Pharmaceuticals are an important element of medical and veterinary practice, with beneficial effects on human and animal health, food production and economic welfare. Despite these many benefits, pharmaceuticals are a concern when they are discharged into the environment.
Pharmaceutical household waste from expired or unused medicine does not only offer zero therapeutic benefit, but contributes to environmental pollution when disposed of via improper routes. When flushed in household drains, these medicines can enter freshwater systems. Illegal dumping and landfills present further pathways of possible environmental leakage of medicines disposed in municipal solid waste.
The adverse environmental impacts of improper disposal of pharmaceutical household waste are threefold. First, evidence is growing that certain pharmaceuticals affect ecosystems. Observed impacts on wildlife include mortality, changes to physiology, behaviour or reproduction. For instance, laboratory and field tests show that traces of oral contraceptives can cause the feminisation of fish and amphibians, and residues of psychiatric drugs can alter fish behaviour. In addition, improper disposal of antibiotics can contribute to the development of antimicrobial resistant bacteria. Second, unused or expired medicines present a possible public health risk of accidental or intentional misuse and poisoning if extracted from waste bins. Third, unused or expired medicines constitute wasted healthcare resources and economic losses. These risks are likely to be exacerbated in the future, as pharmaceutical usage is projected to continue to increase, due to demographic, epidemiological and lifestyle changes, such as an ageing and growing population, the rise of chronic health conditions and the availability of inexpensive generic treatments and changes in clinical practice.
OECD’s legal instruments provide a strong rationale for policy intervention in this area. The OECD Council Recommendation on the Environmentally Sound Management (ESM) of Waste calls for Adherents to implement policies and/or programmes to ensure that waste be managed in an environmentally sound and economically efficient manner. In addition, the OECD Council Recommendation on Water calls for Adherents to prevent, reduce and manage all sources of water pollution, in surface and ground waters and related coastal ecosystems, while paying attention to pollutants of emerging concern. Preventing pharmaceutical household waste and ensuring the effective collection and environmentally sound treatment of unavoidable waste is thus an important policy objective.
This report outlines measures to reduce the amount and impact of unused or expired medicine. Policymakers will find in this report inspiration and pragmatic support to translate ambitions into actions that improve health and protect the environment.