A recent WSJ article highlights an increasingly important issue with which society is slowly grappling, drugs in our water. The story talks about the mellowing effect of anti-anxiety drugs turning our rivers into a modern-day Woodstock for pisces, an undersea counter-culture seeking escape from the pressures of a world filled with big scary predators. Come to find out, however, some fish are so mellow, they apparently aren’t too concerned about getting eaten. Big problem if you’re not a predator.
Drugs in water is an issue with which I have become increasingly familiar since my time at U.S. EPA’s Office of Water. My morning ritual at EPA was to arrive early and spend an hour or so skimming the half-dozen journals awaiting me – LAT, NYT, WaPo, BNA,InsideEPA – to spot the latest environmental crisis or Bush EPA story that would often consume my day. I recall one Friday morning where this particular issue took on a life of its own. Friday’s were typically quiet – a lot less regulating going on than Monday’s – and usually a slow news day. My morning started as usual. With my special EPA edition “20,000 TMDLs” coffee-filled mug in hand, I strolled into the office that morning, grabbed the WaPo – usually my first read – and as I strolled toward my desk, I took a big gulp and . . . it jumped off the page, “Male Bass in Potomac Producing Eggs: pollution suspected cause of anomaly in River’s South Branch.” Front and center on A01 of the WaPo. Reading the article, I learned about a population of male bass in the upper reaches of the Potomac River that were bearing eggs rather than gonads. I knew then it wasn’t going to be a typical EPA Friday. Yup – no better way to grab Congress’ attention – the phones starting ringing off the hook.
While we have a pretty good understanding of where these drugs come from, we don’t entirely understand their impacts on humans and the environment. Drugs enter our environment a number of different ways, but predominantly through natural excretion by humans (e.g., sex hormones, birth control pills, antibiotics, mood stabilizers, painkillers, etc.) and livestock (mostly antibiotics and growth hormones), but also through the improper disposal of unused drugs. The U.S. Geological Survey has conducted numerous studies across the U.S. to determine the prevalence of pharmaceutical and personal care products (PPCPs) in our waterways and their implications.
When you take your daily biobreaks and flush the toilet, the un-metabolized portion of any drug you’re on is flushed either to a septic tank or a sewage treatment plant, and ultimately into groundwater or surface water. Neither septic tanks nor most sewage treatment plants are equipped to remove the millions of pounds of PPCPs that are discharged every day into our environment. Upwards of a third of all prescribed drugs go unused each year, which means that 200 million pounds of unused pharmaceuticals, if improperly disposed, could enter and impact the environment.
I have spent the better part of a decade promoting more public awareness on the effects of improperly disposed drugs on our Nation’s waters and aquatic systems, including doing a number of PSAs like this one. And I’m very proud to be associated with a company, United Water, who, along with its partners, such as NCPA and Dispose-My-Meds, has made this educational process a high priority.
And before any of you swear-off tap water altogether, let me remind you, water is vital to life. It’s equally important to remember that medicinal drugs have been in our environment for as long as we humans have walked the earth and peed in our waters. The only difference now is that there’s a lot more of us on earth peeing, we use a heckuvalot more drugs than we used to, and, with modern technologies, we are able to detect drugs in the environment at infinitesimally low levels. And while EPA maintains that there is no evidence of adverse human health effects, the evidence is abundantly clear that we’re impacting fish and other aquatic critters who live out their lives in this medicinal soup.
This is not nor should it be construed as a jihad against pharmaceuticals or their manufacturers – like others, I’m incredibly fond of my drugs and a grateful beneficiary of their effects. For me, this is about society taking a hard look at the impacts we’re having on the natural environment and, similarly, the potential risks that we may be creating for ourselves. For example, some studies have chronicled the effects on wildlife, which have raised sobering questions about the effects of estrogen-laced water on “maleness” – yes, there is growing concern that drugs in our water could be resulting in male shrinkage – or a permanent form of the “frightened turtle” effect for you Seinfeld fans.
There’s no guarantee that take-back programs will solve the problem. However, unless we can find a way to reduce the amount of drugs entering our waterways, EPA will eventually be forced to regulate. Looking into my crystal ball, that regulatory path would inevitably lead to new regulations that would require communities to retrofit their sewage treatment or drinking water plants with advanced technologies, which would carry a HUGE price tag. Alternatively, we as a society can adopt an incremental approach, and allow education and take-back programs to reduce the loading of drugs to our waters and which, if successful, may potentially forego more costly and restrictive regulations. This to me seems the better option for the time being.
PhRMA, who represents the pharmaceutical industry, has waged a battle against take-back programs, arguing they aren’t effective and pointing to other disposal options, which, admittedly better than dumping down a toilet, are not as effective in protecting the environment as take-back programs. The manufacturers are also rightly concerned about being saddled with the costs of collecting and disposing of unused drugs, as reflected in the ongoing litigation between PhRMA and Alameda County CA, who adopted local requirements compelling drug manufacturers to take responsibility for the disposal of left-over drugs. While I’ll be watching this case closely, I remain hopeful that one day, one of the industry giants will recognize the great opportunity that is presented here, and turn this into positive marketing, product-branding, and corporate responsibility initiative. No doubt consumers will pay more for drugs if the industry is compelled to foot the bill for such programs. But for me that is a small price worth paying.
So a couple of closing pointers. First, continue to drink tap water – it’s safe and it’s good for you. Second, don’t use your toilet as a trash can. If you have old drugs in your medicine cabinet, don’t dump them down your toilet. Participate in a local drug take-back program near you. Type in your zip code here to see if there is a pharmacy near you who will properly dispose of your unwanted drugs. And if there isn’t one, start one.
Lastly, I would be remiss if I didn’t extend a special thanks to my former EPA colleagues, including Suzanne Rudzinski, who, in a display of good government, recently removed a major regulatory hurdle to these valuable take-back programs. Participating pharmacies are among society’s legions of little platoons who are at the center of conservation.