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Drogas ilícitas em águas: presença e impactos na saúde humana
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Resumo(s)
O presente relatório encontra-se dividido em dois capítulos: Capítulo I, relativo à
experiência profissionalizante em Investigação, e Capítulo II, referente à experiência
profissionalizante em Farmácia Comunitária.
O Capítulo I consiste numa revisão da literatura que aborda o tema drogas ilícitas em
águas: presença e impactos na saúde humana. As drogas ilícitas e os respetivos
metabolitos são introduzidos direta ou indiretamente nos sistemas de esgoto doméstico
através de diferentes vias, incluindo a excreção humana por urina ou fezes, ou ainda pelo
descarte direto proveniente de laboratórios clandestinos. As estações de tratamento de
águas residuais (ETAR) possuem capacidade limitada para remover completamente as
drogas ilícitas e os seus metabolitos e, por esse motivo, resíduos destas substâncias têm
sido identificados não só em efluentes tratados, mas também em águas superficiais
recetoras e, em alguns casos, até em águas destinadas ao abastecimento público. Ao
entrarem no ciclo da água, estas substâncias podem afetar organismos aquáticos e,
eventualmente, a saúde humana, quer por consumo de animais contaminados
(bioacumulação), quer por ingestão de água potável. Os estudos analisados
demonstraram que as drogas ilícitas e os seus metabolitos estão presentes, em
concentrações que variam entre ng/L e µg/L, em águas residuais, águas fluviais,
aquíferos, águas costeiras, lagos, águas superficiais e até em águas potáveis. Destaca-se
Portugal, com a maior concentração de cocaína (COC) detetada em água potável na
Europa (166,7 ng/L). Relativamente aos impactos na saúde humana, estes não podem
ser negligenciados. A exposição prolongada a tais contaminantes, seja por ingestão de
organismos aquáticos contaminados ou por consumo de água potável, pode representar
um risco crónico para a saúde, uma vez que alguns destes compostos podem
bioacumular-se no organismo humano. Adicionalmente, na Baía de São Vicente, no
Brasil, foram detetadas ostras (Crassostrea virginica) com presença de COC, e, nos
Estados Unidos da América (EUA), na costa da Califórnia, foi identificada a presença da
mesma substância em mexilhões. Perspetivas futuras exigem uma abordagem
interdisciplinar que una a farmacologia, a toxicologia ambiental e a saúde pública, de
modo a compreender melhor os riscos associados à exposição prolongada — e
frequentemente em mistura — a drogas ilícitas. A consideração dos efeitos sinérgicos e
cumulativos, bem como a ligação entre ecotoxicidade e toxicidade humana, é essencial
para o estabelecimento de valores de referência e de políticas eficazes de proteção da
saúde e do ambiente. Do mesmo modo, a articulação com estratégias de sustentabilidade, nomeadamente no contexto da economia circular e da crescente reutilização de águas,
deve ser considerada prioritária em futuras investigações, assegurando a proteção
simultânea da saúde pública e dos recursos ambientais.
O Capítulo II descreve a experiência profissionalizante em Farmácia Comunitária,
realizada na Farmácia A. Guerra Pedrosa, sob orientação do Dr. Alexandre Santos, entre
3 de fevereiro e 20 de junho de 2025. Neste capítulo é abordada, de forma sucinta, a
dinâmica dos processos de aquisição de medicamentos e produtos de saúde, a respetiva
receção, armazenamento e outros aspetos logísticos associados ao funcionamento da
farmácia, bem como os serviços disponibilizados aos utentes. De seguida, discutem-se
alguns aspetos de natureza mais burocrática relacionados com a dispensa de
medicamentos, a gestão de psicotrópicos e estupefacientes, e a conferência do receituário
e da faturação. Por fim, são referidas, de forma breve, as formações em que participei e
algumas interações entre utentes e farmacêuticos que ocorreram ao longo do estágio.
