Towards a more sustainable pharmacy

Currently, UNESCO specifies, 80% of wastewater flows into ecosystems without any type of treatment, and practically the 20% that is treated still contains pharmaceutical products and excreted pathogens. As a result, pharmaceuticals are found in many different environments, on every continent, where they cause far-reaching ecological impacts for the same reason they are effective as medicines: they are molecules designed to cause biological change, even at extremely low concentrations. . Research has shown that wild aquatic animals can accumulate pharmaceuticals and that pharmaceutical contaminants alter the behavior, fitness of organisms, and the dynamics of populations, communities, and ecosystems.

An international group of scientists, including Gorka Orive, from the University of the Basque Country (UPV/EHU), and Unax Lertxundi, from the Bioaraba Health Research Institute, call for the implementation of measures to limit the ecological impact of pharmaceutical products. These experts advocate for a greener pharmacy, arguing that while conflicts of interest may be unavoidable, it is possible to limit the negative consequences of pharmaceuticals while allowing society to benefit from such products.

“Despite mounting evidence of its potentially widespread effects, pharmaceutical contamination has not received the attention it deserves,” say the researchers. There are signs that this could be changing, but there is still a long way to go.”

Gorka Orive’s team warns that today human beings consume more pharmaceutical products than ever before. In 2020, the volume of medicines used worldwide reached 4.5 billion doses, and consumption continues to increase. In addition, the drugs are also administered to a wide range of livestock and domestic animals. Although the use of pharmaceuticals brings enormous benefits to human and animal health, it has also led to an increase in pharmaceutical contamination of ecosystems around the world.

From left to right: Unax Lertxundi and Gorka Orive. (Photo: Nuria González, UPV/EHU)

Gorka Orive and his colleagues, in addition to analyzing the context of drug contamination on a global scale, also analyze the context of research carried out in various fields (toxicity, elimination, ecological impacts, pharmacological casuistry…). They also point out the areas of research that should be addressed in order to solve this problem.

In the opinion of the researchers, to effectively combat drug contamination and achieve the ‘One Health’ goal of holistically addressing health and environmental problems, a combination of source and end-of-pipe measures should be applied. process. The pharmaceutical industry and its customers must evaluate and adjust many aspects of the drug life cycle. “Greener drugs need to be designed and formulated with less environmental impact—for example, less biologically reactive or more easily removed from the environment—and drug manufacturing facilities need better wastewater management. A judicious and responsible use of drugs is necessary, both in human and veterinary medicine, and priority should be given to non-pharmacological interventions when possible”, they indicate. They also affirm that it is essential to educate health professionals on the impact of drug contamination.

However, they point out that “it is important to remember the main function of pharmacotherapy, which is to guarantee patients access to medicines that improve their lives. Awareness of the environmental impact of medicines could have unforeseen social effects, such as reluctance to take medicines, feelings of guilt in doing so, and increased mistrust and resentment not only towards the pharmaceutical industry, but towards pharmacotherapy in general ”. They also warn of the danger of reducing access to effective medicines “due to changes in policies or prices that reflect environmental impact. However, while conflicts of interest may be unavoidable, it is possible to limit the negative consequences of pharmaceuticals while allowing society to benefit. It is time to make green pharmacotherapy a reality”, they point out.

The study is titled “Greening the pharmacy.” And it has been published in the academic journal Science. (Source: UPV/EHU)