New story in Science and Health from Time: Pharmacies Don’t Know How to Dispose of Leftover Opioids and Antibiotics Pharmacies Don’t Know How to Dispose of Leftover Opioids and Antibiotics

Today (Dec. 30), a team of researchers from the University of California, San Francisco and the Children’s National Hospital in Washington, D.C., published the results of an investigation into whether or not pharmacy workers could provide accurate information on the disposal of two classes of drugs: opioids and antibiotics. The results are frightening:

The researchers enlisted volunteers to place calls to nearly 900 pharmacies in California, posing as parents with leftover antibiotics and opioids from a “child’s” recent surgery. They asked the pharmacy employees on the line—either pharmacists or pharmacy technicians—how to deal with these unused drugs, and then the researchers compared those answers to the guidelines for correct disposal published by the U.S. Food and Drug Administration (FDA).

The found that approximately 43% of pharmacy workers responded accurately on how to deal with antibiotics; just 23% knew what to do with opioids.

Drug disposal is one of those vexing problems where people generally want to do the right thing, but often simply don’t know how. As Hillary Copp, associate professor of urology at UCSF and the senior author of the study noted in a press release, “The FDA has specific instructions on how to dispose of these medications, and the American Pharmacists Association has adopted this as their standard. Yet it’s not being given to the consumer correctly the majority of the time.”

According to the FDA, unused medications should be put (without crushing any pills or capsules) in an “unappealing substance such as dirt, cat litter, or used coffee grounds;” that mixture should then be put into a sealed container like a secure plastic bag before it is thrown out. In addition, all personal information should be scratched out or otherwise destroyed.

Indeed, in 2017, a team of scientists from the U.S. Geological Survey and Environmental Protection Agency published a paper reporting the results of a study of 38 streams across the country. It found 230 human-created drugs and poisons. And there are significant knock-on effects of improper disposable: many of the drugs identified in the 2017 study are known to kill, harm the health of, or change the behavior of fish, insects and other wildlife. This, in turn, can impact the food chain, and eventually harm humans as well.

Antibiotics and opioids, the two drug classes that the Annals of Internal Medicine study looked at, are particularly malevolent when not disposed correctly.

When antibiotics are disseminated widely throughout the environment, it raises the chances of bacteria developing resistance to the drugs. Any bacteria that encounters an antibiotic, whether in the human body, or in a stream or pond, will attempt to survive. Those that do will pass their genes onto future generations of bacteria, fueling a growing global health concern: the World Health Organization has made it clear that antimicrobial resistance in microbes (which includes antibiotic-resistant bacteria), is one of the globes biggest impending public health challenges, given that it could eliminate some of medical science’s most effective tools against disease-causing organisms.

Meanwhile, research into the impacts of opioids on lab animals suggests that they respond to the drugs much like humans: by self-administering over and over, to their detriment. Scientists are still working on understanding how opioids in the waste stream impact animals living in the wild. One thing is for sure: opioids ARE in the global water supply. A 2018 review of the scientific literature found 22 opioids in wastewater and surface water samples from all over the world.

Perhaps the bigger issue with opioids, however, is that those prescribed them tend to keep them around. The results of a survey published in JAMA Internal Medicine in 2016 found that about 60% of Americans prescribed opioids kept their leftover meds for “future use,” and a number of recent studies and investigations have found that these drugs, when either shared with or surreptitiously taken by relatives and acquaintances, can lead to addiction and overdose.

On the flip side, other recent studies have noted that clearer guidance and take-back events can get people to not only get rid of unused opioids, but to do so in a way that’s environmentally sound. Given the ongoing American opioid crisis, any steps to get this class of deadly drugs off the street—and out of medicine cabinets—could be significant. This most recent study suggests that one place to start might be at the point-of-sale: the pharmacy.

New story in Science and Health from Time: Researcher Who Led Team That Genetically Edited Babies Sentenced to Prison in China Researcher Who Led Team That Genetically Edited Babies Sentenced to Prison in China

(BEIJING) — Three researchers involved in the births of genetically edited babies have been sentenced for practicing medicine illegally, Chinese state media said Monday.

The report by Xinhua news agency said lead researcher He Jiankui was sentenced to three years and fined 3 million yuan ($430,000).

Two other people received lesser sentences and fines. Zhang Renli was sentenced to two years in prison and fined 1 million yuan. Qin Jinzhou received an 18-month sentence, but with a two-year reprieve, and a 500,000 yuan fine.

He, the lead researcher, said 13 months ago that he had helped make the world’s first genetically edited babies, twin girls born in November 2018. The announcement sparked a global debate over the ethics of gene editing.

He also was involved in the birth of a third gene-edited baby.

New story in Science and Health from Time: 20 Ways the World Got Better in 2019, in Charts 20 Ways the World Got Better in 2019, in Charts

The last 12 months have felt chaotic, destabilizing, and on occasion apocalyptic. Toxic nationalist movements have risen across the globe; politics in democratic nations have increasingly polarized; wealth gaps continue to expand; and the specter of climate change lurking at a remove has become an actual monster inside the house.

