From Prescription to Pollution: Rethinking Our Medicine Disposal Habits

Recently, I stumbled upon a piece of information that, in my opinion, should be common knowledge, yet seems to be less recognised than it ought to be. After living in this country for nearly two decades, I was astonished to learn that unused or expired medications can and should be handed over to local pharmacists for environmentally safe disposal. Such an essential piece of information had evaded me for all these years, and when I inquired amongst some of my friends, including those native to this country, they too were unaware of this practice.

One would expect that professionals in the medical field, like doctors and pharmacists, along with waste management companies, would be at the forefront of disseminating this knowledge. Their role in ensuring public awareness on such critical issues cannot be understated. Yet, recognizing a gap in awareness offers an opportunity for change. While I cannot influence the entire medical community, I can certainly initiate a difference starting from our own department. Distributing this information through our internal channels, such as the departmental newsletter, might be a good place to start.

Pharmaceutical residues can pose environmental risks when they enter the environment either from excretion after consumption or through the incorrect disposal of unused or expired medicine.

Trends in Pharmaceutical Consumption:

• A significant percentage of household medicine turns into waste due to various reasons including non-adherence, early recovery, therapy changes, and prescription errors.
• The percentage of household medication that becomes waste ranges between 3% to 50%.
• In 2018, French households disposed of 17,600 tonnes of unused or expired medicine, equivalent to 260 g per person.
• Due to demographic shifts, increased prevalence of chronic health conditions, and other factors, pharmaceutical consumption is increasing in OECD countries. This trend also leads to a rise in unused medicine waste.

Environmental Impacts of Improper Disposal:

• Many medicines, when flushed or discarded, enter sewage waters, risking contamination of freshwater systems.
• Traditional wastewater treatment plants are not fully equipped to remove pharmaceuticals.
• Medicines in solid waste can risk contamination when not disposed of properly.
• Environmental implications include adverse effects on aquatic ecosystems, emergence of antimicrobial resistant bacteria, potential public health risks, and economic losses due to wasted healthcare resources.

Policy Interventions:

• Various policy strategies can prevent medicine waste and reduce environmental harm.
• Measures include improved disease prevention, better packaging sizes, and marketplaces for near-expiry medicines.
• Although eliminating unused medicines completely is challenging, proper collection and disposal remain essential.
• Separate collection of pharmaceutical waste, adjusted to national and local contexts, can minimize environmental and health impacts.
• Extended producer responsibility schemes are effective. For instance, France, Sweden, Portugal, and Spain have such schemes with the highest collection ratios.
• Public awareness is crucial. In Latvia, 60% were unaware of proper medicine disposal methods, while in the Netherlands, 17.5% did not know that liquid medicines shouldn't be flushed.
• To boost awareness, governments can introduce communication campaigns, special disposal instructions, challenges for returning medications, product ecolabelling, and more. Informing health professionals can also amplify the message about proper disposal.

Now that you're clued in on this environmental concern, think twice the next time you're about to toss out unused medication. Instead of just dropping it into the trash, why not swing by your local pharmacist? They'll know the proper way to dispose of it, ensuring it doesn't harm the environment. It's a small step, but it can make a big difference!

Written by Klara Atere

(The original article written by OECD, 2022 Executive summary | Management of Pharmaceutical Household Waste : Limiting Environmental Impacts of Unused or Expired Medicine | OECD iLibrary (oecd-ilibrary.org))