Mitigating pharmaceutical waste exposures: policy and program considerations

Abstract

Pharmaceutical disposal and the environmental fate of medication metabolites directly impacts the public’s health in two significant ways: accidental medication ingestion of pharmaceuticals that were not disposed of properly results in inadvertent toxicity; and environmental health consequences of pharmaceuticals that were inappropriately disposed and which contaminate municipal water supply. In reviewing the effectiveness of medication disposal policy globally, it is crucial to not only determine which policies are effective but also to assess why they are effective. By assessing the root causes for a specific policy’s effectiveness it can be determined if those successes could be translated to another country with a different health care system, unique culture and divergent policy ecosystem. Any intervention regarding pharmaceutical disposal would require a multifaceted approach beyond raising awareness and coordinating pharmaceutical disposal on a national level.While consumer participation is important, effective primary prevention would also include research on drug development that is designed to biodegrade in the environment as opposed to medications that persist and accumulate in the natural environment even when properly disposed. Countries that lack a nationalized disposal policy should leverage the resources and infrastructure already in place in the national health care system to implement a unified policy to address medication disposal in the short-term. In tandem, efforts should be made to recruit the biotechnology sector in high-tech and academia to develop new technologies in medication design and water filtration to decrease exposures in the long-term.

Knowledge, Attitude, and Practice of Unused and Expired Medication Disposal among Patients Visiting Ayder Comprehensive Specialized Hospital

“…With the increasing production and consumption of pharmaceuticals, accumulation and inappropriate disposal of unused and expired household medicines can cause environmental and public health problems [25]. This can be minimized by implementing medicine disposal policy and guidelines [26][27][28][29] and improving awareness of the public on appropriate medicine disposal methods and practices [30]. Therefore, the purpose of this study was to assess the knowledge, attitude, and practice of unused and expired household medicine disposal among patients visiting ACSH outpatient pharmacy.…”

The perception and disposal practices of unused and expired medicines by households in an urban municipality, southwest Nigeria: A comparative cross-sectional study

“…Correct responses were scored '1' and incorrect '0'. The median (IQR) values; respectively 7(6-8), 7(7-8) and 14 (13)(14)(15) for knowledge, attitude and perception were used to dichotomise ≥ median composite values into good/positive/high and those below the mean values as poor/negative/low ratings, respectively. The awareness of respondents on the protocol for disposal of unwholesome medicines was the binary, dependent variable while socio-demographic variables, including knowledge attitude, perception, and types of settlements, were independent variables in the binary logistic regression model.…”

“…Also, ingestion of expired drugs that were inappropriately discarded may lead to toxicity and drug resistance. [14].In the study area, it is a common practice to keep unused and, or expired medications in homes after discontinued use or excesses purchased for self-medication. Usually, expired drugs are not supposed to be disposed of with household refuse and as such when disposed of, may herald apparent health (upon accidental or inappropriate ingestion [14,15], environmental consequences [8, 16,17] and antibiotic resistance [18,19].…”

“…[14].In the study area, it is a common practice to keep unused and, or expired medications in homes after discontinued use or excesses purchased for self-medication. Usually, expired drugs are not supposed to be disposed of with household refuse and as such when disposed of, may herald apparent health (upon accidental or inappropriate ingestion [14,15], environmental consequences [8, 16,17] and antibiotic resistance [18,19]. The study aims to determine and compare the perception and drug management regimen among high-density and low-density households in the absence of national guidelines for the disposal of unused and expired drugs in the study area.…”

“…Also, ingestion of expired drugs that were inappropriately discarded may lead to toxicity and drug resistance. [14].…”