Pharmaceuticals and environmental sustainability: A time for change?

Background: Pharmaceuticals are often improperly disposed, leaching active ingredients into our soil, water and air. Environmental consequences may include risks to aquatic and soil environments, food supplies, along with growth and resistance of microorganisms in sewage treatment. Drugs for humans end up in the sewage system that lessens plant effectiveness and eventually contaminates water. Drug residues may accumulate due to leakage from landfills onto agricultural land. There are direct consequences of drug residue and active metabolites present in the environment, and rising disease patterns may have origins here. While the EPA, DEA and FDA all have policies on proper disposal of pharmaceuticals some of these policies are contradictory and not well regulated or enforced. Methods: This study assesses policies related to creating environmental responsibility for all parties; it critically examines the role of various agencies in the absence of coordinating efforts of personnel and authority to impose penalties for non-compliance. Results: Safe disposal of prescription and non-prescription OTC drugs, along with proper sewage treatment, are needed with upgrading public policies and actions. Lack of personnel to initiate large-scale pharmacy take-backs can prevent misuse and environmental contamination but consumer education about this critical issue is still lagging. Discussion: Sewage water treatment as a historically critical public health measure needs urgent revision, including upgrading facilities for testing water and treatment. Empowerment of the EPA along with coordination and cooperation amongst various agencies will become critical in the coming years. Conclusion: Policy remedies, and strategic partnerships between pharmaceutical manufacturers, regulatory agencies and the public may begin to resolve the public health implications of environmental contamination and misuse of drugs. Pharmaceutical manufacturers need to "become green" in both their manufacturing and follow-through in the drug supply chain.