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Vissa läkemedel bryts ej ner i kroppen utan passerar rakt igenom. De utsöndras då genom urin och faeces via avloppet till reningsverk, eller direkt till miljön. Överblivna läkemedel spolas också ner via avloppet till reningsverk. Kan både släppa ut aktiva substanser, även inaktiva substanser som sedan kan bli aktiverade igen. Kan också få nedbrytningsprodukter i avfallet. Även tillsatsämnen i läkemedel hamnar i mark och vatten.Vad avgör var dessa hamnar och hur länge de förblir där?
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