Fascinating podcast this week from the BBC State of Us team Declan Harvey and Tara Mills. The sensational headline that our cocaine use is so great it has found its way into our much treasured loughs (Neagh and Erne), and rivers (Bush and Lagan), has been widely disseminated across the BBC. These much-loved bodies of water, so integral to our local environment, are being poisoned, we are told, by the legal and illegal drugs we have become so addicted to.
The podcast discusses a paper published in the magazine Environmental Sciences: Process and Impacts, and where it is the first time we have published data on the drug levels in our waterways, it merely highlights the local aspect of a growing Global problem: Drug Pollution. Thankfully, the results suggest we are not yet reaching the level of environmental damage already found elsewhere especially in England close to areas of dense population and in similar locations in the US such as New York.
Unsurprisingly, we are finding drugs and their metabolites, in some cases at levels which can have a toxic effect on animals, in our natural environment. Where do you think these chemicals go? Drinking water was not tested in this study. Still, elsewhere levels of drug pollution is also being detected in the water people drink where water treatment techniques are insufficient to remove the drugs totally.
The range of drugs detected in this and similar studies is extensive and includes; antidepressants, antibiotics, caffeine, benzodiazepines, opiates, amphetamines, ketamine and sex hormones (contraceptive pill and HRT).
High levels of illicit drugs and their metabolites give a fascinating insight into our clandestine drug use, unmasking a middle-class hypocrisy. The lead researcher, Billy Hunter, was surprised to find levels of benzoylecgonine, the difficult-to-pronounce main metabolite of cocaine, in Lough Erne at levels similar to Belfast. Higher levels would be expected in our major population Centre. He suggested that this might be explained by the many hotels along the lough shore where recreational consumption is taking place. His suggestion is certainly consistent with cocaine levels found in river water near music festival sites. Indeed, levels of stimulant drugs in one river after a music festival was such that it caused hyperactivity and muscle damage in the local eel population.
Human excretion, mostly in urine, is the main source of this environmental contamination. But it is important to remember that in Northern Ireland, a large number of prescribed medicines are unused and too much of this ends up being irresponsibly flushed into our sewage system. You don’t have to, and you should not, do this. Each pharmacy runs a service to accept back out-of-date and unused medicines which are then disposed of safely. As they say “Ask your Pharmacist”
Where the N. Ireland study did not look at the local environmental impact there is a developing body of knowledge that the impact is real and very damaging. Caffeine, a constituent of some medicines and our daily pick-me-up in coffee and tea, has been found in concentrations in surface water that have affected animal behaviour, reducing their chances of survival.
It is known that oral contraceptive use, results in a high concentration of ethinyloestradiol in natural water in many regions of Europe. This acts as an endocrine disrupter and has been shown to feminise male fish and cause real problems with fish reproduction. There is also evidence of kidney toxicity in marine animals due to high levels of non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen.
Perhaps the biggest worry, and the NI study did identify some aspects of this, is the creation of anti-microbial resistance from excreted antibiotics that are flushed into the system. One drug, Trimethoprim, which we use to manage UTIs, has been found at levels in the Lagan that could create natural resistance in bacteria in the environment. This resistance can then be transferred back to the bacteria resident in our bodies, causing resistance that makes treatment of severe infections difficult. Believe me, a world without effective antibiotics is not a place you would wish to live in; ask your great-grandmother.
Where the main focus of the podcast was on what this study tells us about our illicit drug habit, for me, the environmental damage that is already occurring from drug pollution is such an important message and needs real and urgent attention. We now know it is here, and it is likely to get worse. It is a direct consequence of the drugs we use, whether they are for justified medical reasons or for recreational purposes. Either way, inappropriate drug use not only damages the individual and society but also damages our natural environment.
I am a pharmacist in Belfast.
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