solve everything. For a headache, go to the medicine cabinet. Do you have attention problems? Visit the doctor. If you need to sleep, buy some cough syrup. Within the past century, the medicalization of society has shaped American society.

The conditioned proclivity for pharmaceutical solutions to social problems has exponentially expanded the production and sale of medical remedies. By way of illustration, the White House's Office of National Drug Control Policy reports that from 1997 to 2007, the number of prescriptions filled for opioid pain relievers has increased, in milligrams, by 402%. Medical and social quandaries aside, this explosion of pharmaceutical drug use pose grave threats for the environment.

While statistics on the degree of pharmaceutical waste remain contested, little doubt exists on its presence in international waters. According to a USA Today article published in 2008, more than a hundred different drugs, including antibiotics, anti-convulsants, mood stabilizers and sex hormones, have been detected in lakes, rivers, reservoirs, and streams throughout the world. Consequently, it is estimated that medicine compromises drinking water supplies of approximately 46 million Americans (Pharmaceuticals and the Environment). Although some experts argue that the concentration of pharmaceuticals remains too miniscule to produce negative effects, concern remains; many other experts legitimize environmental and health concerns, stating that "small" concentrations can still have significant consequences.

Pharmaceuticals, whether delineated as prescription or "over the counter" (OTC), may enter the ecosystem through several avenues. During the manufacturing process, as well as through packaging and distribution operations, medications may permeate the environment through wastewater treatment plants. A study conducted in New York, for example, confirms that water passing through wastewater treatment plants retain pharmaceutical concentrations of up to 1000 times higher than other non-pharmaceutical wastewater treatment plants. Water reservoirs up to twenty miles from these plants possessed concentrations of pharmaceutical remnants.

Moreover, the improper disposal of medications presents ecological risks. Disposal of pharmaceuticals in the trash results in contamination through landfill leachate, the liquid derived from decomposing solid waste. Similarly, the riddance of pills through toilets or drains creates a direct stream for the pharmaceuticals to a water supply. Toilets, also, transfer medical waste to water supplies through human excretion.  Consequently, medications possess the perilous ability to kill bacteria essential to the function of septic systems, in addition to the risk that contaminated water may leak into nearby soil and groundwater. Regardless of the method of entry, pharmaceuticals eventually reach a larger body of water.

Health and environmental concerns mount through the leaching of medicines into the world's water supply. For aquatic species, recorded biological perturbations confirm and continue to cultivate unease with pharmaceutical waste pollution. As evidence of this point, several studies suggest that endocrine altering compounds, found in many forms of birth control, modify the sex ratios of different fish populations. This disruption could have severe consequences on aquatic ecosystems.

These predicaments extend beyond just population permutations. Contamination of aquatic species may result in bioaccumulation; through the food chain, humans may eventually be contaminated with pharmaceutical waste.

Aside from the potential contamination from the pharmaceutical itself, the packaging of medications bestows yet another environmental quandary. The increase in medications increases cardboard and plastic packaging, which has uncertain directions on proper disposal. Where, for example, could a woman recycle her plastic birth control case after she is done with a prescription cycle? Can it even be recycled?

Although efforts to mitigate the possible health and environmental hazards of pharmaceutical waste exist, they are insufficient. Pill drop-off events occur sporadically, and in intermittent locations. Still yet, the "proper" disposal of pharmaceuticals often involves incineration, which is still, to an extent, environmentally harmful (Medication Disposal).

Therefore, to avoid these negative consequences, the management of pharmaceutical wastewater treatment centers should be more strictly regulated. Additionally, more permanent pill drop-off centers should be established. Consumers, as well, might start requesting biodegradable or easily recycled packaging.

Quite simply, however, as an individual, one might try to take fewer pills. This suggestion in no way diminishes the very real necessity of medical treatments for so many people in the world. Indeed, for many, medication is a modern miracle. Nonetheless, in this over-medicated society, it might be possible to occasionally quell the tendency to medicate in unnecessary situations.