Unsafe Disposal of Medicines: A Slow Poison and Global Threat

The Industrial Revolution in the sixteenth century triggered a surge in the rate and volume of garbage production. Urbanization and population growth led to diverse waste in cities, giving rise to issues like littering and open dumps and fostering the breeding of infectious pathogens.

Credit: Volodymyr Hryshchenko

Pharmaceutical waste is a term used to describe unused or expired medications that are classified as hazardous or non-hazardous based on their chemical properties. The pharmaceutical sector is expanding rapidly due to high demand in healthcare and agriculture, which in turn is generating a significant amount of harmful waste. Various sources, including wastewater treatment plants, healthcare institutions, and household disposal practices contribute to this issue. However, standard hazardous disposal practices at homes, such as flushing drugs down toilets or discarding them in regular garbage, can cause dangerous substances to leak into the environment. This contamination may have adverse effects on groundwater, drinking water, and plant life, posing risks to community health.

Impact of Public Health and the Environment

The pharmaceutical industry's waste has led to unintended consequences for the environment and public health. Discarding medication in common waste or sewage networks contaminates soil, surface waters, and groundwater. This contamination triggers bioaccumulation in aquatic organisms, fostering antibiotic resistance and inducing genetic effects. Medicine waste poses risks of poisoning and misuse, especially for children and animals. Toxic chemicals in contaminated water and food contribute to various health issues. Pharmaceutical residues contribute to antimicrobial resistance, species survival issues, reproductive interference, and increased cancer incidence. The breakdown of medicines generates hazardous byproducts that are harmful to organs, particularly with liquid medications.

When contaminants seep into agricultural land and food products, they exacerbate environmental pollution. They mix with dry waste and become accessible to fauna and flora, leading to health effects.

The improper disposal of medicine also presents risks of poisoning and misuse, posing dangers to children and animals. Toxic chemicals present in contaminated water and food can lead to a range of health issues, including metabolic and kidney diseases and genetic disorders.

Sustainable Medicine Disposal

Understanding and addressing waste-related challenges is essential for a sustainable future in modern waste management. A comprehensive strategy that includes policy adoption, industry-wide initiatives, and empowering households through public campaigns and multi-stakeholder collaboration is crucial.

The following are some examples of effective solutions:

  • The implementation of Extended Producer Responsibility (EPR) regulations, which are currently in place in the EU, Canada, Japan, and South Korea. These regulations mandate producers to take responsibility for the entire lifecycle of their products, including take-back, recycling, and final disposal.

  • Setting up waste collection boxes in public areas and using vacuum incineration to reduce pollutants and health risks associated with incineration byproducts.

  • Initiating programs that allow individuals to return medications to pharmacies for safe disposal. For example, the Australian Government introduced the 'National Return and Disposal of Unwanted Medicines' (NatRUM) program in 1998, which is now accessible to every pharmacy.

  • Conducting environmental monitoring, especially water quality monitoring for pharmaceutical residues, to identify contamination areas and prioritize disposal mechanisms.

  • Utilizing medication deactivation systems, such as drug deactivation pouches, that allow users to safely deactivate and dispose of medications in household trash, reducing the risk of accidental ingestion or environmental contamination.

  • Implementing 'Public Education and Awareness' programs to promote responsible medication disposal practices and emphasize the benefits of responsible practices.

  • Encouraging partnerships and collaborations between government agencies, pharmaceutical companies, healthcare providers, and environmental organizations to create sustainable disposal solutions.

Strategies to empower homes for eco-friendly medicine waste disposal | Credit: Prakash Mulakalapalli

Call for Global Policy Action

The escalating global problem of medicine waste, particularly in developing nations with inadequate monitoring and regulations, requires urgent attention. Standardized regulations for hazardous waste management at public and household levels are crucial. The aftermath of the COVID-19 pandemic has worsened the problem worldwide, increasing the use and storage of medicines. Neglecting this problem could have devastating consequences on public health and the environment. With urbanization and population growth, it is imperative to address this issue promptly. Decisive global and national policy actions are imperative to mitigate the consequences of unsafe drug disposal and safeguard ecosystems.

Conclusion

The proper drug disposal methods often remain unfamiliar to the public and healthcare providers (Insani et al., 2020). Lack of systematic approach for collecting medicinal waste, coupled with lack of awareness leads to mixed waste in landfills and garbage dumps. As consumers, we must be mindful and responsible of the disposal of our medications. Research and development to create drugs with reduced environmental impact should be encouraged. By promoting responsible disposal practices and waste collection initiatives targeting communities, institutions, and diverse groups, we can collectively create healthy environment for future generations.

Prakash Mulakalapalli

Dr. Prakash, a former dental surgeon turned public health advocate is a Research Fellow at the Public Health Foundation of India. With a background in clinical research, he now spearheads community health projects and public awareness initiatives, dedicated to improving public health services and promoting healthy lifestyles. Passionate and committed, he strives to make significant contributions to the advancement of public health.

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