We in Niagara County, NY, are currently working on a Pharmaceutical Waste Collection Program because, in part, an Associated Press article in the spring of 2008 reported on a five month inquiry into the drinking water of 62 metropolitan areas and 51 smaller cities. They found that the drinking water of at least 24 American cities contains trace amounts of a wide array of pharmaceuticals and their by-products. These include antibiotics, heart medications, psychiatric drugs, hormones such as those in birth control pills, and others.

Municipal drinking water supplies are extensively regulated by the US Environmental Protection Agency (EPA), which sets limits on certain contaminates, but there are no federal regulations handed down that include pharmaceuticals. The 24 cities that detected pharmaceuticals through voluntary testing efforts are under no obligation to report them, or treat for them. About half the utilities surveyed do not normally test for pharmaceuticals.

Environmentalists have been watching the feminization of fish increase and hypothesize the presence of hormones flushed into watersheds as a possible explanation.

According to research done by the Kaiser Family Foundation in 2006, the average number of prescriptions for each person increased from 7.9 in 1994 to 12.5 in 2005. Many older or chronically ill Americans have many more. Often, after the death of a parent or loved one, surviving family members are left with large amounts of powerful and potentially dangerous narcotics. Accidental overdose or the misuse of prescription medications has become a significant problem. Prescription narcotic abuse has become epidemic among adolescents. The source of those medications is typically their parents’ bathroom cabinets.

On June 7, 2008, the City of Rochester Water Bureau had a goal to collect 10,000 pills for the EPA Great Lakes 2008 Earth Day Challenge. The event was an overwhelming success with 80,000 pills being collected. When combined with the 46,000 pills collected at a previous event, the final result is that the Rochester area collected 126,000 pills! That is 126,000 pills that have been kept out of the hands of adolescents and out of our ground water, drinking water and soil.

It is my hope that you will print this letter to encourage public officials to hold pharmaceutical waste collections.

DEAR READER:
Shortly after I printed that article, I received a truckload of letters telling me my error, some polite, others more harsh. When I received your letter, I was very impressed with the information you provided. Not only were you polite and informative, you also provided me with an opportunity to promote an excellent program. Your county appears to have done an amazing job collecting over 125,000 unused or outdated pills.

I have printed your letter in its entirety in the hopes that others counties and states around the country will use your program as an example. It not only keeps pills out of the soil and water, it also, as you pointed out, keeps them out of the hands of our youth. Thank you for writing.

DEAR READER:
Since my article appeared in late May, I have received several letters on the subject. While some were not as strong as yours, I have chosen to address the subject again with the hope I can redeem myself.

Unused over-the-counter and prescription medications can be found in almost every household, nursing home and hospital in the country.
In the past, discarded pharmaceuticals were commonly flushed away. Out of sight, out of mind. Since those days, studies have revealed that over-the-counter and prescription drugs may have a harmful effect on water supplies and soil. The trace levels are extremely low, but do exist. The major concern is the possibility of drugs ending up in drinking water sources.

To confuse the issue and to my reporting credit, the Office of National Drug Control Policy (www.WhiteHouseDrugPolicy.com) advises that more than a dozen drugs, including oxycontin and morphine, be flushed and gives other approved disposal methods.

There are several organizations that recycle drugs. Such organizations generally use leftover drugs prescribed to American HIV patients for HIV sufferers in other countries. The expensive retroviral medications are collected after patients in the United States switch prescriptions, stop the medication or die. They are then passed onto individuals throughout foreign countries. The organizations enlist the help of a physician, clinic or hospital who collects and ships the medicine to the programs. Laws in the United States don’t allow redistribution of any medications in this country but there is no prohibition when exporting to other countries.

Data provided from the FDA Shelf Life Extension Program reveals that almost 100 different drugs stored in their unopened original containers would remain stable for almost five years following their expiration date. One very expensive antibiotic was tested and found to be safe and effective nine and a half years after the expiration date listed. Two other medications were found to be effective after 25 years and retained antiviral activity after boiling and being held at 149-185 degrees Fahrenheit for several days. Medical Letter journal consultants believe most drugs — even those opened and stored under reasonable conditions, retain up to 80% of their potency for up to two years after the expiration date. Despite this evidence, most manufacturers urge disposal of “expired” medications. However, they can be a great benefit to recycling programs.

Many states have a hazardous waste collection program that can properly dispose of medications. Check with your local pharmacy or hospital, or even your state offices to determine if they have a program in place to aid in the disposal of unwanted medications.