Side effects may waylay nature
Experts now warn that flushing unused medicines down
toilets and drains could pollute our waters and harm
By John Myers
It's house-cleaning day at Grandpa's home and you come
across a medicine cabinet full of expired prescription
drugs, stuff Grandma never got around to throwing out.
Conventional wisdom has been that expired medicines --
prescription or over-the-counter -- could be dangerous
and should be flushed down the toilet to prevent accidental
But a growing number of scientists and sewage treatment
officials now are warning that those drugs often can't
be removed from wastewater. Many are passing into the
environment, where their effects largely remain unknown.
Based on some early effects, however, experts believe
there's cause for concern. Locally and nationally, people
are being asked to bring their unused medicines to a hazardous
waste disposal site rather than flushing them.
Antibiotics, painkillers, hormones and other medicines
are turning up in waterways, raising worrisome questions
about potential human health and environmental effects.
Some are so-called endocrine disrupters that can change
the way animals, fish and even people's biological systems
In some cases, officials say drugs may harm natural bacteria
-- "bugs" that break down and clean sewage,
allowing other pollutants to make it through into the
The issue, long in the news in Europe, made domestic
headlines recently when the U.S. Geological Survey found
traces of dozens of chemicals -- painkillers, estrogen,
antidepressants, hypertension medicines and more -- in
water samples from 30 states, including Minnesota.
Fish in water from Duluth and Twin Cities sewage treatment
plants, for example, are turning from male to female.
So far, researchers have not been able to trace the origin
of estrogens that cause the changes. But they say it's
best to keep as many chemicals out of the water as possible.
"Our treatment plant simply was never intended to
remove these kinds of chemicals," said Kurt Soderberg,
executive director of the Western Lake Superior Sanitary
District. "There's growing evidence that some of
these chemicals are getting into (the environment). Common
sense dictates that we try to keep them out of the system."
The WLSSD is in the infant stages of a new program to
collect unused medicines at its Household Hazardous Waste
facility in Lincoln Park/West End. The district is slowly
trying to get the word out to homeowners and hopes to
begin an outreach to local medical facilities and pharmacies
"We're in the infant stages on this," said
Heidi Ringhofer, the WLSSD's supervisor of operations
and maintenance. "We're just scratching the surface
on this locally."
Deb Swackhamer, University of Minnesota scientist who
has studied why fish change sex downstream of wastewater
plants, said medicines and other compounds can get into
our waters many ways.
Estrogens that are making male fish turn female were
originally suspected to come from birth control hormones.
Now, Swackhamer and others say that probably isn't true.
They suspect the culprit lies in a combination of hormones
that are joining forces in the complex sewage effluents
our society now sends to treatment plants.
Other chemicals are equally worrisome. Antibiotics, for
example, have been found in Minnesota rivers downstream
from large livestock farms, apparently residual from drugs
given livestock to keep them healthy and gaining weight.
More antibiotics get into waterways every time we use
antibacterial soaps and cleaners. And they pass through
people who take more than their body can process.
Surely, Swackhamer said, the environment doesn't need
people flushing more down the toilet.
"If we're teaching bugs (diseases) out there to
be resistant to our suite of antibiotics, we're in for
some big trouble," she said.
It's clear we use a lot of drugs. The Environmental Protection
Agency estimates that we buy more than $100 billion in
medicines each year, about 1.5 percent of our gross domestic
product. That's tons and tons of pharmaceuticals.
It's not clear how much of that Americans flush each
year, or how many are stored in medicine chests because
patients don't realize the drugs have expired or don't
know they may be dangerous. One study estimated the nation's
nursing homes discard anywhere from $73 million to $378
million worth of drugs a year. Some are incinerated, but
many are flushed.
St. Mary's/Duluth Clinic Health System, for example,
gives its unused drugs to a contractor to be incinerated
with other hazardous medical waste.
Other countries are leading the U.S. in getting medicines
out of the water. Australia has collected more than 760
tons of medicines since starting a program in 1998 that
encourages consumers to return unwanted drugs to pharmacies
so they can be incinerated. Canada has a similar program.
Most U.S. pharmacies, however, won't accept unused or
unwanted medicines. Walgreens, one of the nation's largest
pharmacy chains, will not accept any returned drugs, company
officials said last week.
The EPA is just now studying whether to develop formal
"The age-old wisdom of flushing medication down
the toilet... is probably the least desirable of all the
alternatives," Christian Daughton of the EPA's Las
Vegas laboratory wrote in an overview of the issue, published
in a scientific journal last spring.
The agency is promoting a program called the Green Pharmacy
to get medicines out of waterways. So far, however, there's
no money, regulations or even a public awareness campaign
planned to put the program into action.
Minnesota and Wisconsin have no official effort. But
Michigan's Department of Environmental Quality has compiled
a brochure with a stern warning "... any and all
disposal of drugs down a drain or toilet is strongly discouraged."
Some of the concerns already are being taken to heart.
A new contraceptive, a vaginal ring, comes with do-not-flush
instructions because it still contains estrogen after
it's been used. Women are instructed to wrap the NuvaRing
in an accompanying foil patch and put it in a trash can
out of reach of children and pets.
"We aren't going to be able to solve every problem
people want to flush and send our way," Ringhofer
said. "The key is to keep it out of the water to