ZOMFG!!! Pharmaceutical terrorism!

Naw. This is more likely a case of an older person flushing some old prescription drugs down the toilet:

In a February interview with The Associated Press, Mayor Robert Cluck said trace concentrations of one pharmaceutical had been found in treated drinking water, but he declined to name it. He said revealing the name in the post-9/11 world could cause a terrorist to intentionally release more of the drug, causing harm to residents.

"I don't want to take that chance," Cluck said. "There is no public hazard, and I don't want to create one."

. . .Drinking water in Arlington, Texas, tested positive for trace concentrations of the anti-anxiety medication meprobamate, city officials revealed Monday in response to a series of public records requests. . .

. . .In water samples taken in October 2006, concentrations of the drug measured around 1 part per trillion. [emphasis mine]

The hysteria surrounding "toxins" and "terrorism" derives in large part from the tremendous strides made over the last decade or two in the sensitivity of analytical chemistry instrumentation and methodologies. But just because someone could detect something in the water supply doesn't mean there are toxicity concerns.

What strikes me as odd is that meprobamate is a very old anti-anxiety drug that is barely used today because of safer, more effective alternatives that bring in far more revenue for drug companies. This fact leads me to think that someone was cleaning out their medicine cabinet, maybe for an aged parent who was moving into a retirement community.

You may know meprobamate by its old trade name, Miltown, first marketed in 1955 following its discovery in the late 40s by chemist, Frank Berger. Dr Berger first worked on this compound in England and published in 1946 on the compound's tranquilizing effects in animals. When he moved to the States to work in a New Jersey pharmaceutical company, the drug took on the brand name of Miltown after the nearby township of Milltown (spelled with two Ls).

I consider myself a student of pharmacology history but this story is fresh in my mind because of the news coverage following the death of Dr Berger barely two months ago.

The misled government officials who feared that meprobamate contamination of the water supply might have been intentional terrorism appear to have not considered that the lethal dose of the drug is somewhere between 12 and 20 grams. The drug is still available in 200 mg and 400 mg dosage forms.

So, as PharmGirl queried me when tipping me off to this story, how much meprobamate would a "terrorist" have to add to the Arlington, TX, water supply to have any adverse effect on the population? Would there even be enough meprobamate on the wholesale chemical market in the US, or even the world for that matter, to have even approached any risk of toxic effects. This sounds like a great exercise for Rick's chemistry students over at Science, Shrimp & Grits.

Pharmaceuticals are in our water supply but are these concentrations dangerous? Perhaps the greatest real concern is with regard to estrogens from the urine of women taking oral contraceptives and antibiotics that drain into watersheds from livestock urine and feces.

Mike Nizza at the NYT blog, The Lede, took on this issue back in March with his post entitled, "There Are Drugs in Drinking Water. Now What?"

As the father of toxicology, Paracelsus, is quoted in various translations, "It is the dose that determines the difference between a poison and a remedy."

Arlington, TX officials may care to have read an old toxicology book for guidance. Heck, they might have even found some use in doing a faculty web search for experts at their own University of Texas at Arlington or over at UT-Southwestern Medical School.

Proper disposal of expired or unused medications is advised, usually in solid waste landfills rather than flushing down the toilet. However, even the White House's own drug policy guidelines are confusing on that issue as they state that FDA recommends that certain drugs, many that are controlled substances, actually be flushed.