Law on Expired Medicines in Romania
Although they are hazardous waste, expired medicines are often thrown in the trash, down the toilet, or haphazardly. It is estimated that every year in Romania, 1,500 tons of expired medicines end up in landfills or in the sewage system. However, they should go to specially designated places, such as hospitals, whether state-owned or private. Not in pharmacies, as has been the case until now.
We have a new law in this regard, which comes into force on January 1, 2024.
Why was a special law needed for expired medicines?
The main reason why expired medicines must be treated in a special way and not left with household waste is related to antibiotic resistance. Apparently trivial diseases, such as a dental abscess or pneumonia, which we could treat with antibiotics until recently, now kill us because common antibiotics are no longer effective. Why? Because we took too many, haphazardly, but also because we end up ingesting significant quantities of antibiotics without even realizing it. From the water we drink, for example. Or the water we use for cooking. The explanatory statement for the new law cites a study showing that 65% of rivers in Romania are contaminated with antibiotics.
The initiator of the law, Adrian Wiener, USR deputy and primary care physician in internal medicine, explained on the PRO VERDE show on Pro Tv Digital, how serious the situation is: "There are tens of thousands of deaths in Romania, over a million globally. Antibiotic resistance is practically classified by the World Health Organization as being among the top 10 global risks in terms of threats to humanity.
The problem of antibiotic resistance is that bacteria are exposed to small, constant doses of antibiotics, and this exposure practically generates resistance. (...) Water that, for example, comes from rivers into the (public) network is not perfectly filterable in terms of these small antibiotic molecules, and of course, it ends up (in the network)."
The problem of antibiotic resistance is so serious and widespread because it affects all of us, even if, individually, our behavior is correct. In other words, it is not enough not to take antibiotics haphazardly or to always drink filtered water. Because stronger bacteria, which have become resistant due to the behavior of those around us, are the same ones that can attack us, the prudent ones.
Procedure for handing over expired medicines
Although there is no clear procedure for handing over expired medicines, the initiator of the law says that there is no need for specific implementing rules, as is the case with other laws, which, although theoretically in force, cannot be applied in practice due to a lack of regulations.
Things should be quite simple to organize. In the hospital yard, a special, well-marked container, dedicated to medicines that can no longer be used. Where people can go and throw them directly, without protocols and other cumbersome procedures that some pharmacies applied until now and which were discouraging.
Ideally, without the cardboard packaging, as that can go to paper-cardboard recycling. So it can be reused. While the medicines go directly to incineration. There is currently no other safer method for their destruction than burning. Which, of course, we can say is still a polluting option. But, if the procedure is done in authorized centers that comply with all standards, it should be the safest method. As it were, the lesser evil.
Flaws in the law
The new law was necessary and long-awaited because in Romania there was practically no clear law that assigned responsibility for expired medicines to any institution. There was an old ministerial order which stipulated that the population must hand over medicines to pharmacies, but this obligation for pharmacists was not specifically provided for in a law, which left things in a grey area. Whoever wanted to, accepted them; whoever didn't, didn't. And they couldn't really be held accountable. People were sent from one pharmacy to another. Until, probably, they gave up. So the medicines ended up where they shouldn't. And the risk of antibiotic resistance increased.
However, why responsibility was transferred from pharmacies to hospitals is an enigma. And a problem with the law. Everyone has a pharmacy closer than a hospital. Not to mention the areas of the country where there is no hospital at all.
In most of Europe, pharmacies are the ones that assume this responsibility, not hospitals. In our country, however, as the initiator of the law also says, the lobbying done by pharmacists was stronger.
The problem arising from the choice of hospitals is also related to money. If the principle of "extended producer responsibility" had been adopted, which applies to packaging, for example, the costs would have been borne by pharmaceutical manufacturers. However, since they were excluded from the scheme, just like pharmacists, the money for the entire operation will come from hospitals. That is, from public funds. That is, our money, everyone's money.
Another problem with the law is that it does not also solve the safe disposal of other special waste, such as syringes, ampoules, or mercury thermometers. For which, at present, there is simply no legal solution.
However, what kind of medicines are accepted, if supplements or veterinary medicines are also included, you can find out by watching the video interview.
