Running Head: THE IMPACT OF DRUGS ON THE ENVIRONMENT

The Impact of Drugs on the Environment Jamie A. Adesso Empire State College

Author Note This paper was prepared for Nature in American History taught by Professor Cassetta

THE IMPACT OF DRUGS ON THE ENVIRONMENT For centuries, people have sought out cures and treatments for illnesses and diseases. During ancient times, natural and herbal remedies were common to use, as well as holistic methods of healing. As times changed and technology advanced, modern prescription medicines came into existence and with them, environmental hazards. Although prescription drugs have been around for almost a century, research regarding the environmental impact of these substances did not start until the 1980's, and even then, the public was not aware of the discoveries. When information was finally available to the public in the early 90's, it caused much concern among environmentalists as the impact of pharmaceutical drugs on soil, water, and wildlife, along with illegal substances, was discovered to be detrimental to nature, as well as to the animals ingesting products from the contaminated areas. When you think about the number of prescription and over the counter drugs in your home, you can probably say that you have at least five bottles of some type of pain reliever, cough or allergy medicine, or other treatments for illnesses. Some of this medicine probably never gets used or is past the expiration date, which is when you decide to throw the bottles full of pills away. Sure, your five or even ten vials may not harm the environment but think about the worlds 6.7 billion people and all of their discarded drugs. That is a lot of medicine being flushed into water systems and penetrating the soil at various dumpsites. Add to that, all of the illegal drugs that are unused, dropped, or lost, as well as the chemicals released during manufacturing. So what, you say; if medicine is good for people to take then it must be okay for the environment to decompose of it, right? Wrong! While this may sound logical, it really is

THE IMPACT OF DRUGS ON THE ENVIRONMENT not; in fact, it is quite ignorant. Improper disposal of drugs, legal or illegal, negatively affects the environment and its inhabitants. Types of Drugs Beta, or B-Blockers, are commonly and heavily used to treat patients with heart disease, high blood pressure, and glaucoma. Stewart Owen, Emma Giltrow, Duane Huggett, Thomas Hutchinson, JoAnne Saye, Matthew Winter, and John Sumpter (2007) showed that in Germany alone, over 100 to 250 tons of B-blockers are prescribed per year and in Europe, Canada, and North America, this drug is prevalent in sewer systems, rivers, and other waterways (Cleuvers, 2005). Morphine, ketamine, codeine, and methamphetamines are all painkillers, the last of which is an ingredient in crystalmeth, a street drug that is highly abused and has serious side effects. In a 2010 study conducted by Angela Lin, Xiao-Huan Wang, and Cheng-Fang Lin, the previously mentioned painkillers, along with their compounds, were shown to exist in high levels in rivers, hospital effluents, and wastewater treatment plants (WWTPs) located in Taiwan. The existence of these drugs in Taiwans water systems poses health risks to human and marine life and the surrounding environment. Sulfonamides are a common base ingredient in veterinary antibiotics and are highly absorbed by soil, as proven by Zhaosheng Fan, Francis Casey, Heldur Hakk, Gerald Larsen, Eakalak Khan (2011). Prophyphenazone and aminopyrine, drugs that help to reduce fevers and relieve pain, along with antipyrine, a medicine prescribed to those suffering with ear infections, were found at dominantly high levels in Croatian landfills and along the surrounding area (L.H. Keith, L.L. Needham, T.L. Jones-Lepp,

THE IMPACT OF DRUGS ON THE ENVIRONMENT 2000). This same study also showed high levels of these drugs in nearby waterways, though it did not mention the impact of the drugs on neighboring wildlife. Waterways and Fish Of the 18 different types of prescribed Beta Blockers, 12 of them were found either in the sewer systems, waterways, or both on the North American continent. These drugs are created so that people with heart disease may be treated and live a longer and healthier life. People are much larger than fish and other aquatic animals that live in the water, not to mention the significant differences in body composition. Keeping this in mind, think about the side effects this medication has on human beings, such as weakness, fatigue, increase of asthma symptoms, or the potential to make a persons diabetes worse (Skye Schulte and Rebecca Stahl, 2010). Now, think about the impact this drug can have on fish. In a study conducted by Owen et al. (2007), fish that come into contact with this particular drug decrease in numbers and produce fewer eggs, of which less actually hatch. This problem arises from just two days of exposure to these drugs at minimal levels (Huggett et al., 2002). Higher levels of exposure are associated with growth impairment and a huge decrease in glucose production while any exposure at all can affect brain functions in regards to breeding cycles, behavior, and sleep patterns, the last of which is also a side effect of the drug in humans (Owen et al., 2007). Among all of these side effects, the worst one occurs when a fish cannot respond to a change in oxygen levels and as a result, dies (Owen et al., 2007). It is unfortunate that animals must suffer because we are so careless and what is worse is that this impact is only from one type of drug.

