According to popular thought in Western culture, there is a pill for whatever ails you. And indeed, the market reflects this belief.
The average American spends almost $1,000 per person per year on pharmaceutical drugs. Canada is next at around $600 and countries like France and Germany are spending around $500 according to an article by Valerie Paris. The Centers for Disease Control and Prevention in the US stated that the percentage of persons using at least one prescription drug during one month in 2012 was 48.7 percent and the percentage of people using three or more prescription drugs was 21.8 percent. Three quarters of visits to the physician’s office in the US resulted in drug prescriptions. A Mayo Clinic study released in June 2013 revealed that nearly 70 percent of Americans were taking at least one prescription drug. That was up 48 percent from 2008.
The numbers don’t lie, most of the people walking around the North American continent are on drugs. The use of pharmaceuticals is a debatable issue to be discussed in other blogs, but the expulsion of their ingredients is not. The fact is that these drugs are being shared — by our neighbours, local lakes, plants, … wildlife. It is a toxic soup of which no one can predict the final effects.
A good way to visualize this predicament is by using cigarette smoking as a metaphor. A smoker lights up on the street, takes a few puffs and starts walking. The smoke is still coming off the cigarette but it is also being expelled by his lungs, only a fraction of the chemical ingredients are now in his body, and even those will have to be expelled since they can not be used as building blocks to create healthy tissue and cells. And we all know what a drag it is to be walking behind a smoker on the street. In fact any large urban center is polluted, not just by car exhaust, but by smokers. If you don’t believe me go to one of the cleanest cities on the continent, St. John’s Newfoundland, and inhale deeply for a few days and then come back and head to your nearest urban downtown. You will be amazed at the air quality difference and be choking and gasping for a day or two until you, once again, adjust to the pollution. How would pharmaceutical drugs be any different? They are not a food source, so they are not being turned into healthy muscle, bone, glands and ligaments either.
Drinking waste water
According to WHO International, from 2005 and 2009 between 15 and 25 pharmaceuticals were detected in treated drinking water worldwide and more pharmaceutical compounds were detected in untreated water sources, such as wastewater, surface waters and groundwater. The compounds found were largely attributable to pharmaceuticals of very high usage, including antihyperlipidaemic compounds and non-steroidal anti-inflammatory drugs. In the US the most common prescriptions are for psychosis, dementia, respiratory problems and rheumatoid arthritis.
A newer study conducted in 2013 by the US Environmental Protection Agency looked at samples from 50 large wastewater treatment plants and tested for 56 drugs including oxycodone, high-blood pressure medications, and over-the-counter drugs like Tylenol and Ibuprofen. More than half the samples tested positive for at least 25 of the drugs monitored. High blood pressure medications appeared in the highest concentrations and most frequently. We can conclude that a lot of Americans are tense and stressed out, but in trying to solve this problem are they in turn putting an unknown stress on the environment?
The contamination of water by pharmaceuticals has only been studied for about a decade and although no warnings have yet been announced by governments, it is considered an important issue to keep monitoring. When a pharmaceutical company applies for new drug approval in the US they have to submit an estimate of how much of the drug may end up in the local environments. A model is developed calculating how many people will take the drug, how it will pass through the human body, and how it will degrade in water. If the estimate is over 1 part per billion the FDA can ask for a more thorough evaluation of how that drug will affect aquatic life. But what about plants and other animals, what about us?
The most common example known by the public is how freshwater habitats around the world have been contaminated with the synthetic estrogen used in birth control pills. While concentrations are often around .5 nanograms per liter, concentrations as high as several hundred nanograms per liter have been found and scientists have connected this contamination with the feminization of fish populations. In one bizarre study, U.S. and Canadian government scientists purposely contaminated an experimental lake in Ontario with around 5 nanograms per liter of ethynyl estradiol. (I think most scientific studies are bizarre if they intentionally cause harm to other living organisms. What gives humans a right to experiment with life in this way is beyond what I can understand.) They then studied the effects on minnows in the lake. These fish normally mature sexually at two years of age and complete a single mating season during their lifespan. Exposed to the ethynyl estradiol, the male minnows’ testicular development stalled and the males started making early-stage eggs instead. That year’s mating season was a disaster and in two years the minnow population crashed. Oops, no more minnows.
The complexity of toxins
This kind of finding has created a movement known as “green pharmacy.” In an article published by Yale Environment 360, Sonia Shah points out some of the alarming ‘side effects’ of pharmaceutical use. New technology has allowed scientists to find the presence of chemicals in the environment at more minute concentrations and this reveals the wide dispersal of human and veterinary drugs across the planet. Scientists have now detected trace amounts of more than 150 different human and veterinary medicines in all environments including the Arctic. Eighty percent of streams and nearly a quarter of groundwater sampled in the US by the United States Geological Survey was found to be contaminated with a variety of medications.
This is where things heat up. We are no longer talking about a small experimental lake somewhere in Ontario with one type of drug, but the streams, lakes and ground water supplies containing a cocktail of potential contaminants. If it was illegal drugs we were talking about, we could be comparing this to the Playboy Mansion on a Saturday night in the 70’s. Now we have a combination of drugs, pesticides, and other trace chemicals compounding the problem. Scientists have tried to reproduce the effects of these inadvertent mixtures by analyzing a combination of antidepressant, fluoxetine, and the herbicide clofibric acid in trace amounts on water fleas. (Again, the poor fleas.) While low concentrations of fluoxetine or of clofibric acid have no effect on the fleas, when they are exposed to both compounds in combination more than half will die. Oops, no more water fleas.
