Response to Lea Graber’s Oct. 15 editorial cartoon

Lowell Anderson, professor of pharmaceutical care and health systems, University of Minnesota; co-director of the Center for Leading Healthcare Change

The report that Lea Graber references in her Minnesota Daily editorial cartoon titled “Introduction of birth control pill in Canadian waters causes Fathead Minnow population to drastically decline” addresses an important environmental issue.

Her cartoon focuses on the widely documented feminization of male fish due to estrogen in lakes and streams. Similarly, there is evidence of such products as Prozac, NSAIDs and antibiotics in the water supply.

The antibiotics can contribute to antibiotic-resistant bacteria. The majority of the medicines that humans use, and those used to treat domestic animals, are excreted in the urine or feces in either an unchanged condition or as active metabolites. In many cases, these byproducts of human and animal use enter the water supply for re-use.

By wisely choosing which medications to use, we can reduce the number of potentially hazardous medication metabolites that we excrete, which ultimately enter the pre-load of the water treatment facilities. By reducing the water treatment pre-load, the quantity of these metabolites that remain in the water supply is reduced. The water that we drink is cleaner.

The Center for Leading Healthcare Change at the University of Minnesota’s College of Pharmacy is developing a program that will provide information on the relative environmental hazard of prescribed medications — allowing for the most effective and least polluting product to be prescribed. This material will serve as a resource for both prescribers and users of medicines. Every person who prescribes or takes a medication can make a difference by considering the potential impact of the proposed medication on the environment.

Commitment to diminishing the problems that Lea Graber addressed in her cartoon is consistent with rational medication use that is a goal of our health care system.