For several years we have been aware of problems with our drinking water from industrial and agricultural pollution sources, but it was not until relatively recently that we began to develop an idea of the potentially serious problem of how medications were making their way into our drinking water supplies. While the evidence about the human health impact is conflicted within the literature, nearly all studies, even those that do not offer a direct contemporary link between adverse health effects and the pharmaceuticals in water, suggest that if not halted, this will become a major threat to human health almost everywhere in the United States.

There are a broad range of pharmaceuticals that have been detected in varying amounts in thousands of supplies that have served as testing sites for multiple researchers. Among these are common medicines such as antibiotics, hormones, and pain medications in addition to long-term medications to regulate problems with cholesterol, heart problems, and diabetes, for instance. There are few questions about how these drugs got into the water supply in the first place. Scientists know that pharmaceuticals infiltrate water supplies through wastewater, which current treatment systems do not eliminate and until more research is conducted into sustainable options, they will not regulate or break down. People tend to flush their unused medications down the toilet or run through their garbage disposals, thus putting them directly into the wastewater system or, through no fault of their own, they excrete them into wastewater systems as most drugs are not fully absorbed by the body. While there is nothing anyone can do about how much of their medicine they absorb into their body, the flushing and disposal issues are one important aspect of prevention that nurses should make sure they address with their patients.

At this point, the policy response on national, state, and local levels has been scattered at best, but knowing that there are some alternatives for the preventable aspect of pharmaceutical water pollution through medication collection and proper disposal actions, nurses can pick up the slack leaders are lacking—especially with an issue that is of great importance. Nurses can use their communication skills and trust-based relationships with their patients to explain proper medication disposal procedures and can spearhead the effort to increase awareness of the problem. While there are, as of yet, no direct references to this matter in any prominent peer-reviewed nursing journals or books specifically, one should assume that spreading this information is a vital responsibility for nurses and part of their ethical commitment to providing the best information. To this end, nurses need to remain acutely aware of the issues facing our nation in the face of this crisis and read about new developments that signal a growing threat to human health due to medications in drinking water supplies.

Generally, the literature makes the conclusion that while this is not yet a public health crisis, it is an ever-growing threat, especially with more people on medications of some sort than at any other point in history. The research is not always in agreement about the current state of the growing problem but it is unified in its conjecture that if this continues, we will be heading for some stark and drastic problems in national health. Nurses need to stay on top of the most recent research so they can best advise their patients about this threat and let them know about some of the ways they might help stop it.

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