THE IMPACT OF DRUGS ON THE ENVIRONMENT Many other drugs, such as controlled substances, make their way into water systems and negatively affect the environment and its inhabitants. Controlled substances are worse than other drugs because they are highly addictive, which means that doctors are not the only source of obtaining these medications. Many controlled substances often become available on the street after alterations occur that enhance the original drugs side effects. The biggest problem with controlled substances is that they last a long time, which means that they have a high level of potency that causes the drug to remain strong even after it makes contact with the sewer system (Lin, 2010). As a result, biomagnification, which is the transmission of a toxin through the food chain, or bioaccumulation, which is the accumulation of a chemical in higher than normal amounts, occurs (United States Geological Society [USGS], 2010).

A hypothetical example of the biomagnification of mercury in water up through the food chain and into a wading bird's eggs (USGS, 2010).

THE IMPACT OF DRUGS ON THE ENVIRONMENT These occurrences are due to substance abuse and human waste products that enter the sewage treatment plants, which are not designed to manage controlled substances (Lin, 2010). As a result, the drugs escape the WWTPs and enter the waterways, contaminating the environment and its wildlife. Taiwans Environmental Protection Agency sets the standards for WWTPs and reports that they are currently only taking minimal safety precautions as required by law (Lin, 2010). These low standards have resulted in high levels of morphine, codeine, methamphetamine, ketamine, cocaine, and components that make up these drugs, in Taiwans rivers, hospital effluents, and in deionized water, which is water in its purest form. Unfortunately, Taiwan is not the only country whose WWTPs are not upgrading their safety standards. Codeine and morphine exist in four of Spains rivers and in almost every river and lake in Italy, the United Kingdom, and Switzerland. In the United States, researchers found methamphetamine in surface waters, which are directly affected by WWTPs (Lin, 2010). Additionally, there are people and organizations that have anonymously admitted to dumping their prescription waste directly into rivers, making it hard to determine just how much of the problem lies with wastewater treatment plants. When fish come into contact with morphine, it causes their heart rate to decrease and then rapidly increase to an excessive rate, where it stays for at least two days. As a result, a negative, though less severe impact, affects the respiratory rate of the fish (Nathalie Newby, Kurt Gamperl, Don Stevens, 2007). Codeine has not been studied specifically on fish, but it can harm animals by causing convulsions and respiratory depression, either of which can be fatal (Nathan Eddy, Hans Friebel, Klaus Hahn, Hans

THE IMPACT OF DRUGS ON THE ENVIRONMENT Halbach, 1968). Studies show that methamphetamines, like codeine, have toxic effects on animals in general. Brain and nerve damage is one possible side effect depending on the amount of the dose, which, at high levels, can cause convulsions and elevated body temperatures that are sometimes fatal (National Institute on Drug Abuse, 2011). It is important to note that these drugs do impact animals other than fish because many species come to the water to drink, swim, or prey on fish, so while the drugs are concentrated in water systems, they are not limited to impacting only marine life. Unlike the other controlled substances mentioned, Ketamine, when properly administered, does not negatively affect fish. Cocaine, on the other hand, greatly affects their behavior as it causes the fish to go through withdrawal periods that last five days and experience high levels of anxiety when the drug is not present. When it is present, the fish experience various types of abnormal brain activity (Marcos Lpez-Patio, Lili Yu, Howard Cabral, Irina Zhdanova, 2008). Luckily, fish are not a threat to the wellbeing of people but this psychotic state caused by cocaine in their environment can create an unsafe environment for other aquatic species. However, researchers still need to conduct studies to determine if there are any harmful side effects to people who consume these drugged fish. Usable Water Water is the most abundant of all the Earths natural resources, yet less than three percent of water is freshwater. Freshwater is the only source of drinkable water for human beings and in the United States alone; people consume 94,000 gallons of water in a single year. More than half of this consumed water comes from lakes, reservoirs, and rivers; however, an EPA study conducted in 2000 showed that just under 40

