Drugs Down the Toilet

(Submitted for publication in the UMA Bulletin; I am an Editorial Board member)

“They have found that a lot of prescription drugs are turning up in our drinking water. People not only pee drugs into in the toilet but they also dump the unused prescriptions in it. They have found hormones, antibiotics and many other kinds of drugs. Depressing news, don’t you think? Don’t worry about it: drink the water; it also has antidepressants and xanax.”

Funny. Not funny. But Leno is right.

Articles like “Drugs Are in the Water” have documented that a significant number of fish in the Potomac and its tributaries are hermaphrodites. Feminization is seen with drug concentration as low as 5 part per trillion. Fish swim in waters where 10+ pharmaceuticals have been detected. Every bluegill, black crappie and channel catfish had levels of antidepressants. A survey of 139 streams showed that 80% contained prescription drugs and fragrances, sunscreens, etc. They survive biodegradation and wastewater treatment.

An AP study showed that most drugs are metabolized only 80% which explains why antibiotics, antidepressants, anxiolytics, anticonvulsants and hormones re found in the drinking water of 41 million Americans. Twenty four major metropolitan areas were surveyed. Philadelphia had 56 types of drugs in its water. Unfortunately, this type of study is rarely made available to the public.

The problem is sure to be widespread since no tests are available to look for the problem. The EPA doesn’t know what to make of the whole thing: “a few parts per million of drugs in the water may or may not be a problem.”

I feel the problem seems obvious but we may be aware of only the tip of the iceberg; the effect of combinations of these chemicals and their additive/synergistic effect are not known. For sure we are seeing more antibiotic resistant bacteria.

In view of this pressing issue the Environmental Committee is contemplating bringing this issue to the floor of our upcoming House of Delegates meeting this year. Your input is welcome; we are not sure what measures we could take as doctors. But, in the meantime we encourage you to visit: http://www.medicationdisposal.utah.gov/disposal_locations_events.htm for a list of places where our patients could drop off unused prescriptions (police stations and pharmacies.) Perhaps we could display said list prominently in our clinics. Maybe we could insist that all pharmacies do likewise. While we cannot tell patients to cross their legs and not pee, we could become more conservative in our prescribing habits.