Precisely Right

By Dustin Renwick

Close up image of a the inside of a pill bottle filled with blue pills.During his State of the Union Address a few weeks ago, President Obama outlined his vision for a Precision Medicine Initiative, “a bold new research effort to revolutionize how we improve health and treat disease.” The proposal has received praise from universities, think tanks, and the National Institutes of Health.

One EPA researcher has been at the forefront of this topic for more than a decade already.

Christian Daughton—a recipient of three EPA Pathfinder Innovation Project awards—has focused his research on topics related to precision medicine, more commonly known as personalized medicine.

The basic premise: treatments targeted to the individual instead of the statistically average patient.

In the past, Daughton says, small-town doctors could know their patients and corresponding medical histories, which facilitated individualized treatments, prescriptions and doses. The White House effort updates that historical ideal.

“This new initiative from President Obama is making use of the latest advancements in clinical research to capitalize on making drugs more effective,” Daughton says.

His work at EPA explores the intersection of medicine and the environment. The drugs prescribed in the doctor’s office can eventually end up, in some form, in our waterways. They can contaminate our water resources and harm the species that call those aquatic environments home.

Pharmaceuticals typically enter the environment through human excretion and bathing, as well as improper disposal, such as dumping pills down the drain or tossing them in the trash.

“Human health is intimately connected with the health of the environment,” Daughton says. “If one is ignored, there can be ramifications for the other. But the connections—such as disposing of unused medicine or simply daily excretion and bathing—might not be obvious, and they might not be short-term. That’s why they often escape people’s attention.”

“If you optimize healthcare for treating the patient and the environment as one, you optimize the choice of medication, if any, as well as the dose regimen for the individual patient.”

When doctors tailor precise prescriptions for each patient, they can minimize leftovers, theoretically reduce costs throughout the healthcare system, and succeed in dispersing fewer doses to the environment.

That all adds up to a reduction in the amount of medication that finds its way down a drain or into landfills. Another major advantage: potentially reducing the incidence of recreational use and accidental poisonings among children.

“It’s hard to find any negatives to it other than it’s not easy to implement,” Daughton says.

But the White House has taken a first step toward that reality by making precision medicine a priority.

About the Author: Writer Dustin Renwick is a student contractor with EPA’s Innovation Team and a frequent contributor to “It All Starts with Science.”

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