This report is divided into two chapters: Chapter I, concerning professional experience in Research, and Chapter II, referring to professional experience in Community Pharmacy. Chapter I consists of a literature review addressing the topic Illicit Drugs in Water: Presence and Impacts on Human Health. Illicit drugs and their metabolites are introduced, directly or indirectly, into domestic sewage systems through various routes, including human excretion via urine or faeces, as well as through the direct disposal of waste from clandestine laboratories. Wastewater treatment plants (WWTPs) have limited capacity to completely remove illicit drugs and their metabolites. Consequently, residues of these substances have been identified not only in treated effluents but also in receiving surface waters and, in some cases, even in water intended for public supply. Once these substances enter the water cycle, they can affect aquatic organisms and potentially human health, either through the consumption of contaminated animals (bioaccumulation) or through drinking water. The studies reviewed showed that illicit drugs and their metabolites are present, in concentrations ranging from ng/L to µg/L, in wastewater, river water, aquifers, coastal waters, lakes, surface waters, and even drinking water. Portugal stands out for reporting the highest concentration of cocaine (COC) detected in drinking water in Europe (166.7 ng/L). Regarding impacts on human health, these cannot be overlooked. Prolonged exposure to such contaminants, whether through the ingestion of contaminated aquatic organisms or through drinking water, may pose a chronic health risk, since some of these compounds can bioaccumulate in the human body. Furthermore, in the Bay of São Vicente, Brazil, oysters (Crassostrea virginica) were found to contain COC, and in the United States of America (USA), on the coast of California, the presence of COC was also detected in mussels. Future perspectives require an interdisciplinary approach combining pharmacology, environmental toxicology, and public health, in order to gain a deeper understanding of the risks associated with prolonged—and often mixed—exposure to illicit drugs. Considering synergistic and cumulative effects, as well as the connection between ecotoxicity and human toxicity, is essential for establishing reference values and effective health and environmental protection policies. Likewise, linking this issue to sustainability strategies—particularly within the context of the circular economy and the increasing reuse of water—should be regarded as a priority in future research, ensuring the simultaneous protection of public health and environmental resources. Chapter II describes the professional experience in Community Pharmacy, carried out at Farmácia A. Guerra Pedrosa, under the supervision of Dr. Alexandre Santos, between 3 February and 20 June 2025. This chapter provides a concise overview of the processes involved in the procurement of medicines and healthcare products, their reception, storage, and other logistical aspects associated with the pharmacy’s operation, as well as the services provided to patients. Subsequently, some administrative aspects are discussed, including the dispensing of medicines, the management of psychotropic and narcotic substances, and the verification of prescriptions and invoicing. Finally, brief mention is made of the training sessions attended and of several interactions between patients and pharmacists that took place during the internship.
This report is divided into two chapters: Chapter I, concerning professional experience in Research, and Chapter II, referring to professional experience in Community Pharmacy. Chapter I consists of a literature review addressing the topic Illicit Drugs in Water: Presence and Impacts on Human Health. Illicit drugs and their metabolites are introduced, directly or indirectly, into domestic sewage systems through various routes, including human excretion via urine or faeces, as well as through the direct disposal of waste from clandestine laboratories. Wastewater treatment plants (WWTPs) have limited capacity to completely remove illicit drugs and their metabolites. Consequently, residues of these substances have been identified not only in treated effluents but also in receiving surface waters and, in some cases, even in water intended for public supply. Once these substances enter the water cycle, they can affect aquatic organisms and potentially human health, either through the consumption of contaminated animals (bioaccumulation) or through drinking water. The studies reviewed showed that illicit drugs and their metabolites are present, in concentrations ranging from ng/L to µg/L, in wastewater, river water, aquifers, coastal waters, lakes, surface waters, and even drinking water. Portugal stands out for reporting the highest concentration of cocaine (COC) detected in drinking water in Europe (166.7 ng/L). Regarding impacts on human health, these cannot be overlooked. Prolonged exposure to such contaminants, whether through the ingestion of contaminated aquatic organisms or through drinking water, may pose a chronic health risk, since some of these compounds can bioaccumulate in the human body. Furthermore, in the Bay of São Vicente, Brazil, oysters (Crassostrea virginica) were found to contain COC, and in the United States of America (USA), on the coast of California, the presence of COC was also detected in mussels. Future perspectives require an interdisciplinary approach combining pharmacology, environmental toxicology, and public health, in order to gain a deeper understanding of the risks associated with prolonged—and often mixed—exposure to illicit drugs. Considering synergistic and cumulative effects, as well as the connection between ecotoxicity and human toxicity, is essential for establishing reference values and effective health and environmental protection policies. Likewise, linking this issue to sustainability strategies—particularly within the context of the circular economy and the increasing reuse of water—should be regarded as a priority in future research, ensuring the simultaneous protection of public health and environmental resources. Chapter II describes the professional experience in Community Pharmacy, carried out at Farmácia A. Guerra Pedrosa, under the supervision of Dr. Alexandre Santos, between 3 February and 20 June 2025. This chapter provides a concise overview of the processes involved in the procurement of medicines and healthcare products, their reception, storage, and other logistical aspects associated with the pharmacy’s operation, as well as the services provided to patients. Subsequently, some administrative aspects are discussed, including the dispensing of medicines, the management of psychotropic and narcotic substances, and the verification of prescriptions and invoicing. Finally, brief mention is made of the training sessions attended and of several interactions between patients and pharmacists that took place during the internship.
Descrição
Palavras-chave
Água Potável Água Residual Água Superficial Drogas Ilícitas Farmácia
Comunitária Saúde Humana