Doctors prescribe hydrocodone for pain. They recommend ranitidine for acid reflux, a diuretic called hydrochlorothiazide for congestive heart failure.
But you don’t need a prescription to get these drugs in tiny doses. They’re found already in our nation’s water supply — and, according to an upcoming national study, the largest done so far, in higher amounts than drug companies anticipated.
We know how the drugs get there: Our bodies release them when we urinate or flush old drugs down the toilet. And it’s well known by now that pharmaceuticals are affecting fish, frogs and — small amounts of estrogen cause male fish to develop eggs, for instance. But the impact on human health is unclear. Although research on pharmaceuticals in the water supply began almost a decade ago, no one seems to know which compounds need to be removed or how to remove them from the water safely. And no one seems to know which government agency should step forward and take action.
“All of these drugs out there on the market are going to be discharged into the environment and we don’t know what the effects are, because there’s no requirement to do an assessment on the front end,” said Nick Schroeck, executive director of the Great Lakes Environmental Law Center in Detroit.
“We’re not trying to scare anyone, but we need to know what these chemical compounds will do to the environment and what are the long-term effects for humans. No one seems to know.”
The new study, which will be released in January in the journal Environmental Pollution, was obtained by The New Republic. Conducted by the Environmental Protection Agency, it is the largest study of water coming out of wastewater treatment plants.
It looked at samples from 50 large-size wastewater treatment plants nationwide and tested for 56 drugs including oxycodone, high-blood pressure medications, and over-the-counter drugs like Tylenol and ibuprofen. More than half the samples tested positive for at least 25 of the drugs monitored, the study said. High blood pressure medications appeared in the highest concentrations and most frequently.
“We were surprised to find that many drugs occurring across all the wastewater plants,” said Mitchell Kostich, the EPA research biologist who led the study. “We were also surprised to see so many drugs of a particular class — the high blood pressure medications appear at those levels across the board.”
One reason for the higher numbers is better technology, which can trace drugs at smaller amounts. But it’s also because we’re taking more drugs than ever, from over-the-counter medications for headaches to prescription medications for depression, acid reflux and high blood pressure. According to a Mayo Clinic study released in June, nearly 70% of Americans take one prescription drug, up from 48% in 2007-2008.
Health officials say these compounds in water pose a low risk to humans. But they also said that there are no good models to predict the effect this cocktail of low-level medications would have on human or aquatic life. Right now, there are no federal or state regulations requiring drinking water or wastewater plants to monitor pharmaceutical compounds in water.