It’s easy done, and very effective. Though there is rapidly increasing concern about teh presence of pharmaceutical residues in wastewater, and thereby in natural waters, little seems to be done to address the problem.

Wastewater treatment requires urgent upgrade. Ion exchange devices in the wastewater outflow from hospitals and other locations where drug use is high such as nursing homes is a start but much of the pharmaceutical residue in wastewater will arise from a rather more diffuse community origin.

With a pill for almost every ill, the bulk of prescription drug use is for outpatients receiving drugs under hospital or GP care. Excretion of the administered dose, generally in urine, results in wastewater contamination that cannot be managed except at the treatment works though that is resisted by the water industries who prefer to bully key ‘producers’ into additional local treatments in the expectation that that will be enough. That expectation may be the cheap option for water industries, but is unlikely to be a sufficient and satisfactory solution and for this they must do their bit.

Over-prescription must be another focus for attention, together with review of the vast range of non-prescription medicines for which no control in disposal exists. Over-prescription wastes money all round, and generates a substantial waste that tends to be stored in the home medicine cabinet. There is a risk of accidental childhood poisoning. And when the bathroom medicines cabinet is finally cleared out, most of the drugs it holds will find their way into the toilet, further exacerbating the problem.

Better prescribing is essential, as is an attempt to change the approach to OTC medicinal products and use of the toilet bowl for medicines disposal. But where does it all go? In the UK, there is no effective disposal route. Few pharmacists will accept large volumes of additional waste as to them it represents a substantial cost; increases in this route for disposal will increase the cost burden for independent pharmacists and would be unsustainable without cash help.

Across the communities, the problem can be eased by organised collections. This happens across the US and tends to be very successful. Just over a week ago, Officers of the Reno Police Department and Sparks Police Department held our area’s fifth Prescription Drug Round Up event. The Round Up provides a way for citizens to get rid of old or expired medications from their homes, so that they cannot fall into the hands of youth or adults who might abuse them.  The effort is also designed to help minimize the potential for pollution of water supplies and the impact on pets and wildlife as a result of improper disposing of medications by flushing them down toilets.

The event was a tremendous success, as a result of the operation Reno Police Department officials were able to collect and categorize 268,180 prescription pills. These pills will now be safely destroyed so that they cannot end up in the hands of those who might abuse them. Through the five Prescription Drug Round Ups that have occurred in Washoe County since 2009, over a half million prescription pills (555,151 pills) have been turned in and safely destroyed. Of equal importance, the impact on wastewater treatments has been substantially alleviated.

UK Local Authorities and the waster industries, with support from the Environment Agencies, could turn their hand to something positive and trial a similar scheme in the UK. An annual event would be sufficient for most communities. Capture of other hazardous household wastes that might presently accumulate under the sink or in a garden shed, and which might one day find their way to a black bag or even be fly-tipped, can have only a positive environmental effect.

Don’t hold your breath waiting, but surely the minimal effort involved would be far outweighed by teh many advantages. We have raised this issue many times previously on teh Clinical Waste Discussion Forum, and will continue to do so.