San Francisco’s city leaders are poised to pass an ordinance requiring name-brand drug manufacturers to pay for collection and disposal of unused prescription medicines to curb prescription misuse and environmental impacts. Supervisor Ross Mirkarimi’s proposed “take-back program” would allow residents to take unused prescription pills to a secure site for incineration to keep people from flushing them down the toilet or to keep them from being stolen from medicine cabinets.
While there are trace levels of pharmaceutical chemicals in surface water, no one should be surprised how they got there. We take medicines prescribed by our doctors to treat diseases and medical conditions. Some of those chemicals are excreted into the waste water system. The trace amounts are at such low levels that they are measured in parts per trillion – equivalent to one drop of water in 20 Olympic swimming pools. The proposed ordinance would have no impact on wastewater.
Mirkarimi’s ordinance would require residents to store unused medicines at home and take them to a facility for incineration. These are both bad ideas.
Stockpiling drugs at home increases the chance that medicines might be stolen and used inappropriately. The environmental cost of incineration on air quality and the transportation costs of getting the medications to the incinerator outweigh any benefit. As a lifelong environmentalist, I know environmental health and human safety are concerns.
However, we must weigh environmental threats against advantages of a healthy society that benefits from pharmaceuticals and allows us to live healthier lives. Nothing in the scientific literature suggests such low levels are harmful to human health or the environment. Elaborate “take-back programs” are an overreaction to activist scare tactics.
There’s an easier method to dispose of medications properly and to protect the environment without resorting to expensive programs. If unused medicines were properly disposed of in household trash – instead of being flushed down the toilet – the trace amounts of medicine in the environment would decline further.
Complicating that solution, however, is that San Francisco County doesn’t have its own landfill; it contracts with Alameda County and Waste Management Inc. for solid waste disposal. The tax to manufacturers is the city trying to pass that cost to the manufacturers, but not all of them; generic manufacturers get off scot-free, despite representing the majority of prescription refills.
If leadership decides to take action, public health would be better served by further educating people on disposing medication through waste collection systems, where it will be processed safely – not by disposing medication into toilets.
In these difficult economic times, America needs a simple answer rather than expensive drug take-back programs that are likely to add to rising health-care costs.
Patrick Moore is a co-founder and former leader of Greenpeace, and chair and chief scientist of Greenspirit Strategies Ltd. in Vancouver, British Columbia.
UPDATE: Supervisor Ross Mirkarimi delayed the vote for two weeks pending negotiations.