The Environmental and Health Impacts of Disposal Methods for Expired and Unwanted Medications: A Scoping Review

Abstract

The worldwide spike of pharmaceutical production as well as consumption have culminated in a worrying upsurge in pharmaceutical waste, featuring obsolete and unneeded pharmaceutical products. This broadening concern entails substantial dangers to public health and environmental welfare, reinforcing the absolute necessity for proper management approaches. The improper handling of pharmaceutical waste certainly intensifies environmental degradation from several angles, jeopardizes aquatic habitats, and is contributory to the emergence of antibiotic resistance. Regardless of the gravity and magnitude of this critical subject matter, a comprehensive review of the available literature pertaining to the elimination and management of undesired and expired medications remains noticeably lacking. In an attempt to resolve this research gap, an extensive scoping review was carried out, employing search queries across three databases (Medline OVID, Web of Science, and Embase) and grey literature, obtaining an initial 4,269 records and ending in the inclusion of 67 articles for thorough examination. This report seeks to bring together an all-embracing global overview of pharmaceutical waste disposal methods, indicate the subsequent environmental and health consequences associated with these practices, discuss the laws and regulations that regulate waste disposal, and accordingly, outline environmentally-sound strategies for the future for alleviating the adverse impacts of pharmaceutical waste. Furthermore, this paper showcases that a large portion of the 67 included studies (46.2%), mainly from the Global South, indicate an alarming dearth of specific waste disposal laws and regulations, which strongly alludes to the urgency for policy development and rigid enforcement. Another noteworthy discovery is the bleak variance in how pharmaceuticals are discarded of: while medication take-back programs prevail but differ in participation across Global North nations, most medications are disposed of in household waste in Global South nations, which demonstrates substantial variations in public consciousness, regulatory strength, and infrastructure development. All in all, this scoping review perfectly captures the urgency and intricate nature involved in handling pharmaceutical waste. Moreover, the primary results of this thorough analysis chiefly underscore the crucial nature of integrated efforts and initiatives among pharmaceutical companies, healthcare professionals, educational institutions, local communities, and regulatory bodies to develop and put into practice environmentally responsible disposal strategies. 3 Ultimately, this thesis contributes to the discussion of sustainable waste management through urging for holistic approaches that adhere to preventative and corrective choices to safeguard both the environment and public health. Future research should revolve around developing holistic waste management options which successfully target the multitude of difficulties presented by pharmaceutical waste, warranting both the morally-conscious and environmentally-responsible elimination of such substances.