Pharmaceutical Waste : A hidden threat to public health and future generations

Sivakumar Vijayaraghavalu *

Toxic wastes from JNIMS pollute compound of Central Dairy Plant in April 2025 :: Pix - TSE

The widespread availability of medicines has transformed healthcare, extended lifespans and improved quality of life. However, an overlooked consequence of modern medicine is the improper disposal of unused and expired drugs by households.

Every day, people flush medicines down the drain or discard them in regular trash, unaware of the environmental and health risks associated with these actions. This silent crisis is contributing to the rise of antimicrobial resistance (AMR), threatening human health and future generations.

The Hidden Dangers of Improper Drug Disposal

Unused medications that end up in household waste bins or sewage systems do not simply disappear. Instead, they contaminate soil and water sources, leading to the presence of pharmaceutical compounds in rivers, lakes, and even drinking water supplies.

Research conducted by global health agencies has shown that over 50% of the world’s rivers contain traces of pharmaceutical pollutants, including antibiotics, painkillers, and synthetic hormones. These substances not only disrupt aquatic ecosystems but also create favorable conditions for bacteria to develop resistance to life-saving medications.

A 2023 report from India’s Central Pollution Control Board (CPCB) revealed alarming levels of pharmaceutical residues in major water bodies, particularly in urban areas where medical waste disposal remains unregulated. If left unchecked, this pollution could have long-term consequences for both the environment and human health.

How Drug Waste Fuels Superbugs

Among the most dangerous effects of pharma- ceutical pollution is its role in the emergence of multi-drug-resistant organisms (MDROs), commonly known as “superbugs.” These drug-resistant bacteria evolve rapidly in contaminated environments, rendering conventional antibiotics ineffective.

o According to a 2024 study published in The Lancet, antibiotic-resistant infections could lead to 39 million deaths globally between 2025 and 2050, with annual fatalities surpassing 1.9 million by mid-century.
o India has already experienced the emergence of New Delhi metallo-beta-lactamase 1 (NDM-1), a genetic mutation that enables bacteria to resist even the strongest antibiotics available today.
o The Indian Council of Medical Research (ICMR) reports that over 70% of bacterial infections in India now show some degree of resistance to standard antibiotics, complicating treatment strategies.

The presence of antibiotics in wastewater accelerates the development of resistant bacteria. These superbugs then spread through food, water, and human contact, posing a grave risk to public health. If we fail to act now, common infections could become untreatable, and routine medical procedures could turn life-threatening.

The Economic and Health Burden of Antimicrobial Resistance

The consequences of rising drug resistance extend far beyond health concerns. The financial burden of AMR is staggering:
o Higher Medical Costs: Treating resistant infections requires stronger antibiotics, longer hospital stays, and more intensive care, driving up healthcare expenses.
o Increased Mortality Rates : As infections become harder to treat, the number of fatalities due to resistant bacteria is expected to rise dramatically.
o Economic Decline : The World Bank predicts that by 2050, AMR-related health-care costs could reduce global GDP by 3.8%, plunging millions into poverty.

In India, economic losses from AMR-related illnesses are estimated to exceed $1 trillion per year in the coming decade, affecting work- force productivity and healthcare infrastructure.

How Household Drug Waste Worsens the Problem

Despite growing awareness about AMR, many households continue to dispose of medicines incorrectly. Painkillers, antibiotics, and hormonal drugs commonly find their way into sewage systems or landfills, where they enter the environment unchecked.

Self-medication and the casual sharing of leftover antibiotics among family members further exacerbate the problem. When people take antibiotics without proper medical supervision, it increases the likelihood of incomplete treatment, allowing bacteria to adapt and become resistant.

What Needs to Be Done ?

Addressing this issue requires urgent intervention at multiple levels—individual, Governmental, and industrial.

1. Safe Drug Disposal Methods
o Participate in Take-Back Programs : Many pharmacies and healthcare facilities have programs to collect unused medicines for safe disposal.
o Avoid Flushing or Trash Disposal: Flushing drugs contaminates water sources, while discarding them in trash bins leads to environmental pollution.
o Use Official Drop-Off Locations: Many cities have designated collection points for pharmaceutical waste.

2. Educating the Public
o Awareness campaigns should emphasize the dangers of improper drug disposal and the role of AMR.
o Schools and universities must incorporate discussions on AMR and environmental sustainability into their curriculum.

3. Strengthening Regulations and Industry Responsibility
o Governments must enforce strict pharmaceutical waste management laws to prevent environmental contamination.
o Pharmaceutical companies should invest in eco-friendly drug production and waste disposal methods.

Countries like Sweden and Germany have successfully implemented Nation wide drug disposal programs that prevent pharmaceutical waste from entering the environment. India must take similar steps to control this growing crisis.

The Time to Act is Now

The way we handle pharmaceutical waste today will shape the future of medicine. If we continue to dispose of drugs irresponsibly, we risk creating a world where simple infections are untreatable, medical advancements are reversed, and human lives are needlessly lost.

Every individual has the power to make a difference. The next time you find expired or unused medicine in your home, pause before throwing it away. A small effort in responsible disposal can protect countless lives and preserve the effectiveness of essential medicines for generations to come.