As with anything complex, or in other words, outside of the laboratory, scientists have no idea what is happening or what to expect. We are all experimenting with a wait and see attitude and that is not solving the issue.
The US based National Capital Poison Center was founded in 1980 as an independent, private, not-for-profit organization. They list how drugs are getting into our water:
- Drugs and their breakdown products that are eliminated in urine and feces and flushed down the toilet, thus entering the water supply through sewage systems or as leachate from inadequate or leaking septic fields.
- Drugs that are eliminated through the skin and personal care products applied to the skin, that then are washed down the drain.
- Drugs and personal care products that spread onto clothing; when the clothing is washed, the chemicals go down the drain.
- Drugs from health care facilities that may not be legally required to discard drugs as hazardous materials, for example, long-term care facilities, medical and dental offices, and veterinarians.
- Sewage/waste water from hospitals and other health care facilities, from which human waste is flushed or washed down the drain, just as it is at home.
- Drugs from animal feeding operations and ranches.
- Domestic animal waste.
- Illicit drugs.
- Waste water treatment plants that do not filter all drugs, potentially releasing drugs into the drinking water, water used for irrigation and/or into the sludge that may be used to fertilize food crops.
- Storm water overflow, during which water bypasses waste water treatment plants.
- “Straight-piping”, i.e. direct release of untreated sewage into bodies of water.
“People think that if they take a medication, their body absorbs it and it disappears, but of course that’s not the case,” says Environmental Protection Agency scientist Christian Daughton. Many drugs resist modern drinking water and wastewater treatment processes and there are no sewage treatment systems specifically engineered to remove pharmaceuticals anyways. Reverse osmosis can remove virtually all pharmaceutical contaminants but it is expensive for large-scale use and also leaves several gallons of polluted water for every one that is treated. There is now evidence according to the NPA that adding chlorine in conventional drinking water treatment plants makes some pharmaceuticals more toxic.
The NCPC suggests that people at home can do the following to reduce the impact of drugs in the water supply:
- Buy only drugs and products that are needed.
- Buy the minimum quantity needed. Purchasing a “giant size” bottle of medication that cannot be used up before expiring is wasteful; unused drug can enter the water supply when discarded.
- Take only the prescribed or recommended amount of needed drugs.
- Apply skin care products according to label instructions.
- Ask your physician for drug samples, if they are available and appropriate for your condition, before filling a prescription that might not work for you. (Be sure all drug samples are stored safely, out of sight and reach of children.)
- If you have unused prescription medicines, ask your pharmacy if they will take them back for disposal. If not, find out if they know of drug take-back programs in your community.
- If drug take-back programs are not available to you, carefully follow federal guidelines for disposal of unneeded and expired drugs.
- If you have a septic tank/field, be sure that it is maintained properly to eliminate leakage of pharmaceutical and personal care product waste into groundwater.
- Clean up pet waste promptly.
Am I responsible for you?
This all bothers me as much as the people smoking on sidewalks and terraces. I don’t smoke and I chose not to use pharmaceuticals. I can’t remember the last time I took a Tylenol. When I was around eleven I had to take anti-seizure medications that turned me into a pre-teen zombie for about a year. I think it turned me off medications for good for since moving out of my parent’s house I have hardly taken any drugs, and now I don’t take pharmaceuticals at all. So when I have to inhale a big puff of toxic cigarette smoke it bothers me, just as much as the idea that my tap water contains a random cocktail of what ails the neighbourhood and the drugs they take to suppress those ails.
My solution is not the same as the NCPC, I would rather see more extreme suggestions. It would be great if we stop taking medications unless death is the present, actual alternative, not the possible or maybe future outcome. Getting a headache or inflamed muscles can often be solved by changes in diet, proper exercise and physical culture, and by reducing stress and tension with meditation, reflection and good old fashioned non-denominational prayer. There are energetic medicines such as acupuncture and homeopathy which do not use pharmaceuticals that we can try. This all takes a bit more time and self responsibility than stopping by the doctor’s office and getting a bottle of pills, but that is the main point I am making. We are responsible, for our health as well as the health of each other. It would be wonderful if we would not blow smoke in someone’s face … or ask them to ingest the drugs and chemicals we consumed and then flushed down the toilet. To accept our responsibility in how other life is affected by our choices and by what we consume is paramount to solving many of the world’s current dilemmas.
“If you could kick the person in the pants responsible for most of your trouble, you wouldn’t sit for a month.”
~ Theodore Roosevelt
“There’s not a chance we’ll reach our full potential until we stop blaming each other and start practicing personal accountability.”
~ John Miller, QBQ: The Question Behind The Question
The Swiss corporation Novartis generated revenue over 51 billion US dollars by selling pharmaceutical products in 2014. The top 20 global pharmaceutical companies had a combined revenue of 527 billion dollars. There were only 35 countries in 2014 that had a GDP higher than this, 153 countries listed a lower GDP. From 2001 to 2013, total pharmaceutical sales including non-patented over the counter medicines in Canada have almost doubled to $22 billion. This is a market that wants us to keep consuming their product but we need to start questioning their advice, for the future health of a planet — not on drugs.