Koen van Weel
NOS News••Amended
Concentrations of certain medicines occur in Dutch surface water that may have an effect on the behavior of aquatic animals, and thus on the entire food chain.
This is the conclusion of researchers from RIVM and Maastricht University. For the first time in the Netherlands, they have looked at the quantities of so-called psychopharmaceuticals in surface water, which are medicines that are prescribed for psychiatric disorders and psychological problems such as anxiety, depression or bipolarity.
In the Netherlands, concentrations were mainly found of the anxiety inhibitor oxazepam, the antidepressant fluoxetine and carbamazepine, which is prescribed for epilepsy and bipolar disorder.
“These are small amounts, but enough to see effects on the behavior of fish and crustaceans in the laboratory. If those effects also occur in the field, it will affect ‘eating and being eaten’,” outlines researcher Caroline Moermond of the RIVM in it NOS Radio 1 Journal.
“Anxiety drugs make fish braver, sedative drugs actually make fish and crustaceans move less, and that ultimately has an effect on the entire food chain.” Snails are known to release their feet in water with certain concentrations of these agents, which affects their way of life.
Never down the sink
The presence of concentrations of these agents in the water does not seem to have any effect on humans. The main way in which the substances enter the drinking water is through use by patients who pass them out again.
The rinse water goes through the sewage treatment plant before it ends up in the environment. For drinking water there is an additional purification system with specific filters.
The researchers warn that leftover medicines should never be flushed down the sink or toilet, but should always be handed in at the pharmacy. Doctors should also point this out emphatically in the consultation room.
Different way of thinking
Furthermore, they should actually take the environmental impact into account when prescribing medicines. That rarely happens now, explains psychiatrist and researcher Jurjen Luyckx. “As doctors, we have certain guidelines, which state: this medicine is effective for that, or has side effects. I do envision a future in which we also include the impact of medicines on CO2 emissions or on aquatic life. Because we can often choose between different means.”
This is already happening with medicines for asthma, such as inhalers. Some of these are more harmful than others, and the advice is to use the least harmful if it is equally effective for the patient.
Luyckx points out that although there is extensive research into how safe medicines are for humans, hardly any attention is paid to their impact on the entire living environment. “That is something quite new and that is where we should be heading.”
It requires a different way of thinking. “As doctors, we are not yet trained in this,” says Luyckx. “The patient in the consulting room is super important, but we also want to be able to provide good care in thirty years’ time. With the current state of the environment and climate, that is something that we as doctors have to take into account. Also given the damage we can inflict on the environment.”