THE IMPACT OF DRUGS ON THE ENVIRONMENT percent of U.S. rivers and 45 percent of lakes are polluted (Patricia Hemminger, n.d.). This surface water is susceptible to pollution from the air, pipes, waste, personal care products, and more recently, pharmaceuticals. The remaining percentage of drinking water comes from the ground, and the majority of Americas rural population consumes this water, as wells are used in place of water lines, like those prevalent in the city. Groundwater is mostly protected by the filtering action of soil; however, soil is often prone to contamination from a variety of sources, including, pharmaceuticals. Potential health hazards from consuming contaminated water include kidney damage, reproductive problems, stomach ailments, and intestinal illnesses (Hemminger, n.d.). For these reasons, it is crucial for water suppliers to closely monitor drinking water to ensure that the EPA standard levels are met. During the time of Hemmingers report, written sometime after 2000, the EPA was still investigating the impact of pharmaceuticals in waterways and of specific concern were birth control pills and hormone replacement drugs. The EPA wanted to determine whether these drugs posed a threat to aquatic species, wildlife, or people upon entering the water systems. This investigation, as well as others done by the EPA to determine the impact of pharmaceuticals on water systems and marine life, is possible because of the Water Quality Act amendments of 1987. These amendments established a $400-million program to help states to develop and implement nonpoint source management programs based on watershed protection (Hemminger, n.d.). Thanks to this particular piece of legislation, the EPA was able to successfully conclude its investigation, but the outcome, which took eight years to achieve, was not good.

THE IMPACT OF DRUGS ON THE ENVIRONMENT Birth control containing ethinyl estradiol and other hormone replacement therapy drugs have a huge impact on people and aquatic species. Studies showed that all birth control pills affect children, causing men to have smaller genitals, a lower sperm count, breasts, testicular cancer, and a greater number of girls, who are suffering from obesity and going through puberty earlier, being born. In regards to a study conducted on fish, the sexual development was delayed so much that the population of the fish became significantly reduced (Lloyd Alter, 2009). This is a big problem and unfortunately, it occurs at very low hormone levels, so there is currently no way to further filter the drugs out of the water systems, making them unsafe for public use. Soil Pharmaceutical medicines and other drugs are making their way into the environment via human and animal waste, manufacturing processes, and improper disposal of unused and expired products. In addition to ending up in the water, these harmful toxins are also appearing in the soil through a number of different modes of transportation. What is worse is that these medicines are causing bacteria in the soil to become resistant to the drugs that once killed them, allowing the germs to thrive and cause harm to live stock, wild life, and even people. The most obvious means by which contamination is making its way into the soil is through the water. Disposed pharmaceuticals easily affect the surrounding riverbanks while some areas of farmland are often exposed to the poisons by local processing plants that use minimal safety precautions or through area hospital effluents that are not properly lined to prevent toxic fluids from seeping into the ground. Some studies have even shown traces of drugs in tap water, which means soil can easily be exposed to

THE IMPACT OF DRUGS ON THE ENVIRONMENT pharmaceuticals when watered with a hose or watering can. Farmland is further subject to disposed medications with the addition of manure and sewer sludge to the fields, the leading causes of pharmaceuticals in soil, which leads to contamination of crops and illness in grazing animals (M. Diaz-Cruz, Maria Lopez de Alda, Damia Barcelo, 2003). This problem is something that affects us all and a solution must be found soon. Two studies done on soil proved that the sludge from sewage that fertilized fields contained 24 different pharmaceuticals and 12 types of sulfonamides, which is the base drug for some antibiotics (Diaz-Cruz, 2003). This same sewage sludge was also used in landfills and in sea dumping, which further threatens nearby soil, groundwater, and aquatic life. Another study showed that sulfonamides are easily absorbed and quickly transported by soil through cracks, worm holes, plant debris or via particulate-facilitated transport (Fan, et al., 2011). In the landfills alone, high levels of the drug prophyphenazone, a pain killer and fever reducer, were found, along with significantly lower levels of aminopyrine, another pain killer and fever reducing drug, and antipyrine, a medicine used to relieve pain from ear infections (Diaz-Cruz, 2003). These and other drugs that make their way into landfills, leak into the groundwater, drainage water, and surface run-off fluids, each of which carries the contaminants to surface waters. A study conducted by the United States Environmental Protection Agency (EPA) focused on the municipal sludges in Florida and Chicago to determine how the soilplant-water systems are impacted and how the effects of the sludges come full circle when they reach animals and even people. The study determined that cattle, pigs, and poultry that ingested sludge, grain, or foliage from soil containing toxic components, suffered from physiological, pathological, growth, and reproductive damage or

