Author – Srijit Ghosh
“India is reportedly breeding ground for most multi-drug resistant microbes due to extensive usage and improper disposal of medicines into the environment.”
Medicines have become one of mankind’s basic needs. People generally store several medicines to treat common ailments but due to lack of awareness or options, they dispose of such unused and expired medicines with household garbage. While pharmacies incinerate unused and expired medicines, the common man is completely oblivious to the consequences of unsafe disposal practices of expired medical drugs.
According to the Central Pollution Control Board, registered healthcare facilities in India generate around 4,057 tonnes of medical wastes per day. Further, India being the global hub for producing pharmaceutical drugs, treated wastewater samples collected from industrial areas in South India registered toxic levels of antibiotics. Ciprofloxacin, as well as 21 other drugs, were being discharged into this water at rates enough to treat 90,000 people and were extremely toxic to plant and aquatic life.
Need For Proper Disposal Of Medicines In India
Most pharmaceutical drugs become ineffective or even toxic to the human body after expiration, but they are equally hazardous to the ecological balance when improperly discarded. These drugs cause severe environmental pollution by contaminating the water supplies, soil and in turn wildlife. Antibiotics disposed of in sewage water can convert many sensitive microbes to deadly drug-resistant pathogens. Feminization of male fish and renal failure among vultures have also been observed due to exposure to medicines. Further, chemicals added to formulations called ‘excipients’ are also harmful to the environment. so there is an urgent need for proper disposal of medicines in India.
- Since, majority of Indians throw medicines down the drain, limiting the excess purchase of over-the-counter medicines is the first step to being environmentally responsible and saving money.
- Flushing of unused or expired medicines is a highly improper way of disposing medicines in India, which should be avoided. But for certain medicines, flushing is preferable as their dilution in wastewater is safer than the accidental intake of even a single dose by a person without a prescription. Some of these dangerous medicines include Diazepam, Fentanyl, Morphine, Oxycodone, etc.
- Unused medicines should be given back to pharmacies, which can send them to industries to be recycled and reused. This concept sensitizes the community and protects the environment. Another effective way of drug disposal is to donate unused medicines to any community drug take-back programs.
- The eco-friendly way to dispose of solid and semi-solid medications is to mix them with inert substances like pet litters or coffee grounds or leftover tea leaves. This should be discarded in disposable containers or sealable bags to prevent ingestion by animals.
- Liquid medicines should be mixed with salt, flour, charcoal, or non-toxic powdered spices, such as turmeric or mustard before disposal. If a small quantity of liquid drug is present, then one can dilute it with an excess amount of water and then drain it.
- Medical shops need to maintain their stock details in medical store software so that older stock can be easily identified. Further, all the information and labels on drug bottles should be removed to prevent their reuse.
- Medicines in blister packs and medication bottles should be sealed with multiple layers of tape and then placed inside an opaque container and sealed before disposing of them in the trash. This will prevent the contact of expired medicines with animals.
- Neutralization of some drugs by chemical reaction can also be done to prevent their harmful action. A good example is to soak small quantities of β-lactam antibiotics like Amoxiclav in 1N Sodium Hydroxide (caustic soda) for 30 minutes.
- Specialized sanitary landfills can be constructed to dispose of untreated solid, semi-solid, and powdered pharmaceuticals. Local medical disposal facilities should be set up by authorities.
Medicine Donation and Disposal Programmes in India
The most eco-friendly way to utilize unused pharmaceutical drugs is donating them to voluntary NGOs that collect such medicines and distribute them among the poor, old age homes, orphanages, and government hospitals. Here are some of them:
Kerala’s State Drug Control Department launched an initiative named the Program on Removal of Unused Drugs (PROUD), in association with the All Kerala Chemists and Druggists Association to address improper disposal of drugs by households. Under the PROUD initiative, locked kiosks are placed near pharmacies, bus terminals and markets in cities where people are encouraged to deposit unused pharmaceutical products.
ShareMeds is a non-profit initiative established by Krishay Maniar, Youg Sanghvi, and Ayaan Shah in 2019. Their main motto is to reduce the medicinal deficit between the poor and the rich by collecting unused medicines from the privileged sections of society and donating them to charitable clinics. They have started their work in several locations around Mumbai, and have successfully collected around 10,000 strips of tablets and sealed syrup bottles. All were donated within 10 to 15 days after their collection. They are currently operational in Ghatkopar, Santacruz, Marine Drive, and Bandra cities in Mumbai.
Medicine Baba is another non-profit initiative started by a retired lab technician, Omkar Nath in New Delhi in 2015. The death of two laborers due to a lack of medicines after they were injured by a bridge collapse, inspired him to start this initiative. Omkar Nath collects unused medicines from people and distributes them to the poor free of charge. He was awarded Delhi Gaurav Award in 2016 for his immense contribution to society.
Uday Foundation is a non-profit organization initiated by Rahul Verma in order to save people from severe unavoidable circumstances through various social drives. They provide food, clothes, sanitary napkins, medicines, and other items for daily requirements to the needy in Delhi. The Foundation runs a free medical clinic where they treat underprivileged patients. It also provides medical help to critically ill children. The Foundation received the NGO Leadership & Excellence Awards 2015 by ABP News.