Medication study: don’t flush that toilet!

Fifteen percent of unused human medication gets flushed down the toilet. But only about 8% of pet medications get flushed.

So, are veterinarians doing a better job of educating their clients on how to properly dispose of unused medication than physicians?

Maybe, but it’s still not good enough.

A new study by researchers at Oregon State University (OSU) found that 60% of veterinary care professionals surveyed don’t advise their clients when it comes to the proper disposal of pharmaceuticals and personal care products (PPCPs). PPCPs include unused pet medication, flea and tick treatments, and medicated shampoos.

Why aren’t more veterinarians having that conversation with their clients?

NEWStat reached out to Jennifer lam, the study’s corresponding author and a former graduate student in marine resource management at OSU, who said, “I think the disposal of PPCPs – whether pet or human – is just not a popular topic to bring up in medical appointments.”

For example, Lam said, when a client goes to the veterinarian, they’re likely just there because they need medications for their pet, and it likely doesn’t occur to them ask how to dispose of unused medication once the pet gets better.

That makes sense from the client’s point of view. But why aren’t more veterinarians taking the initiative?

Sam Chan, PhD, a watershed health expert with the Oregon Sea Grant program at Oregon State University and a co-author of the study, told NEWStat that there’s a very simple reason more veterinarians don’t talk about PPCP disposal with pet owners:

“Veterinarians are just very, very busy,” Chan said. “And often times their focus is on the immediate health of the animal. So, the last thing they think about is, what do we do with these medications afterwards? That’s just human nature"

To be fair, Chan says that disposal of PPCPs hasn’t been top of mind for most veterinarians or their clients.

“It’s only in the last ten years that we’ve actually been able to start detecting these medications in the water,” Chan says.

Now that technology can give us a good idea of exactly what we’re flushing down our toilets, they’re finding both pet and human medications in large amounts. “It’s not just one medication, it’s two, three, four.”

Chan says it’s a serious environmental problem

Among other issues, researchers found that prey fish who live in water with measurable amounts of anti-depressants are dying off, because instead of coming out to eat and then darting off to hide, they’re spending more time in the open, making them vulnerable to bigger fish.

Researchers suspect the medications are altering the behavior of the fish.

And there’s a lot of medication out there just waiting to be pitched.

Chan said 70% of respondents said they have unused medications in their homes. “Basically, there is a lot of medication that is just stored. And something is going to have to happen to them.” So, what happens?

Can says 60% of medication get tossed in the garbage. “A lot of these meds wind up in the landfill and leach out into the water.”

That’s the good news.

The bad news: about 15% gets flushed down the toilet. “That’s a direct conduit to the water,” Chan points out.

How can veterinarians help prevent further environmental damage? The study suggests that prevention means educating both veterinarians and pet owners on proper disposal options.

Corresponding author Lam says a big issue is a lack knowledge on both sides of the veterinary-client relationship: “People don't know what to do with their unused medicines. The veterinary professionals we surveyed noted barriers such as lack of knowledge on proper disposal, cost, and lack of concern on the part of both client and provider.”

Lam suggests these recommended environmental stewardship practices for veterinary care professional relating to use and disposal of PPCPs:

  • Share and promote new information and knowledge about possible PPCPs environmental stewardship practices through the AVMA and other professional networks, electronic media, and PPCPs product labels.
  • Promote using only the minimum amount of PPCPs needed in client appointments.
  • Raise awareness of drop-off collection boxes and PPCPs collection events in your area. Be clear that these are for both pet and human PPCPs.
  • Be Role models to others in your community through leading by example and promoting positive PPCPs environmental stewardship practices.

Lam can’t emphasis it enough: “There are safe ways to dispose of unused and expired PPCPs that can avoid environmental contamination.”

The best way to begin: More veterinarians need to start having that conversation with their clients.

And the perfect opportunity to start it: while reminding clients that they should keep giving their pets some prescribed medications until it’s they’re gone, even after the pet seems like he’s doing better, such as antibiotics. That guarantees the medication has a chance to work fully, and it also means less unused medication laying around.

Photo credit: © K_Thalhofer

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