Dumped meds can pollute SF Bay, officials warn

Story updated with correction.

In a corner of the cavernous Elihu M. Harris State Building lobby in downtown Oakland, a group of enthusiastic people gathered this afternoon around a table covered in Ziploc bags of brightly colored pills.

“No,” said an organizer to an inquiring passerby, “they aren’t vitamins.”

The pills were there to be thrown, tossed, chucked or otherwise disposed of into one of what organizers hope will be a collection of new pharmaceutical drop-bins throughout Oakland. The Bay Area Pollution Prevention Group, a consortium of wastewater management agencies, spearheaded the cooperative effort that resulted in the placement of a number of locked, metal bins meant to collect people’s unwanted and expired medications and keep them from polluting San Francisco Bay.

The new drop bin in the lobby of the Elihu Harris State Building.

“We all know that the San Francisco Bay is not only the economic engine, but the heart of our region,” said State Senator Loni Hancock, whose district includes Oakland. “And we want to keep it healthy for ourselves and for other living things that depend on it.”

Representatives of the San Francisco Bay Water Board, the East Bay Municipal Utilities District (EBMUD), and the California Highway Patrol then joined Assemblymember Nancy Skinner and Larry Broussard of Assemblymember Sandré Swanson’s office in applauding while Hancock inaugurated the green metal bin by pulling open the top hatch, as one would a post office box, and depositing a plastic bag containing a few old bottles of medicine she said she had cleared out of her medicine cabinet at home.

Jennifer Jackson, who works for East Bay MUD and chairs a public agency called the Bay Area Pollution Prevention Group, said pharmaceuticals have been detected in wastewater effluents (the water that is dumped into the bay after being treated) around the world. To combat this, Jackson’s group has been appearing at public health fairs in the area for nearly five years, offering take-back services to anyone who wants to drop off old medications.

“Over the last three to four years, we have collected an average of 500 pounds [of unwanted or expired medications] per year,” said Sharon Leaf, the outpatient pharmacy coordinator for Alta Bates Summit Medical Center. “It’s pretty amazing to see the volume of meds that we take back,” said Leaf.

Anyone can bring in medications to turn in at any of the three Alta Bates Summit outpatient pharmacies, Leaf said, as long as the pills or liquids are in the original prescription bottle. They also ask participants to scratch out their names with a black marker before turning in their old medications.

“Five years ago we were telling everyone, ‘Flush your unwanted meds down the toilet,’” Leaf said. Since then, she said, a number of studies have come out showing how much this practice was contributing to the increase of pharmaceuticals in the water. Leaf expects a higher volume of old medications to be collected this year as public awareness of the issue increases.

The most drastic effect of pharmaceuticals in the water supply that has been documented by scientists is the feminization of fish. Studies by the US Geological Survey have shown that prolonged exposure to certain medications, known as endocrine disruptors, now found in much of the country’s water supply is causing fish to change genders, from male to female. With an all-female population, the fish would be unable to reproduce and would eventually go extinct.

An important source of this pollution is the flushing of unwanted and expired medications down the toilet. This is particularly common after a hospice patient passes away, leaving multiple bottles of unused medication. By dropping those bottles at the bin in the state building or elsewhere, people can be assured that their medications will be incinerated rather than flushed.

“Waste treatment plants use microbes, which are great at breaking down organic waste,” said Jackson. “But they are not able to break down some pharmaceuticals, because they are very complicated chains of chemicals. Incinerators expose [the drugs] to super high heat, which degrades the chemicals to nothing.”

Only trace amounts of endocrine disruptors have been found in the bay thus far – acetaminophen, the active ingredient in Tylenol, is far more common.  But  local officials are worried that the issue will only grow.

“We focus on prevention,” said Heather Ottaway, the pollution prevention coordinator for the San Francisco Bay Water Board. “There is some initial data out there saying this is beginning to have an impact on fish [here]. So instead of waiting until it’s a problem and cleaning it up, we’re trying to prevent it from getting in the water in the first place.”

The effects of common drugs like acetaminophen in the water supply are less clear, but the existence of this drug at detectable levels points to a larger problem. It is unlikely that many people are flushing bottles of Tylenol and ibuprofen down the toilet. The same is true for many of the medications that contain endocrine disruptors. Endocrine disruptors are hormones, like estrogen, most often found in birth control pills, another drug that is unlikely to be thrown away before the prescribed supply has been used up.

Jennifer Jackson and Heather Ottoway pose with Senator Hancock (center) in celebration of installing the drop bin at the state house.

Then how are these medications entering the water supply? Through the urine of people who are taking them. This problem is, of course, “a harder nut to crack,” as Bruce Wolfe, executive director of the SF Bay Water Board, put it. Changing the levels of medication in people’s urine would “involve getting doctors to buy in,” said Wolfe.  Prescriptions would have to be changed or lessened, and even that wouldn’t stop it.

Jackson said one option was reverse osmosis, a water treatment technology that can remove pharmaceuticals from water by pushing it through a membrane. However, Jackson said, the technology is expensive and has other environmental consequences, including the amount of energy required to run the process.

There’s another public safety hazard to casually dumped medication, said Trent Cross, a California Highway Patrol sergeant who joined in this afternoon’s inaugural of the State Building drop-off bin. “Our primary mission is saving lives, and these [pharmaceuticals] could be deadly in the wrong hands,” Sgt. Cross said.  “We want the public to know that they can’t just dump these items in a bush or trashcan. You might get a kid thinking it’s candy or something.”

Now Oakland residents need not worry about having to dump their old medications in a nearby bush or about feminizing the local fish population. In addition to the drop-bin at the state building and the take-back program at Alta Bates Summit Center pharmacies, there is also a drop-bin at the Rockridge Pharmaca pharmacy.  If none of these options are nearby, more information is available at www.baywise.org or (888) BAY-WISE, (888) 229-9173.

**The following correction has been made to the above article: “Jennifer Jackson, who works for East Bay MUD and chairs a public agency called the Bay Area Pollution Prevention Group, said the group’s member organizations have all seen a rise in the levels of pharmaceutical have been detected in wastewater effluents (the water that is dumped into the bay after being treated) over the course of the last decade around the world.”  Thanks to Jackson for catching the misquote.  Oakland North regrets the error.

Lead image: Loni Hancock disposes of some old meds in the new drop bin at the State House.