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THE IMPACT OF DRUGS ON THE ENVIRONMENT disorders. Mice were also part of this study; however, they were fed body tissues from the animals that ingested the toxins. The mice suffered a variety of health effects, including reproductive problems (EPA, 1981). In regards to meat intended for human consumption, it was deemed a health hazard and cannot be sold or served. It is easy to imagine that this thirty-year-old study has been forgotten or overlooked, as it is hard to believe that all farm animals consume only the food they are given and that farm soil is completely free of pharmaceuticals or other toxic waste elements. Resolution Originally, people were told to dispose of drugs by flushing them down the toilet (Tom Watson, 2007). After scientists discovered the harm this was doing to waterways, the SMARxT DISPOSAL campaign was founded by the United States Fish and Wildlife Services along with the American Pharmacists Association to encourage people not to flush their drugs but to instead return them to a pharmacy for proper disposal (Watson, 2007). Additionally, other companies, such as Covanta Energy Corporation, are hosting take-back events throughout 2011, as 2012 dates have not yet been determined (Anonymous, 2010). Thus far, the company has collected 30,000 pounds of pharmaceutical drugs and is disposing of them in such a way that the water is protected and air quality is controlled. The company started its program after becoming aware that flushed prescription drugs and those that end up in landfills reach surface waters, harming fish and other wildlife, as the contaminants are not removed through water treatment facilities (Anonymous, 2010). These particular take-back events are free as the company converts the waste into sellable energy and saves money for municipalities. Unfortunately, not all take-back events are free and the ones that are do

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THE IMPACT OF DRUGS ON THE ENVIRONMENT not frequently occur. This discourages people from properly disposing of their waste; it is bad enough they have to pay for the prescriptions and they are not going to pay to get rid of them. No solution to this problem exists as of yet but it is something that environmentalists need to work on with politicians and pharmaceutical companies. In October 2010, the take-back programs gained the full support of President Obama when he signed a federal law allowing the drugs to be disposed of safely and legally through hospitals and pharmacies. This issue became a priority when studies showed that discarded drugs were making their way into public drinking water (Charlotte Tucker, 2011). While highly successful events thus far, take-backs are difficult to organize because they require law enforcement to be present, as stated in the Controlled Substances Act. To make collection easier, the DEA is working to enforce a new law that would allow pharmacies to take-back the drugs without the presence of law enforcement. Collection sites are also trying to come up with ways to cover their costs, as charging consumers to get rid of their prescriptions is a deterrent. Currently, the pharmaceutical companies are not paying for or contributing to the take-back programs, which not only need the money to pay employees but also need it to dispose of the drugs through incineration. Contrary to popular belief, it is not safe to dispose of drugs via cat litter or coffee grinds, as they eventually contaminate the ground, so the only current solution is to burn them at special plants that provide air quality control (EPA). Another resolution to this environmentally toxic problem is for people to use expired drugs instead of disposing of them. According to medical authorities and the Harvard University Medical School Family Health Guide Website, prescription drugs are

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THE IMPACT OF DRUGS ON THE ENVIRONMENT safe to take years after they expire, with the exception of antibiotics, nitroglycerin, insulin, and tetracycline (Watson, 2007). The expiration date simply tells the consumer that the manufacturer guarantees the medicine up until the date on the bottle. After this date, the medication may or may not work and is assumed safe to take. Studies have yet to confirm this assumption. While this may prevent drugs from being thrown into landfills, it still does not eliminate the problem. Many of the drugs ingested by people later exit the body and get flushed down the toilet, into the waterways. At this point, the potency of the drugs are reduced, as much of it has been absorbed by the body, but traces of the pharmaceuticals are still making their way into the water. For this reason, doctors are being encouraged to write fewer prescriptions and only give out what is necessary, if anything at all. A new project involving the use of iron to combat pollutants has proven to be quite successful. Large amounts of iron in water are detoxifying pollutants and neutralizing hazards such as fertilizers, heavy metals, pesticides, and toxic materials in a fraction of the time as other, traditional methods (Rhodes, 2011). Research has yet to determine how this new method will affect the impact of pharmaceuticals in the water but if it can clean up toxic waste, there may still be hope that it can also deactivate the negative effects of disposed drugs. Conclusion The impact of drugs, legal or illegal, on the environment is massive. Even in the smallest quantities, some drugs are still strong enough to negatively affect the quality of life for aquatic and wild species, as well as human beings. This problem has been going on for decades and no one was aware of it until the 1980s, possibly the 1970s when it

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THE IMPACT OF DRUGS ON THE ENVIRONMENT is most likely that research began, though there is little, if any, documentation from this time period. Thankfully, the research is ongoing and efforts are being made to reverse, prevent, and combat the impact of drugs on the environment.

