Pharmaceuticals are released into the environment through sewage sludge applied to agricultural soils. Studies have detected various pharmaceuticals in sewage sludge samples at concentrations that could potentially affect soil organisms. Laboratory studies show some pharmaceuticals can accumulate in earthworm tissues. Modeling indicates factors like a drug's properties, soil characteristics, and organism type influence bioaccumulation. While risks to human health are generally low, certain levels of pharmaceutical exposure may subtly affect non-target species like invertebrates through mechanisms related to a drug's mode of action. Further research is still needed to fully understand pharmaceutical impacts on terrestrial environments.