Pharmaceuticals are seen in North Andover, Mass., June 15, 2018. Maine is trying to stop prescription drugs from ending up in the water where they have the potential to harm ecosystems and human health. Credit: Elise Amendola / AP

Many Mainers have heard about the presence of toxic chemicals, such as PFAS, in the environment, but pharmaceutical drugs can also contaminate rivers, soil and living beings when they get into wastewater and landfills.

While Maine does not yet have a full understanding of the scale of pharmaceutical contamination, it is among the states leading efforts to minimize the presence of drugs in the environment before the problem gets worse.

On June 18, a program will go into effect to make it easier for Mainers to get rid of their prescription drugs, free of cost. The Maine Drug Take Back program is the result of legislation passed in June 2021. While drug take-back programs have been organized in the past in some parts of the state, this is the first mandatory statewide program written into law.

People will be able to safely dispose of their unwanted drugs at kiosks set up at registered pharmacies. They will also be able to mail in their pharmaceutical drugs in prepaid envelopes. The collected drugs will then be taken to incinerators.

Maine is the third among five states — the others being Washington, Oregon, California and New York — to establish this program to collect and destroy certain drugs. It will be paid for by drug manufacturers that sell their drugs in the state.

“We want to build this into a model program for the other 45 states to follow, and we want to do it right,” said Robert Burks, the program lead for the program and an ecologist and toxicologist with the Maine Department of Environmental Protection.

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The program will be administered by two organizations, Med- Project, which collects and disposes of unwanted or expired drugs, and Inmar Intelligence, a North Carolina-based data platform company.

The world is only beginning to make sense of the extent of pharmaceutical contamination in water, which can then harm the health of ecosystems and humans. According to a recent study conducted in 104 countries on all continents, pharmaceuticals were not detected in only two out of 258 rivers. The most frequently found active pharmaceutical ingredients were carbamazepine, which is used to treat seizures and bipolar disorder; metformin, which is used to treat diabetes; and caffeine.

“People haven’t quite thought of large-scale efforts to reduce pharmaceutical contamination, and Maine is one of the leading states to do this,” said Burks, who spoke at the 2023 Maine Sustainability and Water Conference in Augusta on Thursday.

The state does not currently have data on pharmaceutical contamination in Maine, he said.

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The U.S. Environmental Protection Agency considers incineration to be the safest method to efficiently destroy the drugs. For the take-back program, Maine will rely on yet-to-be determined incinerators out of state, according to the department. It will also ensure that the program complies with Drug Enforcement Administration regulations.

People often throw away their pharmaceutical drugs by flushing them down the toilet or putting them in the trash where they end up in landfills. These disposal methods contaminate septic systems and landfill leachate, which are discharged into rivers, some of which are used for drinking water.

In the United States, approximately 63 percent of tested samples of sludge, which is generated by the treatment of sewage at wastewater treatment facilities, contained pharmaceutical drugs, according to the United States Geological Survey. 

The drugs also make their way into water through people who ingest them. The human body can only metabolize a portion of the drugs, and the rest enter wastewater, said Nicholas Castillo, a PhD candidate and researcher with the Rehage Laboratory for Coastal Fish Ecology & Fisheries at Florida International University, where he participated in the ongoing research of pharmaceutical contamination in bonefish species.

Organisms can absorb pharmaceutical drugs from the water, resulting in endocrine disruption and genetic and biochemical changes. This alters the behavior, survival and reproduction of aquatic species, Castillo said.

It is not yet known what the long-term effects of exposure to pharmaceutical drugs in drinking water or in seafood are for humans. Some researchers believe that long-term exposure in low doses to mixtures of drugs in water can prove to be harmful for people, especially babies and young children.

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In the study that Castillo worked on, 134 bonefish species in different regions of South Florida and the Caribbean were sampled for pharmaceutical exposure. All of the bonefish were exposed to mixtures of pharmaceutical drugs, according to their blood samples. One fish contained traces of eight antidepressants, at 300 times the level that they would affect humans.

Most wastewater facilities in Maine and the country are not equipped to remove pharmaceuticals from the water. Wastewater treatment plant operators are particularly concerned about nursing homes flushing large quantities of drugs.

“Our concern in the wastewater industry in Maine, as a whole, is the flushing of pharmaceuticals and especially from institutions such as nursing homes that discard their unused pharmaceuticals this way,” said Phyllis Rand, the water quality coordinator at the Greater Augusta Utility District.

In August 2019, the EPA officially banned healthcare facilities from flushing pharmaceutical drugs down the drain.

The state will also be setting up a way for nursing homes to properly dispose of pharmaceutical drugs in compliance with the new state law, Burks said.

“The program is in infancy, but we are planning to extend it to other registered institutions and facilities as permitted,” he said.

Mehr Sher is a Report for America corps member. Additional support for this reporting is provided by the Unity Foundation and donations by BDN readers.

Mehr Sher reports on the Maine environment. She is a Report for America corps member. Additional support for her reporting is provided by the Unity Foundation and donations by BDN readers.