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THE IMPACT OF DRUGS ON THE ENVIRONMENT Bibliography 1) Abuse, National Institute on Drug. "Methamphetamine Information." 2011. Methamphetamine Addiction. 20 June 2011 Retrieved from: http://www.methamphetamineaddiction.com/methamphetamine_meth.html. Provides information about methamphetamine, its uses, side effects, and complications. Includes relevant evidence as to the drugs overall affect on animals in general, with examples of short and long-term consequences. Scientific evidence is referenced to prove that methamphetamine can be fatal in animals. 2) Alter, Lloyd. treehugger. 24 September 2009. 6 July 2011 Retrieved from: http://www.treehugger.com/files/2009/09/epa-looking-at-gender-benderchemicals-in-water.php. Article done on EPA and the results of their research on chemicals in drinking water. Talks about impact on fish and humans. 3) Anonymous. PR Newswire. 17 December 2010. 26 May 2011 Retrieved from: http://www.prnewswire.com/news-releases/covanta-energy-extends-program-tosafely-and-securely-destroy-prescription-drugs-collected-at-take-back-events112069949.html. Offers information about solutions to the drug pollution problem that is contaminating our waterways. Mentions how large companies are doing their part by safely disposing of pharmaceuticals, the dangers of poor or improper disposal, as well as the role the DEA is playing in this process. 4) Cleuvers, M. "Initial risk assessment for three -blockers found in the aquatic environment." Chemosphere 59 (2005): 199-205.

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THE IMPACT OF DRUGS ON THE ENVIRONMENT Talks specifically about the risks of beta-blockers in the aquatic environment. Provides thoroughly researched data using charts, graphs, and scientific evidence as well as experimental findings. Recommendations and comparisons are made based on the collected evidence and findings. 5) Diaz-Cruz, M., Lopez de Alda, Maria, Barcelo, Damia. "Environmental behavior and analysis of veterinary and human drugs in soils, sediments, and sludge ." Trends in Analytical Chemistry 22, 6 (2003): 340-351. Reports research data that mentions how pharmaceuticals get into the soil and how they impact the land, as well as the animals that feed off of it and those of us that eat the animals. 6) Edds, G.T. & Davidson, J.M. EPA. 26 April 1981. 5 July 2011 Retrieved from: http://nepis.epa.gov/Exe/ZyNET.exe/20016SU5.txt?ZyActionD=ZyDocument&Cli ent=EPA&Index=1981%20Thru%201985&Docs=&Query=600S181026%20or%2 0drugs%20or%20soil%20or%20impact%20or%20on%20or%20animals&Time=& EndTime=&SearchMethod=1&TocRestrict=n&Toc=&TocEntry=&QFie. Reported findings done by EPA scientists on the impact of sludge on soil, plants, water, and animal systems. Includes relevant and important information regarding the health consequences related to consumption of products carrying traces of pharmaceuticals. 7) Eddy, Nathan, Friebel, Hans, Hahn, Klaus, Halbach, Hans. "Codeine and its Alternates for Pain and Cough Relief." Research and Experimental Findings. 1968. This report provides a detailed evaluation along with scientific evidence that proves methamphetamine is fatal in animals in general. Information about other

