title: The Environmental footprint of morphine: a life cycle assessment from opium poppy farming to the packaged drug.
abstract: To examine the environmental life cycle from poppy farming through to production of 100 mg in 100 mL of intravenous morphine (standard infusion bag).
  
  
  
  'Cradle-to-grave' process-based life cycle assessment (observational).
  
  
  
  Australian opium poppy farms, and facilities for pelletising, manufacturing morphine, and sterilising and packaging bags of morphine.
  
  
  
  The environmental effects (eg, CO2equivalent ('CO2e') emissions and water use) of producing 100 mg of morphine. All aspects of morphine production from poppy farming, pelletising, bulk morphine manufacture through to final formulation. Industry-sourced and inventory-sourced databases were used for most inputs.
  
  
  
  Morphine sulfate (100 mg in 100 mL) had a climate change effect of 204 g CO2e (95% CI 189 to 280 g CO2e), approximating the CO2e emissions of driving an average car 1 km. Water use was 7.8 L (95% CI 6.7- to 9.0 L), primarily stemming from farming (6.7 L). All other environmental effects were minor and several orders of magnitude less than CO2e emissions and water use. Almost 90% of CO2e emissions occurred during the final stages of 100 mg of morphine manufacture. Morphine's packaging contributed 95 g CO2e, which accounted for 46% of the total CO2e (95% CI 82 to 155 g CO2e). Mixing, filling and sterilisation of 100 mg morphine bags added a further 86 g CO2e, which accounted for 42% (95% CI 80 to 92 g CO2e). Poppy farming (6 g CO2e, 3%), pelletising and manufacturing (18 g CO2e, 9%) made smaller contributions to CO2emissions.
  
  
  
  The environmental effects of growing opium poppies and manufacturing bulk morphine were small. The final stages of morphine production, particularly sterilisation and packaging, contributed to almost 90% of morphine's carbon footprint. Focused measures to improve the energy efficiency and sources for drug sterilisation and packaging could be explored as these are relevant to all drugs. Comparisons of the environmental effects of the production of other drugs and between oral and intravenous preparations are required.
authors: Eco Quantum Life Cycle Consultants, Brunswick, Victoria, Australia.
authors: Scott
authors: S
authors: McAlister
authors: Department of Chemical Engineering, Monash University, Clayton, Victoria, Australia.
authors: Yanjun
authors: Y
authors: Ou
authors: Sun Pharmaceuticals, Princes Highway, Port Fairy, Victoria, Australia.
authors: Elise
authors: E
authors: Neff
authors: Department of Chemical Engineering, Monash University, Clayton, Victoria, Australia.
authors: Karen
authors: K
authors: Hapgood
authors: University of Melbourne, Melbourne, Victoria, Australia.
authors: David
authors: D
authors: Story
authors: Baxter Australia, Toongabbie, Sydney, New South Wales, Australia.
authors: Philip
authors: P
authors: Mealey
authors: Western Health, Footscray, Victoria, Australia.
authors: Forbes
authors: F
authors: McGain
mesh_terms: D000383:Agriculture; D001315:Australia; D002245:Carbon Dioxide; D058572:Carbon Footprint; D057231:Climate Change; D003247:Conservation of Natural Resources; D004304:Dosage Forms; D004349:Drug Packaging; D006801:Humans; D009020:Morphine / Q000008:administration & dosage / Q000600:supply & distribution*; D010207:Papaver; D010936:Plant Extracts; D013242:Sterilization; D014867:Water
chemical_list: D004304:Dosage Forms; D010936:Plant Extracts; D014867:Water; D002245:Carbon Dioxide; D009020:Morphine
keywords: ANAESTHETICS; INTENSIVE & CRITICAL CARE; PUBLIC HEALTH