Fed Agencies Disagree on Whether Pill Flushing Harms the Water Supply

To flush or not to flush?

That's the question when an alphabet soup of federal agencies come into conflict about how patients should get rid of surplus or outdated prescription medicine. Environmental activists point to trace amounts of prescription and non-prescription drugs that show up in drinking water supplies and say that the drugs cause water  contamination that's a threat to the health of human beings.

The Drug Enforcement Administration (DEA), Food and Drug Administration (FDA), and Environmental Protection Agency (EPA) all want to rid the country of drugs that can be harmful to children or used illegally by addicts. 

The question remains, though, on how the drug destruction should be accomplished. The FDA is okay with flushing, the DEA doesn't care how the drugs are disposed of as long as they're off medicine shelves, and the EPA thinks dropping pills into the toilet is a water-borne health hazard.

The issue of drug disposal is up this weekend as the DEA sponsors National Prescription Drug Take Back Day from 10 am to 2 pm on Saturday, Oct. 29. The nationwide program urges prescription drug owners to drop off their unused and unneeded pharmaceuticals at various local sites for disposal.

The DEA has a roster of drop off locations on their website. In Woodbridge, residents can get rid of their unwanted medicines at the .

The reason for the DEA-sponsored drug drop off program is evident, said DEA spokesman Jeffrey Scott. Drugs, he said, "weren't being disposed of at all."

"Our reason for the program wasn't driven by environmental concerns. For us, it's not an environmental issue," Scott said.

The DEA's concern, he said, was that "licit drugs were being used illicitly. We don't want 'diversion,' that's when a drug is taken and sold to your friends, that's the diversion of a prescription drug."

This is the third time the federal agency is pushing their take back program since the last time in May. They've collected 309 tons of drugs at 5,300 drop off sites in the program's short history, Scott said.

The drugs the DEA collected are incinerated at high temperatures, he said. 

But for those who can't wait for the collection program, the DEA points to directions on the FDA's website on how to dispose of the drugs, including over-the-counter drugs, and pet medications. The focus is to make the drugs as unpalatable as possible for any incipient drug users who might be tempted to take them.

The FDA suggests grinding up any pills and mixing them with distasteful substances such as used coffee grounds, in an effort to keep drug users from snapping the pills up. The mixture can be put in a sealed plastic bag and thrown into regular household trash, the FDA website says.

The FDA also recommends flushing old pills down the toilet. "There is a small number of medicines that may be especially harmful and, in some cases, fatal" so certain drugs should be flushed down the toilet, the website says. Those drugs include heavy duty painkillers, many of which are morphine-derivative pharmaceuticals, or synthetic opioids that produce a similar effect, such as oxycontin.

According to FDA spokeswoman Shelly Burgess, the trace amounts of medicines found in drinking water don't occur in quantities large enough to harm human health. 

"Scientists, to date, have found no evidence of harmful effects to human health from medicines in the environment," Burgess said in a statement.

More interesting is that the FDA not only thinks flushing drugs down the toilet is a safe practice, but that the trace amounts in water don't come from drug flushing as much as from human beings who take drugs and pass urinary and fecal matter from their bodies into the toilet.

"We are aware of recent reports that have noted trace amounts of medicines in the water system. The majority of medicines found in the water system are a result of the body’s natural routes of drug elimination," Burgess said. "Based on available data, [the] FDA believes that the known risk of harm to humans from accidental exposure to these medicines far outweighs any potential risk to the environment from flushing them."

Environmental groups and agencies vehemently disagree.

"We don't recommend flushing pharmaceuticals down the toilet. It's better to take them to the police station. There are studies that suggest that pharmas can pass through waste treatment plants and wind up in our waterways. If you have an opportunity to take them to a drop off, you should do it," said NJ Dept. of Environmental Protection spokesman Lawrence Hajna.  "Who is going to look through a list and figure out what's good to throw down a toilet? That leaves too much discretion [to individuals]."

Jeff Tittel, executive director of the environmentally-minded NJ chapter of the Sierra Club, said that drug flushing creates long term health and environmental problems.

"In New Jersey, we have found pharmaceuticals in a lot of our waterways. We use a lot of these same rivers for drinking water, like the Raritan all the way up to New Brunswick," Tittel said. "Studies have shown consistently that these low levels of drugs have a big impact on the environment, including fish and wildlife. Young children ingest trace amounts of hormones."

Tittel blames the FDA for giving an OK to the drug flushing problem.

"The problem with the FDA is that they have been a cheerleader for the industry they are supposed to regulate. They are more concerned about the industry than the people who will be taking in these trace amounts of chemicals," he said.

The first rule is do no harm, Tittel added. "If there is something going into the water that could harm someone, we should be getting it out of that water."