injected carbon and for treating fly ash to minimize the effects of the injected carbon on concrete. "Any of these are going to raise the cost \[of using fly ash in concrete\]," says Ladwig. But because incorporation as a concrete component is the largest recycling use of CCW at more than 14 million tons per year, any practice that reduces this option would also increase CCW disposal costs and amounts.

Balance
=======

EPA has yet to finalize any of its proposed rules, so it is too early to say what requirements will be placed on individual power plants and what technologies the utilities will use to achieve those requirements.

Suttles, a staunch advocate of strict controls on power plant emissions, is cognizant of the impacts that new regulations may have on disposal costs and recycling of CCW. But he does not believe such impacts are justification for compromising public health and safety.

"We are starting to see the true cost of using coal as an energy source," he says. "Yes, we may be taking pollution that would have gone into the air and creating a land disposal problem, \[but\] our position is that you have to account for all these risks. The result is that using coal is not cheap. We need to be pushing energy efficiency and renewable energy."

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![Above: Aerial photos of the Kingston Fossil Plant showing the storage pond in June 2007 (left) and 8 days after a dam failed on 22 December 2008 (right). Below: More than 5 million cubic yards of waste was released into the Emory River during the Kingston spill. A preliminary assessment published 8 months later revealed elevated levels of arsenic and mercury in the river water and sediment.](ehp-117-a498f2){#f2-ehp-117-a498}

![](ehp-117-a498f3){#f3-ehp-117-a498}

![](ehp-117-a498f4){#f4-ehp-117-a498}


Introduction {#Sec1}
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Illicit drug use is defined as the use of illegal drugs such as heroin, methamphetamine, lysergic acid diethylamide, and marijuana; aberrant non-medical use of pharmaceutical drugs includin