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Rx for Action

A blog devoted to helping people find local medicine take-back programs and highlighting current research findings and pending legislation.


Eco-directed Sustainable Prescribing: An Alternative Approach to Reducing Drug Waste

Anne, IISG's P2 summer intern, has been busy the past couple of months, but she took a breather from data analysis to write this blog post on eco-directed sustainable prescribing practices. It's a good primer for those who haven't heard of this approach to pollution prevention.

Eco-directed sustainable prescribing is comprised of 2 concepts:

1. Reducing the dose or usage of certain medications

2. Prescribing drugs based on the amount of drug eliminated from the body

This is the approach Dr. Christian Daughton proposed in his paper on reducing the amount of medicinal waste excreted into the environment.

Over the last decade the primary approach to reducing drugs in the environment has been to decrease the amount of medication in our water supply once it has already entered the ecosystem. The main way this has been accomplished is through efforts of improving water treatment plants and having drug collection sites or events. Daughton argues these current practices are still needed, but are not sustainable solutions.

In theory, the eco-directed sustainable prescribing is a valid approach since the primary source of medication entering the water supply is through human excretion. The goal behind this idea would be to provide prescribers and patients with an excretion profile for each drug to determine its level of entry into the environment. With this profile they could then determine the best treatment option while also considering the environmental impact. By considering the excretion level of a drug, this could limit the amount of drug eliminated into the water supply by preferentially prescribing drugs that are extensively metabolized.

Unfortunately, there are many uncontrollable factors affecting the amount of drug excretion from person to person. This somewhat limits the feasibility of the eco-directed sustainability approach. However, it is a good start to understanding alternative options to address the issue of medicinal waste.

If you would like to read the entire article it is available at:

Image courtesy of U.S. EPA.

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Posted by Laura Kammin at 4:20PM on 7/15/2015
Categories: Latest Research