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What are the implications of finding drugs in the North Fork of the Shenandoah River?

In trying to help with the investigation of the causes of the  fish kills in the North Fork, the Friends of the North Fork of the Shenandoah  completed a yearlong study to determine the extent of organic contaminants in the river.  The findings detected a total of 59 chemicals. There were herbicides, insecticides, PCB’s, synthetic hormones, two common drugs (pharmaceuticals) and other human household chemicals such as the insect repellant, Deet. The drugs were Codeine, a common narcotic derived from opium used as a cough suppressant, analgesic and hypnotic and Effexor, an antidepressant with numerous possible side effects, some relatively serious. Also found was a synthetic hormone found in birth control pills.

Recent attention has been given to pharmaceuticals in rivers because the science of detecting them at very low concentrations is a recent development. The human body generally takes up drugs rather inefficiently, thus they are prescribed at high relative doses so the body will absorb effective levels, but a relatively high amount passes through the body and enters its waste stream. Because water treatment plants and septic systems are not designed to remove them, they end up in the rivers and stream.  Also, many people dispose of unused or expired drugs by flushing them down the toilet.

Obviously, a major concern of people is the potential effect of these and other compounds in our drinking water, some of which comes from the North Fork. These effects are unknown and it must be emphasized the levels of these chemicals in the River are extremely low. Public health officials are just beginning to become aware of the extent of the situation, and it probably is an issue in rivers and streams throughout the United States. It is, however, easy and intuitive to conclude that the effect of long term exposure to these and other contaminants found can only be adverse, if subtle, and the potential exists for them to act together in concert at lower levels than if they were acting alone.

In light of these facts, government environmental and public health agencies have adopted new guidelines for disposal of unused drugs.  They suggest dissolving them and/or liquid medications in a liquid after crushing them into small bits.   Then you should mix them with something undesirable such as coffee grounds or kitty litter before dumping them in a plastic bag or jar and disposing of them in the trash.  In a landfill, the drugs will have years to decompose before, if ever, entering a waterway.  If dumped into a toilet, they will be in the river in days.  The medical, drug, law enforcement, and environmental communities are beginning to work together to develop return programs.