Flushing Meds-EcoMyth Cartoon-Web

Fishing for the Facts: Is It Safe to Flush Old Meds?

What to do when it comes time to ditch old and unused medicine? Flushing old pharmaceuticals down the toilet may seem like a better option than simply trashing them. After all, the FDA recommends flushing some drugs in order to keep them from being accidentally ingested by others. Problem is, like everything else we flush, medicine we send down the pipes ends up in waterways…and potentially beyond.

That’s part of what has prompted organizations like the Alliance for the Great Lakes and the Metropolitan Water Reclamation District (MWRD) to call for further investigation into the impact of chemical contaminants in our water, and to advocate safe disposal of medicines through local drug take-back programs. We talked with Olga Lyandres, PhD, the Alliance’s research manager, and Debra Shore, MWRD commissioner to find out why they think participating in drug take-back programs are the best option.

Counting Dosages…in Our Waterways

Let’s take a little field trip over to good ol’ Lake Michigan, with Lyandres as our guide. As she points out, this aquatic gem provides drinking water for more than 40 million people—and recently tested positive for a whole slew of chemical contaminants, including several categories of pharmaceutical products.

Here’s a case in point: As Lyandres details in a recent Alliance investigation of contaminants of ecological concern, a popular cholesterol drug has been found in trace concentrations in Lake Michigan waters. Cholesterol drugs are now being commonly detected in waterways around the country, and experts like Lyandres worry that they could impact aquatic animals’ physiological systems, potentially altering the ecosystem.

“Fish and other creatures are exposed to trace amounts of pharmaceuticals in combinations that don’t exist in nature—hormones from birth control pills and Viagra, Prozac and other anti-depressants, and so on,” says Shore. That’s partly why the EPA, she points out, generally recommends against flushing unused or expired medicines down the toilet.

An important distinction: The low levels of pharmaceuticals in water are a threat to the aquatic organisms that are chronically exposed to them, rather than to tapwater-chugging humans, agree Lyandres and Shore.

Yes, tap water is safe to drink. As Shore says, municipalities that filter and supply drinking water test it to EPA standards multiple times a day. In other words, drink up, people. (Photo by Lloyd De Grane/Alliance for the Great Lakes)


Similar concerns surround other widely used pharmaceuticals. According to Lyandres, aquatic organisms’ chronic exposure to anti-depressants could potentially “mess with the way the brain regulates various signaling pathways and could have subtle but unforeseen impacts.” Antibiotics in large amounts in water could potentially cause resistant microbes to develop. Hormone drugs could have toxicological effects on the endocrine system, which governs functions like growth and development, metabolism, and reproduction. In fact, the USGS has conducted numerous studies of the effects of endocrine-disrupting chemicals on fish, finding reproductive organ changes ranging from reduced size to cancerous cells to displays of both male and female characteristics. The MWRD is also championing research on this topic.

Another complicating factor: The retention time in Lake Michigan is around 100 years, adds Lyandres. That means that stuff that was discharged 50 years ago is still making its way around the lake—including legacy contaminants that have been banned for decades—and we don’t know what the impact of pharmaceutical contamination will be 20-30 years from now.

Lyandres and her colleagues think there’s sufficient reason to be concerned about pharmaceutical contaminants in the Great Lakes—and waterways of all other types, too. According to this USGS study, 80 percent of U.S. streams contain small amounts of human medicines. Steroids, OTC drugs, and bug repellents were the most commonly found chemical groups. But with upwards of 50,000 pharmaceuticals on the market today, there is just not enough info in the books to know the full story yet.

The good news is that lots of other smarties are working to fill in the gaps in our knowledge base. The U.S. EPA Great Lakes National Program Office, together with the National Oceanic and Atmospheric Administration, U.S. Fish and Wildlife Service, U.S. Geological Survey, and Environment Canada, have launched a program to monitor the presence of these chemicals in water, air, sediments, fish and birds, and identify effects these chemicals might have.

Prescribing Safe Medicine Disposal

So, what to do with those old meds in the meantime? Our experts say, bring ’em to a local take-back program.

Most take-back programs employ an incineration process to destroy pharmaceutical waste. True, burning contaminants come with its own degree of environmental impact. But, as Shore points out, the EPA has approved several types of incinerators for safe disposal of pharmaceutical waste with minimal air pollution. With this method, potentially harmful chemicals are mostly removed from the environment, whereas flushing them merely transfers the chemicals into the water stream.

By the way, if you’re wondering if sending meds to the landfill is the answer, that’s also a no-go, as there’s still the risk of groundwater contamination.

EcoMyth Outcome: Myth Busted

Flushing is neither a safe nor eco-friendly way to dispose of unused drugs. Safe take-back programs help protect waterways—and the many living creatures that live in and around them.

One Green Thing You Can Do

Bring your unused meds to a safe take-back program.

For details, check out the following take-back programs, as recommended by Debra Shore:

The EcoMyths Multiplier Effect

If 100,000 of us take a small bottle full of unused meds (say, a hundred 200mg tablets), to a safe take-back location, we’ll keep almost 4,500 pounds of questionable chems out of our waterways each year.

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