Pharmaceutical pollution of freshwaters is occurring globally. Once in the environment, they pose diverse risks. While pharmaceutical pollution is mostly investigated from an environmental perspective, this thesis integrates the environmental dimension of impact assessments with the societal dimension of identifying drivers and exploring societal solutions. The research follows the rationale of the drivers-pressures-state-impact-responses (DPSIR) framework and presents investigations of pharmaceutical pollution from different sources (pressures, state, impact) as well as related societal elements (drivers, responses). Chapters 2 and 3 analyse the pharmaceutical emission and their environmental pressure using the grey water footprint (GWF) as an indicator of water pollution. In Chapter 4 a framework to assess differences in pharmaceutical pollution from a variety of livestock types in conventional and organic production systems is developed and applied. Chapter 5 presents an investigation of the current societal system causing pharmaceutical pollution as well as exploring alternative future solutions.