Drugs go where?

in antibiotics •  5 years ago 

drugs.jpg

         Recently, I started to see more PSAs like this pop up in places at work. I came across this particular one in the bathroom. The grayed out part is drop off locations for outdated and expired drugs. Given there is an opiate issue in my state, this is part of nailing two birds with one stone.

         Yeah, it should be common sense that drugs entering the environment is a problem. It is already affecting aquatic life. At what point does it affect people in physical ways? That is anyone's guess. However, these pharmaceutical products already affect healthcare more than many people realize.

         We talk of antibiotic resistant bacteria (ARBs), the rise of their genes (ARGs), and "superbugs". Some people may think this is due to overuse of antibiotics. They are not wrong, but it is not the utilization of them on patients that create them. Remember, the patients recover from the infection through successful treatments.

         One of the problems is the disposal from these drugs. Another is the current technology used in water treatment. Drugs pass through your system, that is a physiological fact. Your body does not always break down everything. A certain level antibiotics will make their way into the sewage system.

         Now, imagine flushing whatever drugs you take straight down the toilet. It turns out, more than a third of the people do that according to this Penn State article back in 2012. Can you understand how germs become more and more resistant? We are speeding up evolution by eliminating wild type bacteria that are susceptible. In return, we leave mutants with resistance genes to proliferate.

         This is a global issue. It should be obvious that whatever trace of antibiotics in the water is above the MICs. MIC refers to the minimum inhibitory concentration of a drug. This means the concentration is more than enough to prevent visible bacterial growth. This has been a known concern even in the early 2000s in a study done in Germany. (Kummerer K., Henninger A.)

         Affluent countries have water treatment facilities that surpass their less fortunate neighbors. How do lower income countries fare when it comes to this growing threat? Turns out there was an one-year study done in Vietnam on the subject. It looked at both antibiotic usage of a rural and urban hospital. It then analyzed and compared their wastes. It showed that the presence of drugs are generally lower after water treatment. How much different from countries like USA? Well, in some cases, better, but in some, worse. (La Thi Quynh Lien, et al)

Other things to consider

         Now, what of those ARBs that make their way into your drinking water? Different disinfection methods exist to kill the bacteria. But, the most important thing is to disrupt the ARGs.

         In a piece written by Joan B Rose this year, it touched on some of those methods. Can our technology help mitigate the pending crisis? Only time will tell. As it stands, we can kill off harmful ARBs with certainty. Eliminating the ARGs from the ecosystem is quite another story.

         Before I moved to the USA, I have never consumed tap water. People boiled their water due to the risks of parasites, etc. that aren't visible to the naked eye. Would water filters help reduce the level of drugs in your drinking water? I have yet to research into those.

At work

         It is evident that antibiotic resistance is on the rise. I have worked at the current hospital for five years. In that time, I have seen the increased resistance of various bacteria.

         For example, Morganella and Pseudomonas species with imipenem resistance are no longer questionable. When I started my job, those were things I had to retest to make sure they were not errors.

         The instances of other carbapenem drug resistance are also increasing. By protocol, the lab runs tests to see if the bacteria contain those ARGs or are they due to some other mechanisms. And that's how much the bacteria have evolved in FIVE years.

What now?

         Do yourselves a favor, do not dump your prescription in the trash or flush them down the toilet. Please dispose them at a designated location.

         Not only our behavior needs to change, but our technology as well. I don't expect researchers will find a way to super-boost our immune system anytime soon. In this case, better waste treatment methods and strategy need to be priority before it is too late.

Authors get paid when people like you upvote their post.
If you enjoyed what you read here, create your account today and start earning FREE STEEM!
Sort Order:  

I live in the US and personally know people who save antibiotics. They self-treat with a less-than effective dose, and do so inappropriately. That's a good way to grow a superbug.
In my community, we have drop-off points for unwanted medication. These locations are often inconvenient and only open on special days. I think every hospital and police station should have some setup where people can just walk in and drop off unwanted meds. We should make it easy to do the right thing.
As for going to the hospital... don't, if you can help it. And get out as fast as possible. Press the doctor for release. It's actually possible to sign yourself out against medical advice (I've done it). Contrary to what hospital reps tell you, insurance companies will still pay your bill.