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THE IMPACT OF DRUGS ON THE ENVIRONMENT side effects or reactions are mentioned, providing further detail about the impact of this drug on wild life species. 8) Fan, Zhaosheng, Casey, Francis, Hakk, Heldur, Larsen, Gerald, Khan, Eakalak. USDA. 1 June 2011. 5 July 2011 Retrieved from: http://www.ars.usda.gov/research/publications/publications.htm?seq_no_115=25 8129. Research project done by the USDA to determine the effects of veterinary pharmaceuticals on soil and the rate at which they are transported. 9) Hemminger, Patricia. Pollution Issues. 6 July 2011 Retrieved from: http://www.pollutionissues.com/Ve-Z/Water-Pollution-Freshwater.html. Informational account that provides details as to the effects of pharmaceuticals in the water systems, necessary saftey precautions for consuming fish exposed to high levels of drugs, and legislation passed to allow the investigation of these occurences. 10) Keith, L.H., Needham, L.L., Jones-Lepp, T.L. Issues in the Analysis of Environmental Endocrine Disruptors. San Francisco, 26-30 March 2000. Report of researched data and findings in regards to the levels of propyphenazone, antipyrine, and aminopyrine in landfills and the surrounding areas in Croatia. 11) Lin, Angela, Wang, Xiao-Huan, Lin, Cheng-Fang. "Impact of wastewaters and hospital effluents on the occurence of controlled substances in surface waters." Chemosphere Volume 81, Issue 5 (2010): 562-570. Provides evidence from scientific studies and research in regards to the harmful impact improper drug disposal has on the waterways of Taiwan and briefly mentions those of the U.S., U.K., and some other European countries. Includes

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THE IMPACT OF DRUGS ON THE ENVIRONMENT information about current disposal methods, the impact on aquatic wild life, as well as people, and the lack of safety measures taken by the waste water treatment plants. 12) Lpez-Patio, Marcos, Yu, Lili, Cabral, Howard, Zhdanova, Irina. "Anxiogenic effects of cocaine withdrawal in zebrafish." Physiology & Behavior 93, 1-2 (2008): 160-171. Provides a brief overview of the impact that cocaine has on zebrafish. The findings of this controlled experiment were reported based on findings, treatment, and other statistical data. Links to related sites are provided. 13) Newby, Nathalie, Gamperl, Kurt, Stevens, Don. American Veterinary Medical Association. June 2007. 20 June 2011 Retrieved from: http://avmajournals.avma.org/doi/abs/10.2460/ajvr.68.6.592?journalCode=ajvr. Provides information about the impact that morphine has on flounder. This was a controlled scientific experiment in which the findings were reported and recommendations made in regards to further testing. 14) Owen, Stewart, Giltrow, Emma, Huggett, Duane, Hutchinson, Thomas, Saye, JoAnne, Winter, Matthew, Sumpter, John. "Comparitive physiology, pharmacology, and toxicology of B-blockers: Mammals versus fish." Aquatic Toxicology Volume 82, Issue 3 15 May 2007: 145-162. Talks about the effects beta-blockers have on people in comparison to the extreme dangers they pose to aquatic wild life, specifically fish. Experimental data was used to gather this information and the findings are reported with recommendations for further testing.

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THE IMPACT OF DRUGS ON THE ENVIRONMENT 15) Rhodes, Jon. The Optimistic Futurist. 10 May 2011. 6 July 2011 Retrieved from: http://theoptimisticfuturist.org/index.php/environment/problem-polluted-or-scarcewater/new-pollution-cleanup-technique-cuts-cost-75.html. An article that talks about a new waterway cleanup technique that is proven to detoxify industrial waste waters at a fast pace. 16) Schulte, Skye & Stahl, Rebecca. Baptist Health Systems. December 2010. 1 June 2011 Retrieved from: http://www.mbhs.org/healthgate/GetHGContent.aspx?token=9c315661-83b7472d-a7ab-bc8582171f86&chunkiid=29883. Discusses beta-blockers in regards to what they are, how they are used, and what illnesses they treat. Information is provided as to their side effects as well as the various types of beta-blockers. 17) Society, United States Geological. USGS. 4 June 2010. 1 June 2011 Retrieved from: http://toxics.usgs.gov/definitions/biomagnification.html. Various definitions of biomagnifications are provided along with a chart that helps to better explain this process. Links are provided to other related information. 18) Tucker, Charlotte. "Drug takebacks aim to prevent abuse, protect environment." The Nation's Health March 2011: 1, 15. Mentions new laws regarding takeback programs, the DEAs involvement, water pollution, and how to recycle unwanted or expired medications. Includes information about takeback program events and the benefits of these programs in regards to people and the environment.

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THE IMPACT OF DRUGS ON THE ENVIRONMENT 19) Watson, Tom. The Seattle Times. 5 May 2007. 26 May 2011 retrieved from: http://seattletimes.nwsource.com/html/homegarden/2003693594_ecoconsumer0 5.html. Includes information about the impact that pharmaceutical waste has on the environment as well as new disposal methods. Provides information about the drug takeback programs and the facts behind expiration dates.

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