In 2001, 14 percent of Pennsylvania youths surveyed admitted to taking someone else’s prescription drugs. The state Coroner’s Association reported that there were 2,500 drug overdoses in the Commonwealth last year.
As Pennsylvania works to remedy the scourge of prescription drug misuse and abuse, the presence of pharmaceuticals in our rivers and streams is a double dose of reality for those concerned about water quality in the Keystone State.
An investigation by the Associated Press in 2008, found a total of 56 pharmaceuticals or byproducts — antibiotics, pain relievers, and heart, mind, and veterinary drugs — in the City of Philadelphia’s drinking water. Small quantities of drugs, including antibiotics, sex hormones, and anti-seizure compounds, were detected in public drinking water supplied to over 40 million Americans across the country.
While 70 percent of all antibiotics are used are for agriculture and animal husbandry, the U.S. Geological Survey (USGS) found in Pennsylvania that the greatest source of pharmaceuticals in the rivers and streams is sewage treatment plants.
Pharmaceuticals find their way into the environment through treated effluent from sewage treatment plants, farmland irrigation with reclaimed wastewater, septic systems, manure from treated livestock, raw sewage discharges, and leaching from municipal landfills.
Our bodies excrete portions of pharmaceuticals that we take and have not been metabolized. This includes metabolites that may have biological activity of their own. For many pharmaceuticals, about 90 percent of the drug is metabolized. In some cases, a significant amount of the parent pharmaceutical is released as human waste or sweat.
Scientists believe the main way a great majority of pharmaceuticals are getting into the wastewater, is through disposal. It was reported at the Susquehanna Water Science Forum in 2013 that 54 percent of medications went into the trash and 35 percent went down the toilet or sink.
Many people still believe that keeping drugs out of the wrong hands means flushing unused medications down the toilet. In fact, they are introducing portions of those compounds into rivers and streams and eventually even drinking water.
While treatment plants may remove 95 to 98 percent of pharmaceuticals from sewage, low concentrations are still active biologically. No one treatment method can currently remove all pharmaceuticals.
In Pennsylvania, the USGS found low concentrations of pharmaceuticals that are used for other than agricultural purposes, upstream of drinking water intakes. This suggests that most pharmaceuticals near those intake sites entered the stream environment via municipal wastewater-treatment effluent or on-lot septic systems.
Private wells, which may also harbor pharmaceuticals, often receive limited to no treatment before consumption.
So far, there is little evidence that human health is negatively impacted by pharmaceuticals in the water. But health experts are concerned that small amounts of so many pharmaceuticals could have a synergistic and negative effect in humans. On the other hand, the effects on aquatic life from these “contaminants of emerging concern” in the water are well-documented, shocking, and sad.
Intersex fish have been found in the Susquehanna River. According to USGS researcher Dr. Vicki Blazer, about 90 percent of male smallmouths sampled had sexual abnormalities that include eggs growing in their testes. This intersex condition is believed to be linked to the presence of pharmaceuticals in the water.
Smallmouth bass in the Susquehanna continue to bear lesions and sores from a “perfect storm” of factors such as abundant, harmful runoff of nitrogen, phosphorus and sediment, herbicides, cosmetics, detergents, and hormones in animal and human waste. These can weaken the smallmouths’ immune systems and make them vulnerable to disease.
A drug take-back program operated by the Pennsylvania Department of Drug and Alcohol Programs (DDAP) manages 410 drop-boxes across the Commonwealth where unused pharmaceuticals can be turned in for proper disposal. Since the program began two years ago, 32,000 pounds of prescription drugs have been collected.
For more information about the drug take-back program and locations of the boxes, visit the DDAP website at www.ddap.pa.gov.
Geisinger Health Systems and others also have turn-in programs. Each year for the past 10 years, the federal Drug Enforcement Agency has hosted a National Prescription Drug Take-Back Day.
Clean water counts. We can all help protect our precious water supplies and rivers and streams, by limiting the amount of unused pharmaceuticals that get into the trash, sewers, septic tanks, and wastewater treatment plants.
Harry Campbell is PA executive director of the Chesapeake Bay Foundation.