Thank you

The pharmacies themselves I think should have take back programs if they don't already - it's way more convenient and less intimidating than going to the police station.

I'll have to check into that. Certainly, it's not widely advertised if it is so. People should have a little label on their bottles, automatically applied, that reminds them to return unused medicines to the pharmacy, any pharmacy.
You're right about the police. It can be intimidating.

Something I hadn't thought about but in less affluent countries , selling antibiotics over the counter and educating people not to take them for headaches is perhaps more important.

I'd suggest that most people in countries like Vietnam don't dispose of them anyway, just save them for next time and use what they have available instead of paying for consultations and more antibiotics when they have some left from last time, regardless of whether they are the correct type or not. When I first started travelling in SE Asia, Amoxicillin seemed to be used in the same manner that I used paracetamol.

Don't even get me started on the bent doctors here who admit people with insurance for nothing more than a slight flu, being stuck in sterile hospitals too much is hardly boosting their immune system and gets it used to being mollycoddled for even the slightest attack. Over time, this must also decrease the body's built in defence mechanisms.

Posted using Partiko Android

I'd suggest that most people in countries like Vietnam don't dispose of them anyway, just save them for next time

I save mine just because they really don't have an expiration date. And they have given me speedy recoveries in times when I don't want to get sick.

being stuck in sterile hospitals

One of my seniors went to Scotland recently as part of her master's program online. The professors did point out that keeping people in the hospitals too long, thanks to the socialist waiting time, generally turn a slight problem into a bigger problem. Often, an infection becomes with ARBs.

This is not so much because they are cuddled, but due to the fact that is where you'd find the nasty bugs about due to use of drugs, etc. That's just a feature of the setting. Can't really avoid it.

Scotland is more of a socialist healthcare system than England, they don't even need to pay for the car parking lol

But my experience in England generally is that you're shown the door ASAP these days. As an example, when I had tonsils removed as a kid, I was in 3 nights, now it's day surgery. My Mum had a replacement knee, replaced. In and out in 4 days . Things are very different these days but of course I accept the risks of the Superbugs we read about.

I would argue however that our universal healthcare system is infinitely better than a purely private one and all the abuses and fake inflated pricing systems, especially as regards to drugs, which that creates

Posted using Partiko Android

I would argue however that our universal healthcare system is infinitely better than a purely private one

I'm not too familiar with a real private practice because even in the US, healthcare entities derive much of their income from the government.

It's like the tuition prices. Uncle Sam just keeps matching the asking price.

Also very prevalent in US water, according to articles I've read, are hormones and antidepressants. From people's meds, and not just them flushing leftovers as is more the case with antibiotics, since people usually take hormones and antidepressants continuously: it's in their pee! That's why you can pee in the compost only if you're not on pharmaceuticals, or else you can get pharmatoes.
If there are no drug collection places where people live, they can dispose of old meds by burying them in something gross in the trash, or that will disguise them. The recommendation is usually like coffee grounds, but I'm pretty sure if you put them in with scooping the kitty litter it would serve the same purpose! ;)

  ·  5 years ago Reveal Comment

@enforcer48, In my opinion Medical Industries are becoming a business and just a Profit Making space and there are many theories which tells that Drugs are harmful. Stay blessed.

Posted using Partiko Android

That's a bit of an oversimplification.

Antibiotics are useful, but they also come with aftereffects on our environment.

Yes.

Posted using Partiko Android

“minimum inhibitory concentration” would be a good album name.

I’ve always wondered how much chemotherapy physically affects loved ones around the patient.

Posted using Partiko iOS

I’ve always wondered how much chemotherapy physically affects

That's an entirely different beast and not within the scope of this post.

Congratulations @enforcer48! You have completed the following achievement on the Steem blockchain and have been rewarded with new badge(s) :

You distributed more than 28000 upvotes. Your next target is to reach 29000 upvotes.

You can view your badges on your Steem Board and compare to others on the Steem Ranking
If you no longer want to receive notifications, reply to this comment with the word STOP

Vote for @Steemitboard as a witness to get one more award and increased upvotes!