Summary / Key takeaways
Pharmaceuticals are a significant and often overlooked source of environmental harm. Active pharmaceutical ingredients (APIs) enter ecosystems through human excretion and improper disposal, persisting in water, soil, and wildlife. Wastewater treatment systems cannot fully remove these compounds, while landfill and low-temperature incineration can further release contaminants and contribute to antimicrobial resistance. At the same time, pharmaceutical production and disposal carry a substantial carbon footprint, accounting for a notable share of healthcare emissions. Even high-temperature incineration, while effective at destroying APIs, has environmental trade-offs, including greenhouse gas emissions and toxic byproducts. Reducing pharmaceutical waste is therefore critical for both environmental and public health.
The most effective approach is waste prevention, reducing unnecessary prescribing, dispensing, and disposal. Proper segregation of pharmaceutical and associated physical waste (e.g., packaging, PPE) enables safer and more sustainable handling. Applying reduce, reuse, and recycle principles, alongside safe return and disposal programs, can further minimize environmental impact and support a shift toward more circular systems.
A systems approach is needed, guided by the waste hierarchy: rethink and redesign, reduce, reuse, and then manage residual waste. Key actions include conducting waste audits, strengthening education and training, and embedding sustainable practices across healthcare. Empowering professionals as stewards and supporting policy and operational change will drive more sustainable pharmaceutical use and waste management.
Playbook: Pharmaceutical Waste Management
Suggested Citation:
Lam I, Wong G. Pharmaceutical waste management. Version 1.0. [Internet]. CASCADES; 2025 [cited DATE]. Available from: https://cascadescanada.ca/.