It’s difficult, in the context of the daily onslaught of bad news and its demands on our attention, to remember that when you look at the long arc of human civilization, there are many, many things that continue to get better. As a sort of balm for the pains of a traumatic year, here are 20 concrete examples showing how, in many ways, the best time to be a human living on Earth was 2019.

Editor’s note: It often takes a year or two (or more) to collect global data, so some of the figures shown in this article are from 2017 or 2018. All, however, were newly published in 2019.

Environment/Climate/Energy

Right now, it’s hard to find reasons to be optimistic about human civilization’s relationship with nature. The best thinkers on the planet have been releasing report after report telling us that, without world-upending alterations to our lifestyles and institutions, humankind is doomed to face catastrophic climate change within the next generation or two.

Nevertheless, there have been some positive advances in the worlds of environment, climate, and energy in the past year. For example, the latest figures show that the global community is continuing to protect more and more parts of the Earth that are essential to biodiversity—and thus, long-term human survival—from exploitation.

In addition, fewer people than ever before in recorded history are dying because of air pollution:

While at the same time, more and more people around the world gained access to electricity…

…and the share of energy coming from renewable sources reached an all-time high.

This good news is due largely to renewable energy becoming more and more price-competitive with fossil fuels; it’s getting to the point that many of the oil and gas majors are themselves investing in green energy. In 2019, such companies sealed some 70 clean-energy deals, according to Bloomberg data. And on the other side of the coin, investors are starting to rapidly divest from fossil fuels. An analysis undertaken by the environmental advocacy nonprofit 350.org found that assets of institutions now committed to divestment grew a ridiculous 22,000% from 2014 to 2019. Yes, you read that right:

Again, there is a staggering amount of work still to be done, but these are encouraging signs of the world is starting to come to terms with reality.

Economic & Social Development

Access to the sorts of resources that enable people to improve their lives has, in general, expanded in the last year. Electricity is important, but safe drinking water is even more essential, and the latest data from the World Health Organization and the United Nations Children’s Fund show that a greater percentage of the world population has access to potable water than ever before.

Though it can be very challenging to determine, on a global scale, who is rich and who is poor, and how wealth is distributed, most methodologies are in agreement: more working people have the financial means to live securely than at any other time in recorded history. The chart below tracks a metric that accounts for inflation, as well as the variation in expenses from country to country.

Access to health care, safe drinking water, reliable electricity, and financial capital all have a huge impact on one thing the majority of parents everywhere care about most: that their children can get a good education, and therefore, opportunities that they themselves didn’t have. So it’s no surprise as these other metrics continue to rise, so do the rates of global literacy—a fairly good indicator of overall education.

Similarly, students enrolled in primary schools across the globe finished their schooling at a rate higher than ever before.

Gender Equality & LGBT Rights

Even better, the historic gap between male and female students finishing primary school continues to narrow, according to the UN Educational, Scientific and Cultural Organization:

Other significant, ongoing advances in global gender equality can be seen in the data published over the last year. UN data show that fewer and fewer adolescent girls are being exploited by being married off and forced to have children in their teens, for example.

And, though there are still miles to go to achieve gender equality at the highest level, at the very least, electorates around the globe are continuing to wise up, voting a larger share of female legislators into office than in every year since these data have been tracked by the Inter-Parliamentary Union.

These are, of course, relatively meager gains, and there remains a massive global gender gap that, at current rates, the World Economic Forum predicts will take another 100 years to close. But at least the trend is in the right direction.

Health

Perhaps the most straightforward (if overly simplistic) way to assess total global health is to look at life expectancy. And on that front, the world appears very healthy indeed. According to the United Nations Population Division, a person born in 2017, on average across the world, could be expected to live to be 72.4 years old, the highest number in nearly six full decades of record-keeping.

One of the primary reasons for these ongoing improvements in long-term outlook is the widening dissemination of effective care models for newborns and for women throughout the course of pregnancy and delivery. Both infant mortality and maternal mortality rates reached new lows in their respective recorded histories (at least globally; the U.S. is unique in its failures on these fronts).

Another reason for the overall increase in life expectancy is that more and more people around the world are gaining access to essential health care services.

Of course, that means one-third of people still cannot get basic health care. But we are making real progress all the same.

Drilling down to the level of specific illnesses, one compelling example of recent successes in public health is the global response to AIDS/HIV, which has led to significant advances in both prevention and treatment. New HIV infection rates are at an all-time low, and the percentage of people with HIV receiving antiretroviral treatment is at an all-time high, according to UN data.

And for good measure, one last chart: while it’s true that more and more people are getting cancer every year, it’s also true that medical science has become better and better at treating this class of illness. In about 20 years, the global cancer mortality rate has fallen about 15%.

It’s one of many, many examples of the reality that the world has never before witnessed a time of such immense potential when it comes to human health.