Pharmaceuticals are indispensable for a high quality of life. However, in recent years the widespread occurrence of a variety of active drug ingredients in the aquatic environment and sporadically even in drinking water has been demonstrated. Being only insufficiently eliminated in conventional sewage treatment, there is growing evidence that the substances and their metabolites have adverse impacts on aquatic organisms. Given the demonstrated environmental relevance of pharmaceuticals the question arises: What are sustainable strategies to adequately address it?