As many of you have seen from reporting in the local papers, there is now widespread contamination of the country's drinking water by small amounts of pharmaceutical drugs. It does not appear to matter whether the source is city drinking water, rural well waters, watersheds, or even commercial bottled water. The problem also does not appear to be confined to the United States, or developed countries, but is found world-wide since pharmaceuticals are now widely distributed –often with much less control and regulation in the rest of the world. Some examples – in Philadelphia 56 pharmaceuticals or their by-products were detected in treated drinking water. Some of the medications were for pain, infection, high cholesterol, asthma, epilepsy, heart problems and mental health issues. 63 pharmaceuticals or their by products were found in the city’s watersheds.

In southern California minor tranquilizers and anti-convulsant medications were found in the drinking water (please - no jokes about this is what it takes to live in California). A drinking water treatment plant in New Jersey found small amounts of angina medications for heart patients and traces of a major tranquilizer. Washington D.C.’s tested positive for 6 pharmaceuticals. San Francisco’s water supply tested positive for a sex hormone (please – I did ask for no jokes). Tucson, Arizona’s water supply contained three medications, including antibiotics. All told a vast array of medications, including antibiotics, anti-convulsants, mood stabilizers and sex hormones have been found in the drinking water supplies of at least 41 million citizens. In many cases the concentrations of these drugs in parts per billion and trillion are very small and far below the doses that people take. Yet so many medications are being found in drinking water, including acetaminophen (Tylenol) and ibuprofen (Advil) that it is causing scientists to worry about the long-term effects on human health.

The federal government does not currently require any testing of drinking water, and has not set any safety limits for drugs in drinking water. In an Associated Press survey this year of 62 major water contractors supplying US cities, only a little more than a third were carrying out any testing for medication in their drinking water. How are pharmaceuticals winding up in our drinking water? Well…To quote from the famous comic figure Pogo– we have met the enemy – and he is US! When people take their prescription or over-the-counter medications not all of the drug is absorbed by the body – and in many cases substantial quantities are excreted in urine or feces and flushed down the toilet. It is true that sewage is heavily treated before being discharged into reservoirs, rivers and lakes. Water is then cleaned again at drinking water treatment plants for human use, but these procedures by and large do nothing to remove drug residues. Keep in mind also that the use of prescription and over-the-counter medications has been dramatically increasing – in just the last five years the number of prescriptions issued in the US rose 12% to more than 3.7 billion, and over-the-counter sales were around 3.3 billion. The information on this topic being released to date is careful to point out that researchers do not understand the exact risks people face, from decades of persistent exposure to random combinations of low levels of medications. None the less there are very alarming studies on the effects of low levels of medications on human cells and wildlife that are virtually unknown by the public that cause serious and growing concern. Even representatives of pharmaceutical companies are admitting that there is a genuine concern that medications in drinking water, even in small concentrations are causing impacts on human health and aquatic organisms. Recent research is finding that small amounts of medications are capable of causing kidney cells to grow slowly, blood cells to show activity associated with inflammation and that cancer cells were able to proliferate more quickly. Other studies are indicating that medication in waterways is affecting aquatic life, especially male fish and amphibians being feminized. I will admit it can be difficult to get an accurate handle on all of this as so much is unknown. There is limited research and funding on this topic. The EPA just now appears to be gearing up for greater efforts at detection, since so little is known about which communities are facing exactly what medications in their water. Add to this that many independent scientists are skeptical that very, very small trace concentrations of medications may prove harmful to humans. They base this on the fact that tests on lab animals require much higher amounts to cause harm. This is then counter-balanced by the fact that many scientists are concerned that certain drugs or combination of drugs may harm humans over the long term. The concern here is based on the fact that unlike some foods or drugs – water is consumed in sizeable quantities every day. In this scenario our bodies might be able to tolerate a large one-time dose, but smaller amounts delivered continuously over many years might lead to negative effects, including allergies and nerve damage.

Another major concern is chronic low-level exposure of the public to certain classes of drugs; such as medications used in chemotherapy that can be powerful poisons; or drugs that can impede reproduction; mental health drugs that can damage the brain or alter behavior; or antibiotics that could allow drug-resistant strains to mutate and become dangerous. A final concern is voiced by many experts as to the unique danger posed by these low levels of medications. Unlike pollutants such as pesticides, lead, or PCB’s, medications pose a unique danger in that they were specifically designed to work in the human body. Even studies that first qualified the drugs for human use may not tell us enough about longterm exposure. Most drugs are only tested for use over several months –not a lifetime exposure that could occur from medications in drinking water.

One of the articles I have read lately on this topic had a quote from Dr. David Carpenter, Director of the Institute for Health and Environment at the State University of New York at Albany. “We know we are being exposed to other people’s drugs through our drinking water… and that can’t be good”

MAMA has often voiced concern about the number of drugs and chemicals in the environment, and the instructions people are given regarding expired or unused medications. Many are told to flush them down the toilet or put them in the garbage. Both of these methods ultimately comprise our water. The latest research validates our concern, indicating an alarming amount of pharmaceuticals already showing in our drinking and groundwater. MAMA is organizing an effort to establish a permanent program where patients can turn in their expired or unused medicines, hopefully at their local pharmacy. These drugs would then be properly handled to reduce negative impact. Your input would be invaluable.

MAMA is seeking advice as we try to organize and publicize this important effort. If you are interested in helping with this effort, please contact us. We are just starting to assemble a community-based coalition involving health, environmental, law enforcement, and business groups to develop a way of providing the public with easy, safe disposal of unwanted drugs. Please, help Oregon become a leader in dealing with this important health and environmental issue. Contact MAMA at 503-233-4202